The Haringey and Islington MSK service provides a single point of access care model for all MSK referrals (including MSK CATS, MSK Physiotherapy, MSK Podiatry, Trauma and Orthopaedics, Pain Management and Rheumatology).

Referrals are triaged by an advanced physiotherapy practitioner with consultant oversight to ensure patients are referred to the most appropriate service. Secondary care referrals are forwarded to the relevant provider; this helps to improve the patient journey and experience.

For further details on MSK Physiotherapy, MSK CATS and MSK Podiatry, visit the MSK section of the Whittington Health (WH) website below.

WH MSK Physiotherapy and MSK CATS work in seven different sites across Haringey and Islington:

• Holloway Community Health Centre
• Hornsey Central Health Centre
• Bounds Green Health Centre
• Finsbury Health Centre
• Whittington Hospital
• St Ann's Hospital
• Lordship Lane Health Centre

MSK physiotherapy service recovery

Referral reminder 

To ensure your patients try self management prior to referral, please encourage routine MSK Patients to visit the WH MSK website where they can trial the GetUBetter digital supported self-management tool, then self refer to MSK Physio if not better. Please don't refer your MSK patients on first presentation of usually self-limiting conditions, but help the service to manage demand by trialling self management on the website first. 

Routine MSK waiting lists

Routine MSK waiting lists have reduced from 12,000 (October 2023) to 6,000 (April 2024); approximately a 26-week wait. CATS MSK wait lists have also reduced from 2,200 to 1,500 (a 10-week wait).

Community Appointment Day

WH successfully piloted the Community Appointment Day, a new service model designed to tackle long wait lists and increased chronicity, assisting MSK Physiotherapy patients with their condition by addressing the wider determinants of ill health. The initiative was highly successful, with 383 patients attending a two-day event and 45% of those patients feeling empowered to self-manage their condition (and have an open referral to the service). After the successful pilot in East Haringey, the MSK service is now planning a rolling programme across Haringey and Islington.

For more complex patients/those requiring secondary care input, continue to refer via e-RS.

MSK management strategies 

Many musculoskeletal (MSK) conditions can be managed in primary care without the need for an MRI scan or onward MSK referral. 

Strategies that can be used to manage MSK conditions include:

• adequate analgesia 
• activity modification 
• relative rest 
• reassurance. 

In April 2020, Haringey and Islington Directorates within NCL ICB agreed that imaging does not always correlate with the patients presentation and clinical diagnosis, therefore does not always guide appropriate management.

GPs are no longer able to request imaging for:

• lumbar spine, unless red flags are present and sinister pathology
• knees in patients aged >50.

Imaging is indicated for red flags and for changing patient management. Whittington Health has provided a useful guide to whether MRI is indicated or not.

Eligibility Criteria

Inclusions

Patients with an Islington or Haringey GP who:

• are aged 18+
• have an MSK need
• have an underlying musculoskeletal condition.

Exclusions

• aged <18
• patients with red flags
• suspicion of recent fracture requiring intervention
• suspicion of serious pathology (malignancy, infection etc)
• cauda equina syndrome
• screened systemic inflammatory disease requiring medical management.

How to Refer

Locations

WH MSK Integrated Service