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MSK Integrated Triage Service

Information about Planned Changes

Wirral CCG would like to provide you with information in respect of the proposed MSK Integrated service.

The focus of the service will be to provide patients with timely assessment and management of MSK conditions1, community-based access to physiotherapy, podiatry, rheumatology, pain management and elective orthopeadic services.  Prompt and appropriate referral to wider services for example diagnostics, delivery of advice, therapeutic management, education and support to enable patients to achieve and maintain independence and well-being.

The MSK Triage system will:

  • Provide a single point of access, with a comprehensive triage service managed by Specialist MSK Physios
  • Simplify the referral process for GPs
  • Provide a comprehensive and consistent referral and assessment process for patients
  • Reduce duplication and ensure referrals are directed to the most appropriate care pathway to ensuring service efficiency and reduce waste.
  • For patients, enhance the quality of their experience and patient pathway, ensuring they receive the most appropriate bundle of care for their needs
  • Provide an appropriate mix of community and secondary based provision
  • Provide patients with information and advice to support self-management


The service will have the following expected outcomes for patients:

  • Improve the clinical outcomes for patients
  • Reduce waiting times for patients
  • More patients receive the right treatment in the most appropriate place, at the right time
  • Improve the patient experience
  • Patients have the knowledge and ability to manage their condition and are enabled to self-manage
  • Personalised Patient Management Plans in place
  • Patients are empowered to make decisions about their care and treatments they receive
  • Patients’ treatment fits with their lifestyle, minimising the impact on work and employment
  • Patients will be encouraged to continue their treatment using community facilities and resources
  • Patients will have access to a consistent and robust service
  1. MSK Conditions Definition - Arthritis, Fractures, Hip conditions, knee conditions, Lower back pain, maxillofacial conditions, MSK conditions – general & other, osteoporosis, spinal conditions. (Source – NICE guidance)


The model proposes to bring all MSK services under one prime provider, who will be accountable for patient care and the services available to patients. 

The services are:

  • Physiotherapy
  • Podiatry
  • Rheumatology
  • Pain management
  • Elective orthopaedic services

Access to certain diagnostic tests will also be through the service, for example, nerve conduction studies.

The prime provider will be responsible for ensuring the services are responsive to patient needs and that there are appropriate links to wider services in order that patients can access the most appropriate services to support their needs.

Your GP or other Healthcare Professional will be able to make a referral for you to the Triage Service. This referral will be reviewed within 48 hours (urgent referrals known as “Red Flags” will be reviewed within 4 hours).  From this review, you may be directly referred into one of the services, or you may be contacted to have either a telephone assessment or a face to face assessment by a specialist MSK physio.  This detailed assessment will explore your condition in detail and provide you with the best pathway for treatment; this could be a period of self-management, ordering of diagnostic tests and or referral for specific treatment – orthopaedics, pain management or rheumatology.   If you require referral to a service outside of the MSK Integrated Triage Service, an on-ward referral will be made.

The service will be implemented through phases with the proposed Phase 1 triaging referrals for Wirral University Teaching Hospital’s pain management, orthopedic and rheumatology service.

Phase 2 will be for all services with the MSK model – physiotherapy, podiatry, rheumatology, pain management and elective Orthopaedics.  The triage service will receive all referrals for these services.

MSK Questions, Feedback and Comments Form

Wirral CCG welcomes your input on these proposed service changes.  Please use this online form to contact us.  Your feedback will help shape the service on an on-going basis.  

Alternatively, you can download a copy of this survey here.