For Clinicians

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


Making a Referral

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.

GP/Clinician Referral Forms

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.

Generic Referral Form (PDF)

Generic Referral Form (Word)

Inclusion Criteria

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.

Exclusion Criteria

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.

 

Same day/Urgent criteria (not exhaustive but main examples)

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 

  

For clarity: above are not suitability criteria for our services but commonly seen at point of triage and redirected or clinically qualified around urgency/next steps 

  

Urgent  

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) 

Referral Guidelines

Please select the relevant condition from the list below to view the referral criteria. for more information about serious pathology please click here.

Foot & Ankle

Foot

Ankle

Limb Length Difference

Knee

Knee Pain

Knee Trauma

hip

Hip Pain

Girdle Pain

Hand & Wrist

Hand

Wrist

Finger Pain

Shoulder & Elbow

Shoulder Pain

Elbow Pain

Bicep Rupture

Spine

Thoracic Back Pain

Neck Pain

Rheumatology

Axial Spondyloarthritis

Established Inflammatory Arthritis

General Aches and Pains

Generalised Osteoarthritis

Giant Cell Arteritis

Gout

Hypermobility Spectrum Disorder

Inflammatory Mono Arthritis

Inflammatory Polyarthritis

Osteoporosis

Peripheral Spondyloarthritis

Polymyalgia Rheumatica

Septic Arthritis

Suspected Connective Tissue Disorder

The Ehlers Danlos Syndromes (EDS)

Pathway/Pathology Guidelines

Please select the relevant pathway from the list below. These guidelines are regularly checked and updated if/when necessary.

Foot & Ankle

Knee

Hip

Hand & Wrist

Sussex CEC Ganglia Surgery

Sussex CEC Trigger Finger

Sussex CEC Carpal Tunnel

Sussex CEC Dupuytrens

Elbow

Shoulder

Pain Management

Spine

I – CES / Spinal Pathology / Drop Foot / Thoracic Pain / Inflammatory Back Pain

II – Cervical Radiculopathy

III – Lumbar Radiculopathy / Stenosis

IV – Low Back Pain

V – Neck Pain

VI – Pregnancy Back Pain / Scoliosis / DISH / Costochondritis / Headache / MSHeadache-MS

Rheumatology

Musculoskeletal Assessment & Rehabilitation Service (Physiotherapy & Osteopathy)

Physiotherapy Women’s Health

eRS Referral Service Names (For Reference)

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)

Medicines Management Advice

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

Brighton and Hove CCG

Shared Care Guidelines
Follow the links below for the shared care guidelines for each medicine.

Sulfasalazine

Methotrexateoralan

Leflunomide

Circlosporin

Azathioprine

Mycophenolate Mofetil

MSK Training & Research

2023 Learning Materials

Integrated Triage Manual

2017 & 2018 Learning Materials

Hand Injections April 2018

Osteoporosis Assessment and Management

Using Red Flags to Identify Serious Pathology

Early Inflammatory Arthritis

Management of Early Degenerative Knee

2016 Learning Materials

Foot & Ankle

Examination of the Hip

Shoulder & Elbow

Spine

Chronic Pain

How Sussex MSK Partnership Can Support GP Education and Revalidation

Examination of the Knee

Shoulder & Elbow

BESS BOA Supacromial Pain

Hip Pain for GPs Handout April 2016

Hip Pain for GPs 2016

Spine Pain for GPs April 2016

Hand & Elbow Common Conditions

Fibromyalgia and Multiple Joint Pain

Knee Conditions – GP Training January 2015

The Shoulder – GP Training January 2015

Upper Limb Injection Workshop

Injection Workshop in Primary Care

Tennis Elbow RDA

This website is still under development - all information and content here is subject to change