The Integrated Musculoskeletal (iMSK) Service at University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) celebrated its 10th anniversary last month.
The service which saw approximately 7,000 new patients in 2022, has seen some fantastic achievements over the years, including championing a Shared Decision Making approach which empowers patients to take a view on their care and make an informed decision on what is the best route for them.
The service also uses a multidisciplinary team (MDT) approach where it meets fortnightly with clinicians, GPs and community teams, to discuss patients with complex care needs and the best options and support available to them.
In early 2022, the iMSK service moved its Kendal base from Westmorland General Hospital to Kendal Leisure Centre in the community. This has given people with complex musculoskeletal conditions better access to holistic care, closer to home.
Patient feedback has included:
- “Able to get appointment quickly for assessment. Knowledgeable and great manner from staff, discussed options and potential outcome whilst explaining thought process. Very positive experience due to the member of the IMSK team I met. Accessible appointment due to being based in the community i.e., Kendal Leisure Centre.”
- “The location was great at the leisure centre. The clinician was lovely. He was professional and knowledgeable, and he took care explaining to me the options I had and my after-care plan. Really nice guy.”
- “I can’t fault the treatment that I got, my referral came through quickly and was subsequently given an appointment promptly. When I was examined by the clinician, he was thorough and considerate, he was also very professional yet friendly. On having the procedure carried out I had the same person, and he was faultless. I was very happy with the whole experience.”
Shelley Halliwell, Assistant Service Manager for iMSK, said: “I feel fortunate to work for such an incredible team. Everyone works really hard and I think we provide a fantastic service. I’m really proud of how the team carried on during the pandemic and how well we supported patients during such a difficult time.”
Shelley added: “As we mark 10 years it is really important to reflect on all of the fantastic achievements of the service. We have embraced many digital innovations at the Trust and are proud to have been the first team to use digital dictation software which has made recording clinical notes even more efficient.
“The move to Kendal Leisure Centre for the South Lakes Team was a massive step forward for the service, helping health and leisure to integrate.”
Jonathan Ashton, Consultant Physiotherapist and Lead for the iMSK Service, said: “The iMSK service was introduced to ensure that patients are receiving the right treatment, at the right time and to give them first-line treatment as close to home as possible as opposed to being seen in hospital
“Within the first month of the iMSK service we had 30 referrals and now we see approximately 600 new patients a month.”
Jonathan added: “We have recently started a programme with Lancaster University’s Medical School which gives medical students the chance to come and learn more about the iMSK service. This has been a great opportunity for medical students to see non-medical professionals managing a caseload in a de-medicalised way through approaches like Shared Decision Making.”
So, what is the iMSK service?
The iMSK service was introduced in South Cumbria in 2018, following the success of the North Lancashire iMSK team. The service is made up of a team of 11 advanced physiotherapists supported by an admin team.
In 2022, the Bay-wide service saw approximately 7,000 new patients experiencing complex muscle and joint problems. Approximately 20% of these patients were referred from the iMSK service to the Orthopaedic Service at University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) for treatments such as surgery, with some of these patients' receiving treatment, a diagnosis, exercises or advice from the iMSK service first before their referral.
iMSK is a service that sits in between primary (GPs) and secondary care (hospital) and triages, assesses, treats and manages patients with complex musculoskeletal conditions. Its main function is to see patients who were traditionally seen by an Orthopaedic Surgeon and who often do not need surgery. One of the aims of the service is to preserve as many natural hips and knees across the Bay if this is the right approach for the patient, using alternatives to surgery.
The team has worked closely with the hospital’s perioperative group which has developed a patient charter that offers patients resources to make sure they are maximally fit for surgery.
As well as its base at Kendal Leisure Centre, the iMSK service runs clinics from the following hubs: Heysham Primary Care Centre, Ashton Community Care Centre, Ryelands House Clinic, Royal Lancaster Infirmary, Queen Victoria Centre, Bentham Medical Practice, Grange Clinic, Ulverston Health Centre, Alfred Barrow Health Centre and Millom Hospital.
Patients with complex musculoskeletal issues can be referred to the iMSK service by their GP or the Trust’s physiotherapy department. You can find out more about the iMSK service at the UHMBT website here.