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Making it all work for Surrey iMSK (integrated musculoskeletal services) is all in a day’s work but it is not as straightforward as it sounds.

From the start (October 2016) it was clear that patients and commissioners (NWS CCG) wanted something different that would support the local needs of patients. The key part of what made iMSK’s proposition so unique was the application of a biopsychosocial model rather than anything used, a new way of doing things in Surrey.


The model

Theoretically the biopsychosocial model looks at a combination of the biomedical, psychological and social factors to better understand how the workings of the body affect the mind or the workings of the mind affect the body. It sounds more complicated than it really is.

The model worked well for iMSK as it brought together (or integrated) services that would ultimately address the variations in service for patients and in some instances allow patients to self-manage their condition.

As part of the introduction of the model to the team a training programme was put in place to support the changes and challenges for the service.

Knowledge of the model now forms part of the iMSK statutory and mandatory training to ensure that all new starters fully understand how and why the service fits together so well.

Cathy Parsons, Director of Surrey iMSK, said; “We are in the ideal position of being both commissioner and provider which gave us the opportunity to make a real difference for patients in North West Surrey and beyond. We have used the biopsychosocial model to create an integrated MSK service which spreads the patient load across more specialists to reduce our waiting list and levels of surgery”.

“The iMSK service has undergone significant change over the past two years. Alongside remodelling in Orthopaedics, we continue to work with clinical and operational teams in Pain, Rheumatology and Physiotherapy. As these services evolve and adapt, as integral parts of the Biospychosocial model, we will be able to ensure we continue to provide high quality services in the face of growing demand and an aging population.”


Virtual Fracture Clinic

This new clinic, which comprises a Consultant Orthopaedic Surgeon, Virtual Fracture Clinic Nurse and Administrative Support, significantly helps cut the number of times patients have to attend a traditional fracture clinic.

Using the new approach, hospital patients with acute injuries can initially be seen in A&E and then advised they will be assessed in the Virtual Fracture Clinic within a couple of days. Each case is then considered by a ‘Consultant of the Week’ and the patient’s care pathway is developed from there.

Patients will then receive telephone advice from the Virtual Fracture Clinic team who offer guidance on the next steps for recovery. Followup advice on care management is sent to each patient via email or post. Additional patient advice and guidance videos will also be available on the Surrey iMSK website www.surryimsk.com