Three Leeds clinical commissioning groups are aiming to improve the quality of musculoskeletal referrals by adding local pathways to the Map of Medicine.

Leeds West CCG, Leeds North CCG, and Leeds South and East CCG have a combined patient population of more than 810,000, spread over 113 GP practices.

A Leeds project team has agreed the pathways for six musculoskeletal topics; hip pain, hand/wrist pain, spinal pain, knee pain, foot and ankle pain and shoulder pain.

They used Map Transform, a package of care maps and services, to establish their pathways on the Leeds “view” of MoM.

The care maps display referral criteria at specific points within the pathways, with information taking the user to the appropriate local referral form.

A MoM statement says the overarching aim of the care maps is to “standardise and improve” the quality of referrals from primary care to community musculoskeletal and secondary services.

“A triage service for all MSK referrals was in place, and effective at ensuring good conversion rates for surgery following onward referral to secondary care.

"However, was felt that GPs could perform some of the functions of triage, with the patient pathway being streamlined,” it says.

The MSK care maps will be updated depending on their impact on referrals, conversion rates and MRI/ultrasound usage.

Leeds West CCG representative Dr Chris Mills said there is a huge amount of change due in primary care over the next few years and MoM is a “powerful tool” to help GPs manage this.

“The success of CCGs will depend on good communication and a slick implementation process for the numerous pathway redesigns to come,” he added.

Each GP practice has been provided with in-house training, including an introduction to how a GP might build the care maps and referral forms into their workflow.

The Leeds project team has also launched its own Map newsletter to keep GPs informed of progress, upcoming pathways, and feedback.

Review of the MSK pathways prior to referral will be encouraged through awarding QOF Quality and Productivity points and payment.

The long-term goal is to use the MoM to create all future pathway redesigns and work is already underway on pathways for dyspepsia, pain management, and urology.