Physiotherapy & MSK Services
Overview
There can be some confusion about the various physio or physio-led services, as well as how and when to refer to each. Each service has a history/need/role and it is important to use them appropriately for both patients and to avoid annoying the services you’re referring to.
Service Types
Physiotherapy (Self-Referral)
Recommended: Patient Self-Referral
This should be a self-referral (ideally) via patients filling in a form from reception or from our website.
TIP
Self-referral causes less work for our secretarial teams and also reduces delays by 1-2 weeks for patients.
Best for: Patients with specific well-defined pathology where further investigation isn’t required before treatment can be started.
Examples:
- Cervical spondylosis without red/yellow flag symptoms
- Ankle sprain without evidence of a tear
- Recurrent mechanical back pain without radiculopathy
MSK CATS (or MCAS)
Tier 2 Musculoskeletal Service
The Musculoskeletal Assessment and Triage Service sits between primary and secondary care. It was brought in to reduce orthopaedic clinic demand by limiting only those needing surgery to onward referral.
Run by: Specialised physiotherapists with excellent joint assessment and diagnosis skills Can arrange: MRI and other investigations before onward referral Cannot prescribe: Not prescribers
TIP
When discussing referrals, tell patients you are referring them to the ‘orthopaedic services’ - the first step will involve assessment by a specialist physiotherapist.
Best for: Anyone with more complex pathology who may need investigation, or those you think are likely to need surgery.
First Contact Physios (FCP)
Not for GP Referrals
We shouldn’t really be referring cases to the FCPs - think of them as primary care colleagues.
Their role is to see undifferentiated/new presentations in the same way that you might, with the key difference that they will often recommend some physio after assessing/doing investigations.
Rationale: If we have assessed an issue and feel the patient needs more than a self-referral to physio, we should refer directly to MCAS ourselves.
Quick Comparison
| Service | Level | Best For | Refer Via |
|---|---|---|---|
| Physiotherapy | Primary | Well-defined, straightforward issues | Patient self-referral |
| MSK CATS/MCAS | Tier 2 | Complex issues, possible surgery, needs investigation | GP referral |
| FCP | Primary care | New/undifferentiated presentations | Direct booking (not referral) |