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Referral
COVID-19: MSK service guide
Updated November 2020
Scope
This information provides guidance on the management of MSK patients across Northern Devon during the Covid-19 pandemic. The information is based on National Guidance.
National guidance
This guidance is to help primary or community care practitioners recognise serious pathology which requires emergency or urgent referral to secondary care in patients who present with new or worsening musculoskeletal (MSK) symptoms. Serious pathology as a cause of MSK conditions is considered rare, but it needs to be managed either as an emergency or as urgent onward referral as directed by local pathways.
Consider serious pathology as a differential diagnosis if a person presents;
- with escalating pain and progressively worsening symptoms that do not respond to conservative management or medication as expected.
- systemically unwell (fever, weight loss)
- with night pain that prevents sleep due to escalating pain and/or difficulty lying flat
Specialty guides for patient management during the coronavirus pandemic:
Urgent and Emergency Musculoskeletal Conditions Requiring Onward Referral
2WW referrals should continue as normal.
Please see advice and guidance contact details for any urgent MSK queries:
For advice and guidance, speak to the Orthopaedic surgeon on call.
To be used for any urgent opinions for advice and guidance. Regarding acute Orthopaedic injuries can we please ask that any injury where the community minor injury units (MIU's) are considering application of splint/plaster or onward referral to the fracture clinic be discussed acutely.
Contact details for any urgent MSK queries:
7 Day 24 Hour service. Call Northern Devon Healthcare NHS Trust Switchboard 01271 322577 and:
- Between 08:00 and 20:00 ask for the Consultant Orthopaedic surgeon on call
- Between 20:00 and 08:00 ask for the Orthopaedic Associate Specialist (or registrar) on call
Fracture Clinic is working as normal – please refer in usual way.
All new routine referrals will be clinically triaged and will either be added to a waiting list or, if appropriate, A&G will be given.
Please ensure that a practice-based system is in place to check daily for returning referrals with A&G.
Prior to making a routine referral, please ensure that any appropriate Policy or CRG has been reviewed and that all the suggested investigations and management options have been considered.
Existing new and follow-up routine appointments have been cancelled and changed to telephone / video consultation where appropriate.
MSK physiotherapy services continue to see patients with urgent (and COVID situation and capacity dependant routine) conditions. Consultations are in the first instance virtual, follow up appointments are either face to face, telephone or video following a shared decision making process with the patient.
GP Information
National Guidance
Urgent and Emergency Musculoskeletal Conditions Requiring Onward Referral
Patient information
- MyHealth-Devon: Hip Pain
- MyHealth-Devon: Hip Impingement
- MyHealth-Devon: Shoulder Pain
- MyHealth-Devon: Knee Pain
Pathway Group
This guideline has been signed off on behalf of the NHS Devon Clinical Commissioning Group
Publication date: April 2020
Date Updated: November 2020
Pathway Group
This guideline has been signed off on behalf of the NHS Devon Clinical Commissioning Group
Publication date: April 2020
Date Updated: November 2020
