Optimising Musculoskeletal Patient Flow Through Digital Triage and Supported Self-Management: A Service Evaluation Set Within Community Musculoskeletal Care.

Abstract

Introduction: Musculoskeletal (MSK) conditions are one of the leading causes of years of living with disability in the UK, resulting in pressure on the health system and the UK economy. In response to the increasing levels of patients accessing NHS care with MSK conditions across Sandwell and West Birmingham (SWB), a digital triage and self-management tool was implemented in 2023.

Aims: To optimise safety, efficiency, and choice within the community MSK service from the first contact through to specialist MSK care through digital triage and supported self-management.

Methods: SWB's community MSK service implemented two digital tools in January 2023. Objectives included 1. Increase safety, through providing 24/7 access to rapid digital MSK triage; 2. Optimise workforce by releasing clinicians back to face-to-face care, increasing clinical capacity, 3. Increase patient choice by offering digitally supported self-management to appropriate low risk patients.

Results: 4804 patients self-referred to the MSK service through the digital triage tool within the first 12 months. 378 of these patients were offered, accepted, and accessed self-management support using the digital self-management app. These innovations led to the release of 1240 clinical hours for face-to-face care, an average 8-week reduction in waiting times and high patient satisfaction (80% good/very good).

Conclusion: Evaluation over the first 12 month showed that the digital innovations were safe, led to enhanced access to and choice of care pathways, optimised use of clinical staff, and received positive patient feedback. Research is needed in this newly emerging area of practice to support further adoption across the healthcare system.