Allied Health Professional (AHP) Musculoskeletal Pathway Framework (National Minimum Standard)

The National Standards will provide a focus on the clinical pathway for AHPs working closely with medical and other colleagues to improve Musculoskeletal services.


References

[1] Department of Health (2006a) The Musculoskeletal Services Framework. A joint responsibility doing it differently. Available at: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4138412.pdf

[2] Jordan KP, Kadam UT, Hayward R, Porcheret M, Young C, Croft P (2010) Annual consultation prevalence of regional musculoskeletal problems in primary care: an observational study. BMC Musculoskeletal Disorders.11:144.

[3] NHS Scotland Information Statistical Division 2007

[4] European Bone and Joint Health Strategies Project (2005) European action towards better musculoskeletal health. A public health strategy to reduce the burden of musculoskeletal conditions. The Bone and Joint Decade, Lund, Sweden. Available at: http://ec.europa.eu/health/ph_projects/2000/promotion/fp_promotion_2000_exs_15_en.pdf

[5] Health and Safety Executive 2008/2009 Statistics 2008/09. Available at: http://www.hse.gov.uk/statistics/overall/hssh0809.pdf

[6] Black C (2008) Working for a Healthier Tomorrow. Department of Work and Pensions. London: TSO. Available from: www.dwp.gov.uk/docs/hwwb-working-for-a-healthier-tomorrow.pdf

[7] Audit Scotland, 2010 Review of Orthopaedic Services. Prepared for the Auditor General for Scotland, March 2010.

[8] Scottish Government Health Department (2011) eHealth Strategy 2011 - 2017 http://www.scotland.gov.uk/Resource/Doc/357616/0120849.pdf

[9] Woolf AD, Ǻkesson K. Understanding the burden of musculoskeletal conditions. British Medical Journal 2001. 322:1079-1080.

[10] Ahn H, Bhandari M, Schemitsch EH. An evidence-based approach to the adoption of new technology. Journal of Bone and Joint Surgery (Am) 2009: 91 suppl3: 95-98.

[11] Centre for Workforce Intelligence (2011) Medical Specialty Workforce Factsheet. Trauma and Orthopaedic Surgery. Available at http://www.cfwi.org.uk/intelligence/cfwi-medical-factsheets/recommendation-for-trauma-and-orthopaedic-surgery-training-2011 [Last accessed 17/08/12]

[12] Gillam S and Pencheon D. Managing demand in general practice. British Medical Journal 1998; 316: 1895-1898.

[13] Bevan S, Passmore E, Mahdon M (2007). Fit for Work? Musculoskeletal Disorders and Labour Market Participation. The Work Foundation http://www.fitforworkeurope.eu/Website-Documents/44_fit_for_work_small.pdf

[14] Scottish Government Health Department (2008a) 18 weeks: The Referral to Treatment Standard. NHS Scotland. Available at: http://www.scotland.gov.uk/Resource/Doc/211202/0055802.pdf

[15] Scottish Executive Health Department (2006a) A National Framework for Service Change in the NHS in Scotland - Building a Health Service for the Future. NHS Scotland. Available at: http://www.scotland.gov.uk/Resource/Doc/924/0012113.pdf

[16] Scottish Executive Health Department (2006b) Delivering Care, Enabling Health. NHS Scotland. Available at: http://www.scotland.gov.uk/Resource/Doc/152499/0041001.pdf

[17] Department of Health, (2002). European Working Time Directive. Department of Health, London.

[18] Department of Health (2004a) A compendium of solutions to implementing the Working Time Directive for doctors in training from August 2004. Department of Health, London.

[19] Department of Health (2003a) Consultant Contract. Available at:http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Managingyourorganisation/Workforce/Paypensionsandbenefits/Consultantcontract/index.htm

[20] National Audit Office (2008) NHS Pay Modernisation: New Contracts for General Practice Services in England Available at: http://www.nao.org.uk/publications/nao_reports/07-08/0708307.pdf

[21] Goudie A (2010) Outlook for Scottish Government Expenditure. http://www.scotland.gov.uk/Resource/Doc/918/0101183.pdf

[22] Conn KS, Sharp DJ, Gardner ADH. Orthopaedic Specialist Registrar training and attitudes to spine surgery in the United Kingdom: reasons for poor recruitment and suggestions for improvement. European Spine Journal 2002; 11:515-518.

