Musculoskeletal Integrated Pathway Review Project

Group of people

Musculoskeletal (MSK) services in Oxfordshire are commissioned by Oxfordshire Clinical Commissioning Group (OCCG). One of the largest contracts in MSK services in the county for the Musculoskeletal Triage and Tier 2 Treatment Service is held by Oxford University Hospital NHS Trust (OUHT) and was due to expire in 2016.

In 2014, OCCG was required to develop a commissioning strategy for an MSK service that would be future fit, meet patient need, is efficient and would provide a quality service for Oxfordshire patients. They needed input from patients, the public and clinicians. The project was managed in two phases:

1. Phase one: Strategic Outline Business Case (Current state analysis and ‘what constitutes a good service’). Presented to the OCCG Clinical Executives on 23rd September 2014.

2. Phase two: Full business case (future state analysis with recommendations for change). Was presented to the OCCG Clinical Executive and OCCG Governing Body in April 2015.

As part of the current state analysis OCCG explored feedback from both patients who have used the service, GPs and hospital clinicians. The CCG has also conducted data analysis to understand the current demand for the service and patient and clinician experience.

As part of this work OCCG identified an increasing number of referrals and rising expenditure within the service.

Areas that were reviewed within the Musculoskeletal services included;

• Referrals, triage and initial assessment
• Orthopaedics
• Rheumatology
• Podiatry
• Orthotics
• Spinal (neck and back)
• Physiotherapy

In order to thoroughly consider the future options for MSK services in the county and to support the review project a number of engagement activities were undertaken, including forming a patient advisory group (PAG), clinical advisory group (CAG), joint patient, clinician and stakeholder co-design events to gather feedback on the type, range and standard of services people in Oxfordshire would like to see provided, Experience Based Co-Design (EBCD) to inform the co-design workshops and a public survey.

The full engagement report of this activity can be found here:

This consultation has now closed.


  • Opened
    21 Nov 2014 at 09:00
  • Closed
    9 Jan 2015 at 23:59
  • Response Published
    14 Feb 2015


  • Young people
  • Families
  • Older people
  • Carers
  • Mental health
  • Physical disabilities
  • Learning disabilities
  • Autism / Aspergers
  • Sensory Impairment
  • GP services
  • Community Hospitals
Which locality (local area in Oxfordshire) is this for:
  • Oxford City
  • North Oxfordshire
  • North East Oxfordshire
  • South West Oxfordshire
  • South East Oxfordshire
  • West Oxfordshire
Target Audience
  • Families and parents
  • Older people
  • Carers
  • GPs
  • People with a disability
  • People with mental health issues
  • Community groups