Working in multidisciplinary teams - osteopathy and the NHS

London Osteopathic Society

Transcript

1. Working in multidisciplinary teams – osteopathy and the NHS Jonathan Hearsey Clinical Lead - Musculoskeletal Medicine Royal London Hospital for Integrated Medicine Clinical Quality Lead Sussex MSK Partnership Spinal Extended Scope Practitioner Here
2. Osteopathy and the NHS: History •  Fundholding/PCGs/PCTs/CCGs: NHS Trusts •  Circa 2% osteopaths are ‘employed’ by the NHS (iO Census 2014) •  100 osteopaths currently reporting that they see NHS patients (assuming the majority are contracted via SLAs) •  There is a demand – the NHS needs osteopaths in the field of musculoskeletal medicine •  iO internships (UCLH/Nottingham) •  Sussex MSK Partnership 2++
3. The Musculoskeletal Services Framework (2006)
4. Musculoskeletal Services Framework !  For the patient !  Enabling patient choice, informed understanding of outcomes (including risk) !  Tailoring services round the complex needs of the patient !  Self-management and prevention !  Improving patient outcomes through more effective and efficient assessment, diagnosis and treatment !  Organisational efficiency !  Identifying organisational barriers !  Improving the quality, consistency and efficiency of care thereby reducing costs !  For front-line staff !  Patient-centred care !  Evidence-based practice !  Effective clinical governance and clinical audit !  Promoting interdisciplinary team care !  Improving communication between staff
5. The role of the multidisciplinary team !  Provide an expert multidisciplinary opinion for patients referred by their GPs, offering an alternative to direct referral to an outpatient consultant clinic. !  Conduct clinical assessments; organise diagnostic investigations; provide advice and treatment; inform and educate patients; direct patients to appropriate services. !  Agree and test integrated care pathways (ICPs), which must be built on evidence-based guidelines with locally agreed protocols and quality measures. !  Support the development of robust systems for monitoring and clinical audit.
7. Patient ESP GPwSI Ortho Rheum Neuro Pain Imaging
8. Benefits to the patient Shared decision making Patient choice Patient consent
9. Efficient multidisciplinary working •  Patient not therapeutic discipline first •  Collaborative approach to clinical cases •  Advice and guidance by sharing knowledge •  Manages the increasing demand for hospital based services (NHS England initiative) •  Peer review •  Shared decision making •  Patient choice •  Manages and monitors outpatient follow-up appointments
11. •  £240m - 5 year contract (+2) •  Provides MSK services to a population of 650k •  4000 MSK referrals per month •  8 anatomical clinical pathways (including physio) •  800 referrals per month are spinal •  55 Extended Scope Practitioners (Physios, Osteo, OT, Pod) •  Launched a pilot study in November 2016 imbedding two AfC Band 6 osteopaths within the physiotherapy department
12. Primary Care Triage Physiotherapy ESP Assessment Diagnostics Secondary Care Orthopaedic Surgeon Neurosurgeon Rheumatologist Pain Consultant Non-MSK Consultant
13. Royal London Hospital for Integrated Medicine 60 Great Ormond Street London WC1N 3HR
14. •  Clinical Lead – Consultant/AfC Band 8c AHP •  Orthopaedic Physicians/Associate Specialists (3) •  Consultant Podiatrist (AfC Band 8c) •  Physiotherapist (AfC Band 7) •  Advanced Nurse Practitioners (4) •  Medical Acupuncturists (c. 8 BMAS) •  Traditional Chinese Medical Acupuncturists (2) •  Institute of Osteopathy Intern •  Integrated with existing Pain Management, Rheum, Ortho and Neurosurgical teams
15. Referral Assessment by specialist MSK Clinician Triage Acupuncture Treatment by specialist MSK clinician Physiotherapy And Osteopathy Chronic Pain Management Programme (Pain and Emotional Awareness Programme) Podiatry Medical Hypnosis Occupational Therapy Dietician CBT Autogenic Training Discharge
16. NICE Guidelines (NG59) Low back pain and sciatica
17. Referral Physical assessment by MSK clinician Information/advice pack STarT Back Psychological therapies Discharge Paper triage Combined physical and psychological programmes Manual therapy treatment package LBP & Sciatica (Nov 2016)
18. Referral Physical assessment by MSK clinician Information/advice pack STarT Back Group Acupuncture BMAS TCM Acupuncture Discharge Paper triage Allied MSK programmes CBPEP PEAP Autogenic Training Weight loss programme Psychological therapies Treatment with specialist MSK clinician MSK Pathway (Jan 2017)
19. Benefits to the profession Future proofing Definition Adding value to healthcare Championing Benefits to the osteopath Professional development Professional awareness Shared learning Peer review and support
23. email: j.hearsey@nhs.net twitter: @jonathanhearsey address: Jonathan Hearsey Clinic Lead - Musculoskeletal Medicine Royal London Hospital for Integrated Medicine 60 Great Ormond Street London WC1N 3HR