[23] Miller K and Clark D. "Knife before wife": an exploratory study of gender and the UK medical profession. Journal of Health Organisation and Management 2008; 22:238-253.

[24] Logan R and Scott PJ. Uncertainty in clinical practice: implications for quality and costs of health care. Lancet 1996; 347(9001):595-598.

[25] Edwards N. What is causing GP referrals to rise? Health Services Journal 2008. Available at: http://www.hsj.co.uk/primary-care/resource-centre/what-is-causing-gp-referrals-to-rise/1921778.article#.U1e44SxOX1s [Last accessed 09/09/2009]

[26] Roberts C, Adebajo AO, Long S. Improving the quality of care of musculoskeletal conditions in primary care. Rheumatology 2002;41:503-508.

[27] Wennberg JE, Barnes BA, Zubkoff M. Professional uncertainty and the problem of supplier-induced demand. Social Science and Medicine 1982; 16:811-824.

[28] NHS Institute for Innovation and Excellence (2009) Delivering Quality and Value: Focus on Musculoskeletal Interface Services.

[29] Arthritis and Musculoskeletal Alliance (ARMA Scotland, 2011) Musculoskeletal Map of Scotland 2011.

[30] Department of Health (2003b) Improving Orthopaedic Services: A Guide for Clinicians, Managers and Service Commissioners (Action on Orthopaedics and the Orthopaedic Services Collaborative, January 2003) http://www.institute.nhs.uk/index.php?option=com_joomcart&main_page=document_product_info&products_id=232&cPath=67

[31] Briggs TWR (2012) Getting it Right First Time. Improving the Quality of Orthopaedic Care within the National Health Service in England. Department of Health. Available at: http://www.timbriggs-gettingitrightfirsttime.com/downloads/BriggsReportA4_FIN.pdf

[32] Daker-White G, Carr AJ, Harvey I, Woolhead G, Bannister G, Nelson I, Kammerling MA. A randomised controlled trial: Shifting boundaries of doctors and physiotherapists in orthopaedic outpatient departments. Journal of Epidemiology and Community Health 1999; 53:643-50.

[33] Weale R, Bannister J. Who should see orthopaedic outpatients physiotherapists or surgeons? Annals of the Royal Society of Medicine 1995; 91:377-9.

[34] Rymaszewski LA, Sharma S, McGill PE, Murdoch A, Freeman S, Loh T. A team approach to musculoskeletal disorders. Annals of the Royal College of Surgeons of England 2005; 87:174-180.

[35] Byles S, Ling R. Orthopaedic out-patients - A fresh approach. Physiotherapy 1989; 75:435-437.

[36] Roland MO, Porter RW, Mathews JG, Redden JF, Simonds GW, Bewley B. Improving care: a study of orthopaedic outpatient referrals. British Medical Journal 1991; 302:1124-8.

[37] Ross A, Davis W, Horn G and Williams R. General practice orthopaedic outpatient referrals in North Staffordshire. British Medical Journal 1983. 28:1439-1441.

[38] West RR, McKibbin B. Shortening waiting lists in orthopaedic surgery outpatient clinics. British Medical Journal of Clinical Research and Education 1982; 284:728-30.

[39] Durrell S. Professional issue. Expanding the scope of physiotherapy: clinical physiotherapy specialists in consultant clinics. Manual Therapy 1996; 1:210-3.

[40] Owen G. Extended scope practitioners in orthopaedic outpatient clinics: a growing field in the UK. Rehabilitation Management International 1998; 8:6-11.

[41] Rabey M, Morgans S, Barrett C. Orthopaedic physiotherapy practitioners: Surgical and radiological referral rates. Clinical Governance. 2009; 14(1):15-19.

