Commitment to improve Musculoskeletal services across county

A special task group set up to review Musculoskeletal (MSK) services across the county has welcomed a commitment to continue to improve performance.

The Task and Finish Group was the first of its kind in the county set up by the Oxfordshire Joint Health Overview and Scrutiny Committee (HOSC). Members included representatives from HOSC, Oxfordshire Clinical Commissioning Group (OCCG) and Healthshare (new providers of MSK services).

The group aimed to provide assurance to HOSC that MSK services in Oxfordshire were being provided to the highest possible quality within available resources and followed concerns raised by residents and patients.

MSK conditions relate to or involve the muscles and skeleton. The most common are conditions osteoarthritis, back and neck pain, fractures associated with bone fragility, injuries and rheumatoid arthritis.

Review of MSK services

In 2015, OCCG undertook a review of its commissioned MSK services with a view to addressing a number of patient and GP concerns, including long waiting times.

After extensive patient and clinical involvement, OCCG produced a new clinical model and business case that set out how MSK services were operating at the time and recommendations for the future.

A new integrated approach outlined improvements in several areas, including access, self-management, a person-centred approach, networking with the voluntary/charity sector and the integration of assessment with triage and treatment, as well as signposting to lifestyle services and TalkingSpace Plus[1].

Healthshare was commissioned to take over the running of the MSK service by Oxfordshire Clinical Commissioning Group in 2017.

The HOSC Task and Finish Group found there was confusion for patients and staff around the management of the transition from the previous provider. Issues identified by the group and patient watchdog Healthwatch Oxfordshire included a backlog of patients and 35 per cent more referrals than forecast.

HOSC members of the Task and Finish Group noted that throughout the process, including transition and the early days of the contract, OCCG and Healthshare have worked to identify and address issues with the service. OCCG and Healthshare were aware of and already tackling most of the issues outlined in this report.

New phone system installed

Among the issues were problems accessing the Healthshare telephone number, patients not receiving confirmation of appointments and some being asked to travel substantial distances to appointments. These issues have been addressed including the installation of a new phone system.

A series of recommendations were made to OCCG and Healthshare as part of the work undertaken by the Task and Finish Group and an update on progress will be presented at the June HOSC meeting.

Cllr Monica Lovatt, district councillor for the Vale of White Horse, led the Task and Finish Group and said there were many positives to come out of the review.

She said: “We got a very picture of the service and were able to ask lots of questions. Lots of improvements have been made along the way.

“We were pleased with the response. Lessons have been learned and there are reasons to feel positive about the future.”

Comprehensive report

Diane Hedges, chief operating officer at OCCG, said: “We welcome this comprehensive report and the new way of working with HOSC – it has been beneficial to review the transition of MSK services with an independent eye.

“We recognise the problems some patients have experienced during the handover of care and Healthshare has actively worked with us on improvements. We are confident this new care pathway brings better access to timely support than we have previously offered patients. We will continue to work with Healthshare and patients to ensure a more joined up and streamlined experience with good outcomes for patients.”

[1] TalkingSpace Plus is an NHS service that is easy to access, offering a confidential service for adults aged 18 and over who are registered with an Oxfordshire GP. It offers a range of talking treatments and wellbeing activities that help people to overcome their depression and anxiety and stay well.