If you require Advice and Guidance beyond that below, please visit our contact us section for further assistance and signposting information.
For the First Contact Practitioner Portal(s) - Click Here
Referrals should be sent via eRS using the referral form provided below. Inclusion, Exclusion, Urgent Criteria and Referral Guidelines are also provided below. eRS service names are also included for reference. eRS will facilitate selection of the correct service.
If you are a patient please click here for patient self-referral forms.
When referring please include as much detail as possible including previous treatments, other conditions, and attach any previous letters. Please note that Sussex MSK Health does not have access to the 2WW pathway, for more information about serious pathology please click here.
Musculoskeletal Problems for people aged 16 or over.
Over 6 weeks duration of symptoms or meeting urgent referral criteria/post procedure care criteria
MSK Health provide: Musculoskeletal assessment, imaging & diagnostics, treatment & rehabilitation; pelvic health/peri-natal MSK; MDT Pain services; Rheumatology (18+ currently); triage of onwards referrals for orthopaedics. If you are making a referral for triage direct to orthopaedics or an urgent referral, please ensure you review the clinical pathways below to make sure it meets the requirements.
If making an MSK referral, please consider directing to our website for self-help ideas and access to the free GetUBetter digital app that supports people with MSK health issues.
Referrals for people with MSK conditions which are less than 6 weeks in duration – please manage in primary care unless they meet urgent criteria
Conditions needing emergency care: traumatic fractures, cauda equina, acute tendon ruptures (see pathways if unclear), rapid deteriorating myelopathy, acute drop foot, spinal infection, septic arthritis, giant cell arteritis, pathological fractures, insufficiency fractures that need same day care, ischaemic limb compromise, concern for DVT, suicidal intention. Please use appropriate emergency care pathways.
Suspected/known cancer and ‘red flags’ including undifferentiated lumps and bumps unless clear diagnosis of an MSK issue and non-MSK pathology ruled out.
Red flags examples: Immunosuppressed (other than steroids), unexplained weight loss (> 10% body weight in last 3-6/12), severe, unremitting night pain, gait disturbance, rapidly worsening neurological symptoms, Hx of systemic illness
Neurology: e.g. neurodevelopmental disorders; non-MSK Neurology (including peripheral neuropathy); neurological rehabilitation; acquired brain injury; conversion disorders (FND)
Community service support: Falls/frailty/intermediate care services
Chronic fatigue syndrome
Respiratory & cardiovascular conditions
Paediatric patients (anyone <16 years old)
Domiciliary patients who are housebound and those requiring community home visits
Amputee physiotherapy
Chiropody/nail care
Headaches except of cervicogenic origin
Diabetic complications or Charcot arthropathy
The service does not include those services or treatments commissioned by NHS England under the heading of Specialised Commissioning.
Suspected clinical emergencies (for digital signposting/rejection or clinical contact so can: escalate care outside our services; or reject so more appropriate service used; accept as urgent or routine):
CES
MSCC
Temporal arteritis(GCA)
Septic arthritis
Acute progressive neurology – acute foot drop, acute/deteriorating myelopathy
Acute tendon ruptures or other trauma referred that need emergency management (e.g. TA rupture)
Suicidal ideation identified (possible intent)
Suspected spinal infection
Systemically unwell due to MSK issue
Rapidly escalating pain/symptoms despite treatment
Sleep disturbance/unable to lay flat due to current episode
Sudden loss of/change in function
Falls/high risk of falls due to MSK issue
Recent trauma not suitable for T&O needing urgent care/escalation (e.g. XRAY normal, acute tendon not needing same day, mechanical instability)
Social – unable to work, may lose job or unable to perform care responsibility due to current episode
Post-operative/post fracture rehabilitation/post injection rehabilitation
Pelvic health – post natal within12/52/pregnant/post-operative
Progressive MSK neurology & peripheral nerve injury
Suspected new inflammatory arthropathy/autoimmune or acuteCTD/vasculitis conditions that meet BSR guidance
Degenerative cervical myelopathy
Concern for avascular necrosis
Concern (e.g. hip) or review of insufficiency fracture/suspected stress fracture (e.g. spinal/foot)
ED or admission avoidance
MSK acute other exceptions to 6 weeks:
· Bilateral radicular pain (or unilateral progressed to bilateral)without CES
· Acute CRPS
· "Locked" joint
· Acute tendon injury not suitable for emergency management
· Acute injury/trauma not improving/worsening
· Acute foot collapse
· Concern for charcot arthropathy (redirection)
Please select the relevant condition from the list below to view the referral criteria. for more information about serious pathology please click here.