[42] ACT Health. Physiotherapy extended scope practice: Phase 1. Final report. Canberra, Australia: Australian Government; 2008. www.health.act.gov.au

[43] Stanhope J, Grimmer-Somers K, Milanese S, Kumar S, Morris J. Extended scope physiotherapy roles for orthopedic outpatients: an update systematic review of the literature. Journal of Multidisciplinary Healthcare 2012, 5, 37-45.

[44] NHS Education Scotland (2012) AHP Advanced Practice Education and Development Framework (Musculoskeletal) http://www.ahpadvancedpractice.nes.scot.nhs.uk/media/251474/msk%20framework%20(final).pdf

[45] Scottish Executive Health Department (2007a) Better Health, Better Care: Action Plan What It Means For You http://www.scotland.gov.uk/Resource/Doc/210642/0055693.pdf

[46] Sizer PS, Brismée, Cook C. Medical screening for red flags in the diagnosis and management of musculoskeletal spine pain. Pain Practice 2007, 7(1):53-71.

[47] Roach KE, Brown M, Ricker E, Altenburger P, Tompkins J. The use of patient symptoms to screen for serious back problem. Journal of Orthopaedic and Sports Physical Therapy 1995;21:2-6.

[48] Greenhalgh S and Selfe J (2009) Red Flags II. A Guide to Identifying Serious Pathology of the Spine. Churchill Livingstone. Gough-Palmer 2009

[49] Australian Acute Musculoskeletal Pain Guidelines Group, 2004. Evidence-based management of acute musculoskeletal pain: A guide for Clinicians. Australian Government National Health and Medical Research Council http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp95.pdf

[50] Underwood M. Diagnosing acute nonspecific low back pain: time to lower the red flags? Arthritis and Rheumatism 2009;60:2855-2857.

[51] Ferguson F (2009). A Pocketbook of Managing Lower Back Pain. Churchill Livingstone Elsevier.

[52] Gustafson D, Hawkins R, Boberg E, et al. Impact of patient-centred computer-based health information/support system. Am J Prev Med. 1999; 16:1-9.

[53] Klein-Fedyshyn M, Burda M, Epstein B, Lawrence B. Collaborating to enhance patient education and recovery. J Med Libr Assoc. 2005;93: 440-445.

[54] Health Foundation 2011Helping People Help Themselves: A Review of the Evidence Considering whether it is Worthwhile to Support Self-Management: Available at: http://www.health.org.uk/public/cms/75/76/313/2434/Helping%20people%20help%20themselves.pdf?realName=8mh12J.pdf

[55] Gross AR, Goldsmith C, Hoving JL, Haines T, Peloso P, Aker P, Santaguida P, Myers C, and the Cervical Overview Group. Conservative management of neck disorder: A systematic review. Journal of Rheumatology 2007; 34:1083-1102.

[56] Miller, J.; Gross, A.; D'Sylva, J.; Burnie, S.J.; Goldsmith, C.H.; Graham, N.; Haines, T.; Bronfort, G.; Hoving, J.L. Manual therapy and exercise for neck pain. Manual Therapy 2010;15;334-354.

[57] Green S, Buchninder R, Hetrickk S. Physiotherapy interventions for shoulder pain. Cochrane Database Systematic Review 2003:CD004258.

[58] Conaghan PG, Dickson J, Grant RL. Care and management of osteoarthritis in adults: summary of NICE guidance. British Medical Journal 2008;336:502-503.

[59] Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty N, Dougados M, Hochberg M, Hunter DJ, Kwoh K, Lohmander LS, Tugwell P. (2008) OARSi recommendations for the management of hip and knee osteoarthritis, Part ll: OARSI evidence- based, expert consensus guidelines. Osteoarthritis and Cartilage 16, 137-162.

[60] Curatolo M and Bogduk N. Phamacological pain treatment and musculoskeletal disorder: Current perspective and future prospects. The Clinical Journal of pian;17:25-32.

