Review of Haringey's musculoskeletal services

Haringey CCG is reviewing all of the services that we commission for patients with musculoskeletal conditions. We are looking to change and improve how these services are provided in the future.

What is MSK?

Musculosketal (MSK) includes over 200 different conditions affecting joints, bones, muscles and soft tissues. MSK covers individual services like orthopaedics, rheumatology, chronic pain and physiotherapy. As well as back and neck pain, MSK services also deal with shoulder, elbow, wrist, knee, ankle and foot problems.

The national picture

  • There are over 200 MSK conditions affecting millions of people
  • MSK conditions are a major burden on both individuals and the NHS
  • MSK conditions are the most common reason for repeat consultations with a GP (30%)
  • Across the UK 17% of people who require incapacity benefit do so because of a MSK condition
  • By 2020, trauma caused by road traffic injury will become the third highest ranked cause of disabling conditions.
  • MSK conditions cause significant morbidity in all communities, across all ages

What does our current service in Haringey look like?

There are a number of different services which the CCG commissions for people with MSK issues. There are multiple providers and different routes (pathways) into each service:



Type of service/care provided

Whittington Health (community)

Community Physiotherapy and complex MSK conditions

Community Podiatry

Community pain clinic

Physiotherapy and Extended Scope Physiotherapists (senior)




Whittington Health (hospital)

Orthopaedics –
outpatients and surgery

Pain services

Rheumatology services

Podiatric surgery

In and outpatient physiotherapy

Consultant (senior doctor) led care

North Middlesex University

Community Physiotherapy and complex MSK conditions


Physiotherapy and Extended Scope Physiotherapists

Other providers (‘any qualified providers’):

  • Healthcare Ltd
  • Premiere Health and Sport
  • The Injury Care Clinics

Physiotherapy and MSK conditions


Physiotherapy and Extended Scope Physiotherapists


Anxiety and depression related to pain



What are we doing?

We want to understand:

  • The full range of services that are currently provided
  • How effective the different services are at meeting patients’ needs and what patients think of them
  • What other areas are doing and whether there is any good practice which we could learn from.

What are the timeframes for this review?

We are planning to complete the review and make some recommendations for future services by autumn 2017. As part of the review, we have conducted surveys (online and in clinics) and run focus groups with people who have used the services. We have also been speaking to our engagement network to get their input.  

Further questions?

If you have any questions about this review, please contact us on or 020 3688 2700.

Last updated: 04/12/2018