Musculoskeletal Interface (MSKI) Service

Service overview

Advice & Guidance is available to GPs.

For self care advice and links to leaflets please see the Resources section at the bottom of this page.

The MSKI service is a triage service which offers assessment and treatment for people with musculoskeletal (MSK) and/or spinal conditions in Bristol, North Somerset and South Gloucestershire.

It is aimed at people who have persistent pain and have not responded to normal GP care such as advice and pain relief, or other treatment such as Physiotherapy or Podiatry.

It is run by expert clinicians, including Specialist Physiotherapists and Podiatrists and GP’s with a Special Interest. They aim to determine the best course of care using their clinical expertise, evidence and shared decision making.

Following assessment, a patient may be:

• offered self-management advice
• referred for further investigations like X-rays, scans or blood tests
• referred for further treatment such as Physiotherapy or Podiatry
• referred to an injection clinic (where this is not available or appropriate to be done in the GP practice)
• referred for a review by another healthcare professional in Orthopaedics, Neurosurgery, Rheumatology or Pain Services (if criteria are met - please see INNF policies below)
• referred back to the GP for further assessment/intervention

MSK Exceptional Funding Policies (EFR)

Please consider the EFR policies for orthopaedics prior to referral.

 Imaging before referral

• Please see Radiology Guidelines for Primary Care.
• For referrals for Low Back Pain and Sciatica please also see the Spinal Imaging in Primary Care section for advice on when (and when not) to request spinal imaging.

Pre-operative optimisation

If there is a possibility that a patient may need surgery as an outcome of their referral then consider the Pre-op assessment guidelines. Many routine operations are cancelled due to modifiable pre-operative conditions including poorly controlled diabetes, poorly controlled hypertension, iron deficiency anaemia and other conditions. Pre- operative optimisation in primary and secondary care can help to reduce cancellations and improve operation outcomes.

Referral guidance

Please note: this is an elective pathway we have no access to urgent secondary care clinic appointments even if we re-direct to secondary care from triage.

Please see the Referral criteria for Sirona MSK Services

Patients must be registered with a Bristol, North Somerset or South Gloucestershire GP and aged 16 years and over (or aged 10 years and over for those registered in North Somerset). The interface service provides assessment and treatment in person, or over the telephone/video call.

Patients will be offered a choice of the following locations for in person consultations:

Bristol Locations:

• Charlotte Keele Health Centre, Easton
• East Trees Health Centre, Eastville
• Fishponds Health Centre
• Hampton House Health Centre, Cotham
• Hartcliffe Health Centre
• John Milton Clinic
• Knowle Clinic
• William Budd Health Centre, Knowle
• Whitchurch Health Centre

North Somerset Locations:

• North Somerset Community Hospital, Clevedon
• Marina Health Centre, Portishead
• Weston General Hospital

South Gloucestershire Locations:

• Concord Health Centre
• Cossham Hospital
• Thornbury Leisure Centre
• Yate Westgate Centre 

For people with MSK foot & ankle conditions which are not post-operative or traumatic please refer to the MSK Foot & Ankle service.

Refer on MSK Service Referral Form via EMIS Managed Referrals.

Service contact details. Tel: 0300 125 6555   Email: sirona.mskservice@nhs.net

Resources

Patient leaflets/self-care

Sirona MSK Leaflet library - this resource has a wide range of leaflets and self help guides for patients.

MSK Self-help - see this Remedy page for details of My Joint Health Hub, GetuBetter App and self-management for hip and knee pain.

Versus Arthritis – this resource has advice on exercises for foot, shoulder, elbow, neck, knee, back and hip pain.

BESS (British Elbow and Shoulder Society) - this resource has advice on shoulder and elbow pain including a useful patient leaflet for: Shoulder subacromial shoulder pain.

Paediatric MSK problems

Please see Paediatric orthopaedic and Paediatric physio sections of Remedy for children under the age ranges specified.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.