[61] Gureje O, Von Korpff M, Simon GE, Gater R. Persistent pain and well-being: a World Health Organization Study in Primary Care. Journal of American Medical Association 1998; 280:147-151.

[62] Lawrie I and Simpson K. Managing musculoskeletal pain. GPonline.com 2007. http://www.gponline.com/Clinical/article/629673/the-management-musculoskeletal-pain/

[63] Andersson HI, Ejlertsson G, Leden I, Scherstén B. Musculoskeletal chronic pain in general practice. Studies of health care utilisation in comparison with pain prevalence. Scandinavian Journal of Primary Health Care1999;17:87-92.

[64] World Health Organisation (1986) The Analgesic Ladder.

[65] Hunt RH, Choquette D, Craog BN, Angelis CD, Habal F, Fulthorpe G, Stewart JI, Turpie AGG, Davis P. Approach to managing musculoskeletal pain. Canadian Family Physician 2007; 53:11771184.

[66] Silver JK, Audette J. Pharmacological Agents and Acupuncture in Rehabilitation Chapter 9 pp187-203. In Rehabilitation of Sports Injuries Scientific Basis (Ed Frontera WR). Blackwell Science 2003.

[67] Cepeda MS, Camargo F, Zea C, Valencia L. Tramadol for osteoarthritis. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD005522. DOI: 10.1002/14651858.CD005522.pub2.

[68] Towheed T,Maxwell L, JuddM, CattonM, HochbergMC,WellsGA. Acetaminophen for osteoarthritis. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD004257. DOI: 10.1002/14651858.CD004257.pub2.

[69] Smart KM, Blake C, Staines A, Thacker M, Doody C. Mechanisms-based classification of musculoskeletal pain: Part 1 of 3: Symptoms and signs of central sensitisation in patients with low back (±leg) pain. Manual Therapy 2012;17:336-344.

[70] Smart KM, Blake C, Staines A, Thacker M, Doody C. Mechanisms-based classification of musculoskeletal pain: Part 2 of 3: Symptoms and signs of peripheral neuropathic pain in patients with low back (±leg) pain. Manual Therapy 2012;17:345-351.

[71] Smart KM, Blake C, Staines A, Thacker M, Doody C. Mechanisms-based classification of musculoskeletal pain: Part 3 of 3: Symptoms and signs of nociceptive pain in patients with low back (±leg) pain. Manual Therapy 2012;17:352-357.

[72] Xu B, Descalzi G, Ye H-R, Wang Y-W. Translational investigation and treatment of neuropathic pain. Molecular Pain 2012;8;15.

[73] FitzSimmons CR and Wardrope J. Assessment and care of musculoskeletal problems. Emergency Medical Journal 2005; 22:68-76.

[74] Scottish Government Health Department (2012a) National Access Policy www.sehd.scot.nhs.uk/mels/CEL2012_33.pdf

[75] Salisbury C, Montgomery AA, Hollinghurst S, Hopper C, Bishop A, Franchini A, Kaur S, Coast J, Hall J, Grove S, Foster NE. Effectiveness of PhysioDirect telephone assessment and advice services for patients with musculoskeletal problems: pragmatic randomised controlled trial. British Medical Journa;346

[76] Consulting JJ A survey of NHS Physiotherapy waiting times, workforce and caseloads in the UK 2010-2011, Chartered Society of Physiotherapy 2011.

[77] Derrett S, Paul C, Morris JM. Waiting for elective surgery: effects on health related quality of life. International Journal of Quality Health Care 1999; 11:47-57

[78] Maniadakis N, Gray A: The economic burden of back pain in the UK. Pain 2000, 84(1):95-103.

[79] Holdsworth L, Webster V., McFadyen A. Self-Referral to Physiotherapy: Deprivation and Geographical Setting: Is there a relationship? Results of a National Trial, Physiotherapy 2006;92:16-25

[80] Holdsworth L, Webste, V, McFadyen A. Are Patients who refer themselves to Physiotherapy Different from those Referred by GPs?: Results of a National Trial. Physiotherapy 2006;92:26-33

[81] Holdsworth L, Webster V. Self referral to Physiotherapy. Scottish Primary Care 2006;49:16-18.

