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Clinical commissioners give go ahead for musculoskeletal service that will improve care for thousands of local people

15 April 2014

People in Bedfordshire with debilitating musculoskeletal (MSK) conditions such as back ache and tennis elbow are set to get faster, more appropriate treatment closer to home, thanks to a pioneering new service.


Bedfordshire Clinical Commissioning Group (BCCG) has this month signed a contract with Circle Partnership – worth £120m over five years – to deliver MSK services to the 440,000 people of Bedfordshire. One in ten of our population are affected by MSK conditions and the new service will ensure they have access to modern, joined-up care, close to home.


It is being developed with input from local patients and carers who are concerned that existing services are fragmented and can be hard to access. As a result, they often find themselves ping-ponged around different parts of the health service.


For example, under the old MSK service, patients with back pain could visit their GP up to five times and be referred to four separate specialists. But under the new service, patients will be referred to a multidisciplinary team which will assess the appropriate treatment for their condition (see notes for editors).


The first stage of the service has already gone live, and Bedfordshire GPs are now able to refer all patients who need treatment for MSK conditions to a central hub which directs patients to the most appropriate treatment and provider for their condition. The rest of the service will be rolled out over the coming six months.


Our local hospitals – Bedford Hospital and Luton & Dunstable Hospital (L&D) should be part of the new integrated service by the autumn. But patients can continue to request treatment at any hospital in England, including Bedford Hospital and the L&D.


Bedfordshire GP Dr Andy Edwards said: “This service will make a huge difference to patients, offering an integrated, seamless service with more care available in the community. But it is an ambitious project and, as clinical commissioners we will be monitoring it carefully to ensure it delivers the benefits for patients that we are looking for.”


Dr Nick Boyle, NHS consultant surgeon and Circle partner said: "We are delighted that, from today, thousands of patients across Bedfordshire will be able to take advantage of this new integrated model of orthopaedic care, which will improve services, reduce waiting times and provide a one-stop-shop for all patients with musculoskeletal problems. 

"This innovative approach is the first of its kind and is already being copied across the UK. Local doctors in Bedfordshire CCG should be congratulated for their pioneering work which will make a huge difference to patients across the county. "


For further information contact:

Lucie Carrington, BCCG Tel: 07920 459662

Tom Muir, Circle Partnership Tel: 07515 313771

Notes to editors

  • Bedfordshire Clinical Commissioning Group is responsible for planning, organising and buying the majority of healthcare for the people of Bedfordshire. It is run and led by local clinicians, including GPs, nurses and hospital doctors. More information can be found at www.bedfordshireccg.nhs.uk
  • BCCG will continue to have a direct contract for MSK services with both Bedford Hospital and the L&D while they finalise arrangements with Circle. The L&D is due to join the integrated service by early summer and Bedford Hospital in the autumn.
  • Patient choice is enshrined in the NHS Constitution and patients in Bedfordshire can continue to be treated at the hospital of their choice in England. 
  • How the new service will affect patients:


Old MSK model : Mrs A is suffering from lower back pain and goes to see her GP who examines her, prescribes pain killers and advises her on how to manage her condition. The GP tells Mrs A to come back if her symptoms haven’t settled down within four to six weeks. Six weeks later, Mrs A is still in pain and returns to her GP who refers her to a physio. Unfortunately, physio doesn’t work either so Mrs A returns to her GP who refers her to a local orthopaedic surgeon.


The orthopaedic surgeon decides it is perhaps inappropriate to operate but wants an opinion from a neurosurgeon. So the patient once again goes back to her GP who refers her on to neurosurgery.


The neurosurgeon agrees that surgery isn’t the solution and sends Mrs A back to her GP for referral to a pain clinic. The pain consultant sees Mrs A and successfully treats her lower back pain.


New MSK model: Mrs A goes to her GP suffering from lower back pain. Her GP can seek specialist advice from the new musculoskeletal (MSK) integrated service team. She prescribes pain killers, some targeted exercises and tells Mrs A to come back in four to six weeks if her symptoms don’t settle down.


Six weeks later, Mrs A returns to her GP because her symptoms have persisted. Her GP refers her to the MSK hub, where the case is assessed by the multidisciplinary team and the patient is referred to a physio who runs a regular clinic close to Mrs A’s home.


Physio doesn’t work but rather than return to her GP for another assessment and referral, the MSK team discusses Mrs A’s case and refers her straight to the neurosurgeon. He decides surgery is not required for Mrs A and refers her onto the pain clinic where Mrs A’s symptoms are treated successfully. Clinicians also advise Mrs A on how to avoid future episodes of back pain.


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