Established Inflammatory Arthritis
Hypermobility Spectrum Disorder
Suspected Connective Tissue Disorder
The Ehlers Danlos Syndromes (EDS)
Please select the relevant pathway from the list below. These guidelines are regularly checked and updated if/when necessary.
Spine
I – CES / Spinal Pathology / Drop Foot / Thoracic Pain / Inflammatory Back Pain
III – Lumbar Radiculopathy / Stenosis
VI – Pregnancy Back Pain / Scoliosis / DISH / Costochondritis / Headache / MSHeadache-MS
Musculoskeletal Assessment & Rehabilitation Service (Physiotherapy & Osteopathy)
Sussex MSK Partnership Central – Orthopedics
Sussex MSK Partnership Central – Orthopedics -RAS
Sussex MSK Partnership Central – Pain Management
Sussex MSK Partnership Central – Pain Management - RAS
Sussex MSK Partnership Central – Physiotherapy
Sussex MSK Partnership Central – Physiotherapy – RAS
MSK Coastal (Bognor) Sussex Community Foundation Trust
MSK Coastal Pain Asessment/Clinical Evaluation Team (Bognor)Sussex Community Foundation Trust
MSK Coastal Pelvic Health Physio(Bognor) Susses CommunityFoundation Trust
MSK Coastal Pelvic Health Physio Obstetrics (Bognor) SussexCommunity Foundation Trust
MSK Coastal Physio (Bognor) Sussex Community FoundationTrust
MSK Coastal Rheumatology (Bognor) Sussex CommunityFoundation Trust
Sussex MSK Health Physio Brighton
Sussex MSK Health Physio (Worthing)
Sussex MSK Health Physio (Southlands)
Sussex MSK Health Physio (Littlehampton)
Sussex MSK Health Physio (Hove)
Sussex MSK Health Physio (Haywards Health)
COVID-19 Pandemic
COVID 19 Pandemic Amended monitoring may be possible for some patients during the COVID 19 Pandemic. The CCG have published recommendations based on the SPS guidance. Please refer to these links for advice during this period:
https://www.sussexccgs.nhs.uk/covid_related/extending-drug-monitoring-during-the-pandemic/
https://www.sussexccgs.nhs.uk/covid_related/extending-drug-monitoring-during-the-pandemic/
Prescribing Guidelines
Please refer to the formulary for your area using the links below. A link is provided to both Crawley, Horsham and Mid Sussex and Brighton and Hove formularies as there may be slight variations in classifications of medicines in the different areas owing to the degree of clinical confidence of the practitioners.
Crawley, Horsham, and Mid Sussex CCG
Shared Care Guidelines
Follow the links below for the shared care guidelines for each medicine.
2023 Learning Materials
2017 & 2018 Learning Materials
Osteoporosis Assessment and Management
Using Red Flags to Identify Serious Pathology
Management of Early Degenerative Knee
2016 Learning Materials
How Sussex MSK Partnership Can Support GP Education and Revalidation
Hip Pain for GPs Handout April 2016
Hand & Elbow Common Conditions
Fibromyalgia and Multiple Joint Pain
Knee Conditions – GP Training January 2015
The Shoulder – GP Training January 2015
Injection Workshop in Primary Care