[82] Holdsworth L, Webster V, McFadyen A. What are the Costs to NHS Scotland of Self Referral to Physiotherapy?: Results of a National Trial. Physiotherapy 2007;93:3-11.

[83] Holdsworth L, Webster V, McFadyen A. Physiotherapist and General Practitioner Views of Self Referral and Physiotherapy Scope of Practice: Results from a National Trial Physiotherapy2008; 94:236-243.

[84] Webster, V, Holdsworth, L, McFadyen, A (2008) What do patients think about Self Referral, Access & Physiotherapy? Results of a National Trial. Physiotherapy 94: 141-149.

[85] Holdsworth L and Webster V. (2006) Patient Self Referral: A Guide for Therapists. Chapter 12 The most frequently asked questions p 46.

[86] Foster NE, Williams B, Grove S, Gamlin J, SalisburyC. The evidence for and against 'PhysioDirect' telephone assessment and advice services. Physiotherapy2011;97:78-82.

[87] Scottish Government Health Department (2012b) AHPs as agents of change in health and social care. The National Delivery Plan for the Allied Health Professions in Scotland, 2012-2015. http://www.scotland.gov.uk/Resource/0039/00395491.pdf

[88] European Pathway Association (2007) Available at: http://www.e-p-a.org/index2.html [Last accessed 11/02/13].

[89] Jenkins F and Jones R. Care pathways and eth Allied Health Professionals Chapter 3 pp57-81. In Key Topics in Health Care Management: Understand the Big Picture (Ed Jones r and Jenkins f). Radcliffe Publishing, Oxford

[90] Vanhaecht K, Panella M, van Zelm R, Sermeus W. An overview on the history and concept of care pathways as complex intervention International Journal of Care Pathways 2010; 14:117-123.

[91] Rogers H, Maher L, Plsek P. Better by design: using simple rules to improve access to secondary care. British Medical Journal 2009;338:384-387.

[92] Kravitz RL and Melikow . Engaing patient in medical decision making. The end is worthwhile, but the emans need to be more practical. British Medical Journal 2001. 323: 584-585.

[93] Leach E, Cornwell P, Fleming J, Haines T. Patient centered goal-setting in a subacute rehabilitation setting. Disability and Rehabilitation 2010; 32(2):159-172.

[94] Health and Care Professions Council Standars of Proficiency Physiotherapy http://www.hpc-uk.org/assets/documents/10000DBCStandards_of_Proficiency_Physiotherapists.pdf

[95] Schoeb V. "The goal is to be more flexible" - Detailed analysis of goal setting in physiotherapy using a conversation analytic approach. Manual Therapy 2009;14:665-670.

[96] Levack WM, Dean SG, Siegert RJ, McPherson KM. Purposes and mechanisms of goal planning in rehabilitation: The need for a critical distinction. Disability and Rehabilitation 2006; 28(12):741-749.

[97] Wade DT. Goal setting in rehabilitation: an overview of what, why and how. Clinical Rehabilitation 2009; 23:291-295.

[98] Institute of Medicine Crossing the Quality Chasm. A New Health System for the 21st Century. National Academy Press, Washington, D.C. 2001.

[99] Scottish Government Health Department (2010) The Healthcare Quality Strategy for NHS Scotland http://www.scotland.gov.uk/Resource/Doc/311667/0098354.pdf

[100] Chartered Society of Physiotherapy A Guide to Clinical Supervision 2005. Chartered Society of Physiotherapy, London.

