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Orthopaedic, Rheumatology and Pain Services: Engagement Update

Consultation has concluded

last updated 3rd July 2015


We are currently reviewing Orthopaedic, Rheumatology and Pain services across Liverpool to understand how we can best improve them.

The services included in this review are:-

  • Orthopaedics – injuries and diseases of the body's muscles, skeleton and related tissues including the spine, joints, tendons and nerves
  • Rheumatology - injuries and diseases that also affects joints and muscles but is usually connected with the immune system and includes conditions such as inflammatory arthritis.
  • Pain services
  • Neck and back pain clinics
  • Musculoskeletal Clinical Assessment Service
  • Rheumatology Assessment Service

When we talk about Musculoskeletal (MSK) medicine, we mean the diagnosis and treatment of conditions affecting muscles and bones and the impact these conditions have on a person’s life. There are over 200 recognised musculoskeletal conditions ranging from common ailments such as general neck and back pain, to discomfort in muscles and joints. Specific conditions may also include; osteoarthritis, rheumatoid arthritis, sciatic pain, tennis elbow, repetitive strain injuries and sports injuries.

Our Vision

We are aiming to transform the way in which MSK and pain services are delivered, to ensure patients have a positive experience overall.

We believe we can do this in the following ways:

  • Promote patient choice.
  • Follow the principles of shared decision-making which means ensuring patients are involved in decisions about their care
  • Bring together staff from the range of professionals involved in a patients care to collectively agree care plans
  • Ensure that patients see the right clinician, first time
  • Ensure that patients received the best quality care

What's been done so far?

We have already piloted several service changes which are helping us to form ideas about improvements that could be made to the way patients are referred. The piloted changes have also helped us to consider how patients move between clinics and the support they need on their way.

The evaluation of the pilot can be found here.

The pilot has left us with several options to consider:

  • Leave existing orthopaedic, rheumatology, neck and back pain and pain services running separately
  • Integrate existing orthopaedic, neck and back pain and rheumatology services and commission separate pain services

Or

  • Integrate all orthopaedic, rheumatology, neck and back pain and pain services, locating clinics in both hospitals and community settings

We think the benefits of integration for patients would be:

  • Care closer to home, with choice of locations, which are easy to access by both public transport and parking.
  • A one-stop-shop approach for diagnostics and tests
  • Simplified referal routes to receiving appropriate care.
  • Patients could move between services without the need for re-referral so would make less visits to the GP and this would speed up treatment
  • Patients would receive a care plan that moves with them to the next service reducing the need to explain care preferences, existing conditions, or personal circumstances, wrapping care around the patient, their carers and family.
  • A single service would reduce inequity and reduce variability of services across the city

During February and March 2015 we spoke to local people and communities about the options for redesigning these services and feedback so far indicates that patients are broadly in agreement with integrating services and are supportive of locating pain services in the community.

You can view the feedback from this engagement by accessing the reports in the document library

A Workshop was also held on 13th May 2015 to share with local providers a draft model of care. You can view the presentation here.

What next?

Liverpool CCG is now reviewing all comments from the public and service providers and considering options / models for a service redesign. Once these options have been drawn up we will post the feebdack on this page and will be returning to the public and service provider’s to ask for their views on the proposals.

last updated 3rd July 2015


We are currently reviewing Orthopaedic, Rheumatology and Pain services across Liverpool to understand how we can best improve them.

The services included in this review are:-

  • Orthopaedics – injuries and diseases of the body's muscles, skeleton and related tissues including the spine, joints, tendons and nerves
  • Rheumatology - injuries and diseases that also affects joints and muscles but is usually connected with the immune system and includes conditions such as inflammatory arthritis.
  • Pain services
  • Neck and back pain clinics
  • Musculoskeletal Clinical Assessment Service
  • Rheumatology Assessment Service

When we talk about Musculoskeletal (MSK) medicine, we mean the diagnosis and treatment of conditions affecting muscles and bones and the impact these conditions have on a person’s life. There are over 200 recognised musculoskeletal conditions ranging from common ailments such as general neck and back pain, to discomfort in muscles and joints. Specific conditions may also include; osteoarthritis, rheumatoid arthritis, sciatic pain, tennis elbow, repetitive strain injuries and sports injuries.

Our Vision

We are aiming to transform the way in which MSK and pain services are delivered, to ensure patients have a positive experience overall.

We believe we can do this in the following ways:

  • Promote patient choice.
  • Follow the principles of shared decision-making which means ensuring patients are involved in decisions about their care
  • Bring together staff from the range of professionals involved in a patients care to collectively agree care plans
  • Ensure that patients see the right clinician, first time
  • Ensure that patients received the best quality care

What's been done so far?

We have already piloted several service changes which are helping us to form ideas about improvements that could be made to the way patients are referred. The piloted changes have also helped us to consider how patients move between clinics and the support they need on their way.

The evaluation of the pilot can be found here.

The pilot has left us with several options to consider:

  • Leave existing orthopaedic, rheumatology, neck and back pain and pain services running separately
  • Integrate existing orthopaedic, neck and back pain and rheumatology services and commission separate pain services

Or

  • Integrate all orthopaedic, rheumatology, neck and back pain and pain services, locating clinics in both hospitals and community settings

We think the benefits of integration for patients would be:

  • Care closer to home, with choice of locations, which are easy to access by both public transport and parking.
  • A one-stop-shop approach for diagnostics and tests
  • Simplified referal routes to receiving appropriate care.
  • Patients could move between services without the need for re-referral so would make less visits to the GP and this would speed up treatment
  • Patients would receive a care plan that moves with them to the next service reducing the need to explain care preferences, existing conditions, or personal circumstances, wrapping care around the patient, their carers and family.
  • A single service would reduce inequity and reduce variability of services across the city

During February and March 2015 we spoke to local people and communities about the options for redesigning these services and feedback so far indicates that patients are broadly in agreement with integrating services and are supportive of locating pain services in the community.

You can view the feedback from this engagement by accessing the reports in the document library

A Workshop was also held on 13th May 2015 to share with local providers a draft model of care. You can view the presentation here.

What next?

Liverpool CCG is now reviewing all comments from the public and service providers and considering options / models for a service redesign. Once these options have been drawn up we will post the feebdack on this page and will be returning to the public and service provider’s to ask for their views on the proposals.

CLOSED: This discussion has concluded.
Discussions: All (1) Open (1)
  • It's been brilliant to have people's comments over the past few months about how we can improve Orthopaedic, Rheumatology and Pain services in Liverpool, or if indeed improvements are need.

    We would love to keep hearing from you.

    If you have any thoughts, comments or ideas about these services let us know!

    It's been brilliant to have people's comments over the past few months about how we can improve Orthopaedic, Rheumatology and Pain services in Liverpool, or if indeed improvements are need.

    We would love to keep hearing from you.

    If you have any thoughts, comments or ideas about these services let us know!