Musculoskeletal leaders join the HIN for third Improvement Network event

July 10, 2023

On Friday 23 June, the HIN hosted its third Musculoskeletal (MSK) Improvement Network event.

The forum provides an opportunity for professionals involved in delivering or leading musculoskeletal services to share expertise, and discuss and debate how to improve the quality of life of people living with an MSK-related diagnosis.

June’s event attracted over 70 participants, and was expertly co-chaired by Christina Sothinathan, Innovation Business Partner at Chelsea and Westminster NHS Foundation Trust and Advanced Practice Physiotherapist; and Ben Wanless, Consultant Physiotherapist at St George’s Hospital NHS Foundation Trust.

The event started with a friendly live debate between Julia Tabrah and Dr David Herdman on the role of Cervico-Cranial Red Flags. Julia is Consultant MSK Physiotherapist and Clinical Lead for MSK Community Services at NHS England – London Region, and Dr David is Clinical Lead for Neurology and Vestibular Rehabilitation at St George’s University Hospitals NHS Foundation Trust. A red flag tool was shared and discussed and is available on the resource page. The resource outlines some of the key symptoms relating to cervical, spine and headache conditions and can help with decision making for onward referral if concerning features arise through history taking and clinical reasoning.

Dr Lesley Perkins, GP and MSK Clinical Lead at North East London Integrated Care Board (ICB), discussed Quality Improvement (QI) in primary care, outlining how Tower Hamlets Primary Care Network (PCN) used a QI approach to help staff improve communication skills and achieve better outcomes for patients.

The session then had three five-minute showcases of various services, followed by interactive Q&A sessions (see 'Showcases' box on right).


  • Dr Jim Kelly from Ashford Clinical Providers shared Ashford’s success story in commissioning an MSK pathway and how this helps to take pressure off secondary care services.
  • Consultant MSK Physiotherapist Andrew Cuff presented on PhysioNow, a patient self-assessment tool that provides enhanced choice of how and when to access physiotherapy services, bringing care into the community and closer to home
  • MSK Physiotherapist and Strategic Lead for Integrated MSK Services Dee Pratt spoke about the Dual Triage Model, which aims to ensure that patients are referred to the right services at the right time. This helps to reduce delays and allows greater ability to recall and review patients, improving staff capacity.

The final presentation was given by a team from the UK Frost Trial, a National Institute for Health and Care Research (NIHR)-funded multi-centre randomised control trial comparing three common treatments for frozen shoulder. Attendees had the opportunity to discuss the draft pathway and share feedback. This initiative is the largest randomised trial to compare early structured physiotherapy, manipulation under anaesthesia, and arthroscopic capsular release for frozen shoulder.

Sharing her reflections, co-chair Christina said:

The last three events have gone from strength to strength and it’s incredibly inspiring to see so many fantastic leaders and clinicians all in one space. We’ve received extremely positive feedback from attendees and are looking forward to bringing together our learning to accelerate innovations within the musculoskeletal field to drive better outcomes for all.

- Christina Sothinathan, Innovation Business Partner at Chelsea and Westminster NHS Foundation Trust

Please have a look at the slides and resources from this event on this resource page.

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To find out more about the London MSK Improvement Network and other related projects, please contact us.

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