2. Purpose of Framework
This document marks the start of a journey towards reducing unnecessary variation in musculoskeletal care by outlining a minimum standard framework for the management of musculoskeletal conditions across NHSScotland. Its aim is to outline minimum standards for NHS Boards providing musculoskeletal services to help guide organisations in meeting national musculoskeletal and orthopaedic improvement initiatives. These service redesign initiatives are detailed in the Transforming Outpatient Services and 4 Week Rapid Access to AHP Musculoskeletal Services plans. Boards should be working to full implementation of the standards detailed in this document within the timescales outlined in local Musculoskeletal Service Delivery Plans, related to achieving the wider objectives of these work streams[46,47,48]. The document acknowledges that there may be necessary variation in the delivery of these standards and that additional resource may be required in some areas to support the implementation of the standards. The framework provided will help identify those service gaps and support the case for additional resource, where necessary. Many of the standards are already recognised professional standards that should currently be in place or be in the process of being implemented.
The focus of the document is on AHP Services, however, given that musculoskeletal services should provide a seamless pathway for service users then the framework details the expectations on referrers to AHP services, the expectations on AHPs and their role in the work up of patients who require onward referral, if necessary and appropriate.
The document does not provide management advice on specific musculoskeletal and associated conditions. Any references to any specific conditions or management recommendations are cited for explanatory purposes only. The document does not replace specific clinical guidance provided by professional or regulatory bodies. The need for separate work has been identified to define and develop AHP pathways for patients requiring early onward specialist assessment in rheumatology (inflammatory disease) and similarly implementing the national standards related to chronic pain services.
Email: Susan Malcolm