Musculoskeletal

40%

of MSK cases are due to
potentially preventable
risk factors

8 million

people live with a
musculoskeletal condition in
the UK

1 in 5

people consult a GP
about a musculoskeletal
problem each year

Musculoskeletal Introduction box

Musculoskeletal (MSK) conditions account for 30 per cent of GP consultations in England and are a major strain on NHS resources. Effective triaging of patients with MSK disorders is crucial in order to ensure that the right people have access to the right treatments at the right time.

Part of the NHS Long Term Plan is “supported self-management”, a commitment to make personalised care a standard across the health and care system. The aim is to ensure healthcare resources are used effectively by preventing referrals for conditions that can be self-managed from entering the musculoskeletal (MSK) service via remote early intervention and support.

MyPathway Musculoskeletal outpatients

Through the MyPathway app, patients are sign-posted to condition specific resources and lifestyle advice to encourage self-management whilst waiting for their appointment. Patients are asked to complete validated questionnaires digitally to help improve the efficiency of the service. All appointment information is available on the app timeline and patients receive automated appointment reminders to assist with adherence, DNA reduction and improve patient experience and engagement.

The MyPathway clinical portal enables clinicians to review questionnaire responses, send personalised messages and bespoke resources to the patient such as exercise videos, PDFs or URL links.

Musculoskeletal Outpatients

How does it work?

Registration

Patient registers for MyPathway via the app or web browser

Resources

Whilst waiting for their appointment, the patient is sign-posted to self-management resources and lifestyle advice

Questionnaire

Patients are asked to complete baseline questionnaires, such as MSK-HQ, EQ-5D and STarT Back.

Reminders

Appointment information and automated reminders are sent to patients timeline

Monitoring

Clinicians can monitor their patients progress remotely via the MyPathway clinical portal.

Review

On discharge, patients are sent further outcome questionnaires for completion, enabling the service to measure outcomes at patient, service and population level.

Benefits

Improves patient self-efficacy, adhearance and outcomes

Reduced DNAs and increased PROMs returns for the Service

Patient has easy access to all resource & self-management support in the app

Musculoskeletal Supported self-management

MyPathway Musculoskeletal supported self-management

Patients are able to access a wide range of support resources with MyPathway MSK Supported Self-management (SSM). This helps them to create their own activity and goal-setting programmes.

Firstly, patients are triaged via symptom-based questionnaires to check their suitability for the programme. After that, suitable candidates will choose a series of daily/weekly exercises to make up their self-management plan. Daily app push notifications help patients to achieve and track their targets. Following the completion of the programme, patient results are sent to their practitioner who will discharge or refer onwards depending on the results. Patients will have the option to continue using the platform if required.

How does it work?

Registration

Patient registers for MyPathway via the app or web browser.

old-person-icon

Suitability

Patient is sent baseline PROMs to complete.

Exercise Plan

Self-management exercises, activities and group sessions are suggested, and the patient selects those they are happy to try and signs up for a 6 week plan.

Review

The clinician can review the patients results remotely.

Interaction

MyPathway interacts with the patient for 6 weeks, tracking progress against goals and acquiring an intermediate PROMs after the first couple of weeks.

Summary

After 6 weeks a final PROM is requested and a clinical summary is sent to the provider. This can result in either discharge or onward referral.

ongoing-icon

Ongoing

The patient can elect to continue to use the platform long-term and have their outcomes monitored.

Benefits

Encouraging self-management helps prevent unnecessary referrals ending up in MSK service or physio

Saves clinician and patient time as patients can be monitored remotely

Patients have access to MSK validated resources 24/7

MyPathway First Contact Physio (FCP)

The First Contact Physio (FCP) pathway enables GP practice Care Navigators to refer patients directly to the physiotherapy service via MyPathway without the need for a GP appointment, enabling the patient to be receive the right treatment for their condition quickly. On registering for MyPathway, the patient is checked for red flag symptoms and triaged via the completion of baseline outcome questionnaires. Depending on the questionnaire results, the patient is either put on the musculoskeletal self-management programme or sent a link to book an initial assessment with the FCP Service and directed to self-management resources whilst waiting for their initial assessment appointment.

Clinicians can review questionnaire responses online in the patient’s assessment appointment and then arrange further appointments or onward referrals as required.  Clinicians can also send personalised messages and condition specific resources to the patient such as exercise videos, PDFs or URL links via the clinical portal.  On discharge, further questionnaires are sent to the patient enabling the service to collect outcome and experience data which can be measured at patient, service and population level.

Musculoskeletal FCP

How does it work?

Registration

Patient registers for MyPathway via the app or web browser.

old-person-icon

Suitability

Patient is sent baseline PROMs to complete.

Triage

Triage establishes whether patient is put on the MyPathway self-management programme or a Physio appointment is arranged.

Exercise

Where appropriate, self-management exercises.

Benefits

Improved support for rehabilitation following discharge

Early intervention & support advice for patients via condition specific resources.

Enables a more efficient appointment between the patient and clinician

Musculoskeletal Orthopaedics

MyPathway Orthopaedics long-term follow-up clinics

The total number of hip and knee replacements being carried out has risen significantly over the past 20 years. Patients receiving their standard 1-year follow-up appointments for these treatments are often kept waiting for long periods, only for 90% of them to be seen by consultants in spite of having no issues. MyPathway provides a simple screening solution so that consultants only need to see patients with continuing needs.

Patients having hip and knee replacements are invited to sign up to the virtual clinic. 8 weeks prior to the 1-year follow-up, each patient is sent an automated message reminding them to complete a series of online forms, as well get an x-ray at a time and place of their convenience. The clinician will review the patient’s results at the virtual clinic and inform the patient of the advised next steps; discharge, access plan or hospital appointment.

How does it work?

Screening

Patients are screened a year after surgery, by questionnaire and x-ray.

Interaction

MyPathway invites patients to participate in the virtual clinic, sends questionnaires and information, and how to get an x-ray. Non-digital patients are sent paper information by post.

Results

Clinicians review results and invite patients for an annual follow-up appointment if there is a need.

Summary

MyPathway supports patients through screening for annual follow-ups, saving patients and clinicians time.

Benefits

Reduces postage costs as appointments are sent via the app

Saves clinicians and patients time due to reduction in face to face appointments

Patients can monitor their own progress

MyPathway Antenatal Physiotherapy (self-referral)

With MyPathway Antenatal Physiotherapy self-referral, patients are able to refer themselves to the Women’s Health Physiotherapy Team (WHPT). Once a patient has completed the self– referral questionnaire, their details will be reviewed by the WHPT and they will be sent an email asking them to make their first appointment.

In the lead up to their appointment, patients will be given access to resources to help with their condition and to provide feedback on their wellbeing. For the first appointment the patient will have the option of a face-to-face (one-on-one) session, video self-management or a group session with up to other 10 women. The group session lasts between 60-90 minutes and there will be the opportunity for an individual assessment if required.

Musculoskeletal Antenatal

How does it work?

Registration

Patient self-refers and registers for MyPathway via the app or web browser.

Questionnaire

Patient is invited to complete a self-referral questionnaire.

Resources

Resources and information are provided through the app.

Appointment

Once their questionnaire is reviewed, the patient is able to book first appointment face to face or via video call with Womens Health Physiotherapy team (WHPT) via the app.

Benefits

Provides consistant distribution and access to approved self-care collateral

Reduces number of DNAs

Patient feels empowered and in control of their health