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Wirral University Hospital NHS Foundation Trust

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The Musculoskeletal Integrated Service

From 1st July 2018 Wirral University Teaching Hospital (WUTH) has been the prime provider of MSK services. The service includes physiotherapy, podiatry, elective orthopaedics, rheumatology and pain services.

Referrals are triaged by advanced physiotherapists, podiatrists and specialist rheumatology nurses, who will determine the most appropriate service to treat the patient. The aim is to get the patient to the right service first time, avoid unnecessary appointments and reduce the burden on primary care.

Routine referrals will be triaged within 48 hours (working days) and urgent referrals will be triaged within 24 hours (working days).

The patient will no longer be referred back to the GP to be referred on to another MSK service. The entire patient pathway will be managed by the service, with regular communication back to the GP. The only exception to this is where the Assessment Service has discovered something suspicious. In this case the GP will be asked to re-refer under the 2 week rule. The triaging clinician will call the GP surgery to ensure that this is acted on immediately.

There will no longer be access to book appointments directly to a consultant clinic for MSK specialties, however where appropriate and with adequate information on the referral form, patients will be referred directly from triage to a consultant.

Where the triage decision is to refer to a consultant, the patient will be offered choice of secondary care provider.

Non- MSK physio (Womens, Respiratory, Parkinsons, Neuro) will continue to be referred via WROCS.

If the triage service believes that the patient will benefit from an injection, then there are several options. The patient will be given the earliest appointment in one of these services;

  • GP injection service
  • Patient’s own GP (If GP has indicated on the referral form that an injection is available within 2 weeks)
  • WUTH physio led injection clinic