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.

‍

Existing referral forms will be accepted until the copies below are available by Ardens

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.

Pathway/Pathology Guidelines

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

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.

Mycophenolate Mofetil

‍