TAM (Treatments and Medicines) NHS Highland
For MSK physiotherapy: please consider if individual requires specialist MSK rehabilitation or assessment that cannot be met with digital, third sector or local options such as: other MSK options.
- NHS Inform MSK resources https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/how-to-access-msk-services
- Highlife Highland exercise programmes https://www.highlifehighland.com/health-and-wellbeing/
- Elemental social prescribing platform Access Elemental - Marketplace
How to refer:
- Preferred: SCI Gateway (Physiotherapy to local MSK service)
- Avoid paper referrals, where possible, due to delays.
- Referrals will not be triaged until essential information is provided to allow service to decision and plan care.
- Frequent referrers: request SCI Gateway access via eHealth SPoC
Essential information required:
- Reason for referral and clinical history.
- Duration, severity, functional impact, sleep, work, pain levels
- Post op details / instructions/ date
- Neurological signs / red flags
- Previous interventions and response
- PMH / DH, investigations, any developmental details
- School impact
- Please add this information if relevant, as impacts priority given:
- Children of parents working in the armed forces- their parents move regularly, which means care can be interrupted.
- Looked after child – a child under the care of Highland council, for example a child in foster care.
- Homeschooled.
- Traveller's children.
Appropriate referrals (inclusions):
- Age 12 to 16+ with MSK condition
- Needs specialist MSK assessment or individualised rehab
- Unresponsive to other third sector digital / community / primary care options
- Consents and can engage with active rehab
BEFORE referral any investigations such as X-rays, blood tests must have been completed and reported.
Do NOT refer (exclusions):
- Under 12 years – referral via NHSH Paeds pathway
- Uninvestigated red flags or awaiting diagnostics
- For a specific standalone interventions e.g injections, ultrasound
- No clear MSK physiotherapy need/problems.
- Careful consideration if person has significant current psychological/complex needs that may impact ability to engage with active interventions
- Housebound / cannot leave house (refer to community team via SPOA link)
- Careful consideration of creating multiple referrals for the same condition, please discuss with services to ensure best pathway
- Conditions better suited to podiatry / orthotics / other services
Emergency situations (Do NOT refer to MSK physio):
- Suspected Cauda Equina
- Serious neurological deterioration
- Suspected fracture, infection, cancer
- Acute mental health crisis and cannot engage with active approaches
Guidance on Prioritisation of Referrals for 12-16 yrs MSK services
- Category 1 - Urgent criteria – to be seen within 2 weeks where possible:
- Post surgery <3 months with functional limitation.
- Post fracture <3 months with functional limitation.
- Recent onset (<3 months) meeting the following criteria:
- Or have any one of the below:
- Progressive neurological deficit/worsening symptoms despite primary care and attempted self-management.
- First episode off school from impact of current episode.
- Severe pain with no relief/major loss of movement despite documented regular analgesia.
- Significant sleep disturbance from the impact of the current episode despite appropriate analgesia.
- Additional priorities:/Interrupted learners:
- Children of parents working in the armed forces- their parents move regularly, which means care can be interrupted.
- Looked after child – a child under the care of Highland council, for example a child in foster care.
- Homeschooled.
- Traveller's children.
- Category 2: Routine. – everything else. Please refer if a patient has an MSK condition that cannot be managed without specialist input and the patient agrees to active management.
Useful contacts:
- Adult MSK physiotherapy (Inverness & Ross): nhsh.mskphysiotherapy@nhs.scot
- Acute paediatric physiotherapy: nhsh.acutepaedsphysio@nhs.scot
- Community paediatric physiotherapy: Childrens.PTService@highland.gov.uk