Table 1.
NHS Institute for Innovation and Improvement Musculoskeletal Interface Performance Management Indicators (Ealing PCT interface clinic performance, December 2010). Source: CSE Servelec RiO® Data Warehouse Reports Manager
| Interface performance indicator | Outcome |
|---|---|
| 18 weeks Referral to Treatment data | Average referral to treatment time: 8 weeks (includes time for investigations before staring treatment.) |
| Appropriateness of referrals into service | 99% |
| Did not attend (DNA) rates | Initial appointment: 7% |
| Follow-up appointments: 15% | |
| Initial DNAs reduced from 10% in 2009 as waiting times have fallen. | |
| Text reminder service being piloted to reduce DNAs further. | |
| Number of new attendances and follow-ups | New patients: 4682 |
| Follow-ups: 7053 | |
| Average 2.5 visits per episode | |
| Treatments performed in the service and outcomes | Specific postural, stretching and strengthening exercises, manipulation, acupuncture, injections (soft tissue, joint and caudal epidural), FP10 prescriptions. |
| Treatments offered are clinically and cost-effective in accordance with NICE guidelines and NHS Evidence Clinical Knowledge Summaries. | |
| MYMOP2 outcome measure being piloted. | |
| Appropriateness of referrals to diagnostic tests such as MRI | New patients seen: 4682 |
| MRI scans requested: 551 | |
| MRI rate: 12% | |
| Radiology audit in 2007 showed that MRI scans were being requested in accordance with Royal College of Radiologists guidelines. | |
| Further audit on clinical appropriateness planned. | |
| Onward referral rates to secondary care | New patients seen: 4682 |
| Secondary care referrals: 455 | |
| Onward referral rate: 10% | |
| Surgical intervention rates within secondary care | 70%† |
| Capacity and demand monitoring | Block contract |
| 4682 patients/year (interface service) | |
| 6909 patients/year (general physiotherapy | |
| Service at capacity. | |
| Waiting times in steady state: interface clinics, 3 weeks; general physiotherapy, 11 weeks. General physiotherapy stream demand fell by 10% after introduction of referral guidelines in 2009. | |
| Turnaround time for diagnostics. | Blood tests and X-rays, 1 week; MRI Alliance, 2.5 weeks; MRI InHealth (spine) 2.5 weeks; MRI InHealth (peripheral) 3.5 weeks |
† Audit, S Griffiths, personal communication, 2010.