Musculoskeletal, Orthopaedics and Rheumatology
In House
Ashraf & Vijay - joint injections
Consider Physio
(Private Physio, Osteo, Chiropracter)
Foot pain - podiatry
Acupuncture?: they must want to try it, no peripheral oedema nor large limb swelling
New Zealand Scoring essential for big joints (details at bottom of page)
If cannot manage in practice, think musculoskeletal service first (details at bottom of page)
Notes on Physio Referrals
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Physiotherapy is most effective when patients are seen in the acute stage of a condition - as soon as possible after onset. |
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Referrals will therefore be restricted to patients with acute symptoms (including those with an acute exacerbation of a more longstanding lesion). |
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Information regarding X-rays and blood tests should be provided in the referral letter. |
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Conditions: Acute spinal lesions of either soft tissue or articular origin. Acute soft tissue lesions including sprains and strains. Acute joint conditions. |
GPwSI
| Name | Location | Tel | Referral Criteria | How to refer |
| Dr Brooke | referral to eccleshill | ►musculoskeletal service | ●triage service | |
| Dr. Adrian Dunbar | ►musculoskeletal service | |||
| Dr Pennington | eccleshill | ►specifically rheumatology | ●letter |
Specialised Outreach Clinics
| Name | Location | Tel | Referral Criteria | How to refer |
| Chronic Pain Rehab Programme | Horton Park includes physio, psychology, self help |
►chronic musculoskeletal pain | ●referral form |
Joint Injection/Minor Ops Clinics
| Name | Location | Tel | Referral Criteria | How to refer |
| Dr Hughes-Guy | Idle Medical Centre |
►large joint injections ►carpal tunnel ►trigger finger ►De Quervain's |
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| Westcliffe Medical Centre | ||||
| Dr Chadwick Dr Passant |
Windhill Medical Centre |
Consultants
| Name | Location | Tel | Referral Criteria | How to refer |
| Mr Shilders | shoulders | All referrals for
orthopaedics and rheumatology to go through triage do a generic referral letter to the Orthopaedic Surgery "Team" where appropriate |
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| Mr. Taggart | hips n knees | |||
| Mr. Boome | hands | |||
| Mr. Shankar | foot | |||
| Mr. Kluge | primary and revision knee replacement, minimally invasive hip replacement and complex hip revision surgery | |||
| Mr GS Radcliffe | Arthroscopic and reconstructive knee surgery incl TKR | |||
| Mr de Jager | Hand Surgery | |||
| Mr Mann | Foot and ankle surgery | |||
| Mr Grogan | Lower limb joint replacements |
Notes:
Need to distinguish between rheumatology and orthopaedics
Musculo-skeletal Triage Service (MST)
All orthopaedic, MST and Rheumatology referrals should be sent to the MST. There
is a 10% ceiling for referrals direct to a consultant to fall within the marker.
The target is to be review shortly and maybe increased if practices persistently
fail to keep under the target.
MST referral forms should be used if possible but referral letters can be used
if text space is needed.
New Zealand Scoring system
click here for a copy of it
Use for all major joint referrals.
Assessment form to be used.
►<40 refer to physio / manage in Practice
►40 - 69 Refer to MST, use MST joint form
►>70 Send a referral letter + N.Z. Scoring sheet to PCT. Patient maybe sent to
private sector by PCT.