system working to integrate primary, secondary and tertiary care

Through a new collaboration utilising co-design principles between the Royal National Orthopaedic Hospital, The Royal Free NHS Trust, Barnet Enfield and Haringey Community mental Health Trust, North Middlesex Hospital, The GP Federation in  Enfield, patients and the Enfield Borough Partnership; We are bringing the best of primary, secondary and tertiary care for musculoskeletal patients together on the high street. Creating the high street hub will help integrate existing services in this part of London and deliver economies of scale to boost capacity across primary and secondary care. The hub has been placed in an area with high levels of social deprivation and high levels of health inequality. As well as focussing on improving capacity, reducing waiting times and improving access, the Hub will trial new methods of managing patients using the full scope of multidisciplinary teams to deliver the best health outcomes and also start to focus on prevention of musculoskeletal issues.

There are a number areas that we are working on:

·         Non-admitted Patient Tracker List: increasing capacity for Allied Health Professions Lead services utilising highly skilled advanced practitioners to assess and manage patients waiting for their first Orthopaedic appointment. The impact will be a reduction in the number of patients being seen in secondary care

·     Admitted Patient Tracker List: supporting patients physical and emotional wellbeing needs prior to surgery to optimise their condition prior to their orthopaedic operation to help improve post-operative outcomes and

·         Expansion of first contact practitioner services to increase capacity for this already successful service: increasing capacity for GPs, enabling patients quicker access to expert musculoskeletal assessment and treatment and a reduction in secondary care referrals, imaging referrals and prescriptions.

·         Developing innovative approaches to musculoskeletal management including having the Multi disciplinary team under one roof to support the patient’s needs: dieticians to support if patients need help with weight loss, psychologists if the patient needs help with associated comorbidities such as anxiety and depression and occupational therapists to help patients in need of vocational rehabilitation or a dual psychological & physical approach to their rehabilitation

·         Prevention of musculoskeletal problems: this will reduce the burden of MSK condition on individuals and the NHS for years to come