[101] Kadushin A. Supervision in Social Work. New York: Columbia University Press 1976

[102] Nursing Times (2009) An integrated approach to introducing and maintaining supervision: the 4S model. May, Vol 105. No 17

[103] Nursing Times (2010) Clinical supervision using the 4S model 3: how to support supervisors and sustain schemes. May, Vol 106 No 18

[104] Chartered Society of Physiotherapy (2008) Scope of Physiotherapy Practice. Information Paper PD001. Chartered Society of Physiotherapy London. Available at: http://www.csp.org.uk/uploads/documents/PD001%20Scope%20of%20Practice%202008.pdf

[105] Dawson LJ, Ghazi F. The experience of physiotherapy extended scope practitioners in orthopaedic outpatient clinics. Physiotherapy 2004; 90:210-6.

[106] Gilmore LG, Morris JH, Murphy K, Grimmer-Somers K, Kumar S. Skills escalator in allied health: a time for reflection and refocus. Journal of Healthcare Leadership. 2011; 3:53-58

[107] Kersten P, McPherson K, Lattimer V, George S, Breton A, Ellis B. Physiotherapy extended scope of practice - who is doing what and why? Physiotherapy 2007; 9: 235-242.

[108] McPherson K, Kersten P, George S, Lattimer V, Ellis B, Breton A et al. A systematic review of evidence about extended roles for allied health professionals. Journal of Health Service Research and Policy 2006; 11(4):340-7.

[109] NHS Lanarkshire (2011) 18 Week RTT Newsletter Issue No 7 February http://www.qihub.scot.nhs.uk/media/162155/18%20weeks%20newsletter%20-%20issue%207%20-%20february%202011.pdf

[110] Jones V (2001) Tacking delay in orthopaedics. Bandolier Jan 2001: 11-12.

[111] Hourigan PG, Weatherley CR. Developments in physiotherapy: The extended scope practitioner. Association of Chartered Physiotherapists in Management 1998; 3-5.

[112] Aiken AB, McColl MA. Diagnostic and treatment concordance between a physiotherapist and an orthopaedic surgeon - A pilot study. Journal of Interprofessional Care 2008; 22(3):253-261.

[113] Dickens V, Ali F, Gent H, Rees S (2003) Assessment and diagnosis of knee injuries: the value of an experienced physiotherapist. British Journal of Therapy and Rehabilitation. 10 (1):6-11.

[114] MacKay C, Davis AM, Mahomed N, Badley EM. Expanding roles in orthopaedic care: a comparison of physiotherapist and orthopaedic surgeon recommendations. Journal of Evaluation in Clinical Practice 2009; 15:179-183.

[115] Meyer C et al. Should Extended Scope Physiotherapists place patients directly on arthroscopy lists? Journal of Bone and Joint Surgery (Br) 2009. 91-B, Issue Supp_III:502.

[116] Ellis B, Kersten P. An exploration of the developing role of hand therapists as extended scope practitioners. British Journal of Hand Therapy 2001; 6(4):126-130.

[117] Aiken AB, Harrison MH, Atkinson M and Hope J. Easing the burden for joint replacement wait times: The role of the expanded practice physiotherapist. Healthcare Quarterly 2008; 11(2):62-66.

[118] Marangon T, Buttress S (2008) In Scope. Horizon (UK Extended Scope Practitioners Occupational Interest Group). Newsletter. No 29. Jan: 3-10.

[119] Buttress SJ and Marangon T. Legal issues of extended practice: Where does the responsibility lie? Radiography 2008; 14; e33-e38.

[120] General Medical Council, (2001). Good Medical Practice, p15, paragraph 46. GMC, London.

[121] Council for Healthcare Regulatory Excellence (CHRE) Policy Framework. London: CHRE 2009.

[122] Council for Healthcare Regulatory Excellence (CHRE). Managing extended practice. Is there a place for distributed regulation?' London: CHRE 2010

[123] Syme G, Rutter M, Suckley J, Payne C, Russell V (2013) Resource Manual and Competencies for Extended Musculoskeletal Physiotherapy Roles in the United Kingdom. Edition 2. Extended Scope Practitioners. A Professional Network of the Chartered Society of Physiotherapy. (www.esp-physio.co.uk)

[124] Scally G, Donaldson LJ. Looking forward: clinical governance and the drive for quality improvement in the new NHS in England. British Medical Journal 1998; 317:61-65.

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