The three newly-formed clinical commissioning groups (CCGs) in Leeds have launched an ambitious project to improve the quality of referrals by adding local pathways to the Map of Medicine. Leeds West CCG, Leeds North CCG, and Leeds South and East CCG, with a combined patient population of over 810,000 spread over 113 GP practices, aim to ensure all GPs use the care maps when making musculoskeletal referrals.
Having agreed the pathways for six musculoskeletal topics locally, the Leeds project team used Map Transform, a package of care maps and services, to establish their pathways on the Leeds ‘view’. This package supports clinically-led service improvement, and enables cross-service communication via easy online access to the agreed local pathways for all stakeholders. The topics Leeds chose were:
- Hip pain
- Hand/wrist pain
- Spinal pain
- Knee pain
- Foot and ankle pain
- Shoulder pain
The care maps display referral criteria at specific points within the pathways, with information that guides the user to the appropriate local referral form. The overarching aim of these care maps is to standardise and improve the quality of referrals from primary care to community MSK and secondary services. While a triage service for all MSK referrals was in place, and effective at ensuring good conversion rates for surgery following onward referral to secondary care, it was felt that GPs could perform some of the functions of triage, with the patient pathway being streamlined. The care maps are intended to expand GPs’ knowledge of MSK conditions, and also promote patient self- management.