Keywords: Musculoskeletal, Transformation, Covid-19
Purpose: A new city-wide Single Hospital Service (SHS), Manchester University NHS Foundation Trust (MFT), was formed following the merger of three NHS Hospital Trusts. This led to fragmentation and variation in musculoskeletal (MSK) services across the new Single Hospital Service.This coincided with the introduction of First Contact Practitioner (FCP) and the introduction of, ‘the MSK roadmap’.
Along with consideration of the new challenges and opportunities of service provision and restoration in a post-Covid world.
The aim of the project was to develop a programme of work for the safe integration and transformation of the musculoskeletal service across the new SHS.
Methods: An A3 thinking methodology process was used to underpin the service review and project. This included a stakeholder analysis, a review of the current service provision and practice at each site along with a staff engagement exercise.
In conjunction with the Hospital Trust Organisational Development team, a virtual whiteboard ‘MURAL’ was developed. This enabled all members of the team to anonymously share their thoughts, experiences and ideas to support the successful transformation of the service. The ‘MURAL’ board was accessed online and open for comments for a two-week period with reminders being sent to the team every few days.
Six questions were asked:
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What does great communication look like for an integrated MSK outpatient service, which is delivered across south, central, and Trafford hospital sites? (37 responses)
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What do we currently do that is good and, we want to keep? (49 responses)
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What are your ideas for improving the way we work? (42 responses)
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What do we currently do that doesn’t work well? (29 responses)
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What is getting in the way of us being successful? (35 responses)
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What training would be required to support the transformation and integration of CSS MSK out-patient services? (25 responses)
Results: There was a good response to the ‘MURAL’ with a total of 217 responses were received from the team of 78 staff. The responses were summarised into the key themes of communication, service improvement, education and governance.This information was used to inform a service SWOT analysis.
Conclusion(s): The information gained from the current state analysis review, gap analysis, staff engagement feedback, Trust Covid-19 restoration guidance and key national drivers of FCP implementation and pending FCP /ACP verification, nineteen clinical transformation work-stream developments were identified. The work-stream developments were then prioritized according to the potential for clinical risk.
The initial service review has identified the work that needs to be undertake to safely transform the service. The next stage of the project is a further staff ‘MURAL’ engagement exercise to embed the ‘one team’ sense and develop whole team values, mission statement, team charter- for whole team inclusivity.
Impact: This project has identified the musculoskeletal clinical transformation programme work streams. A distributed leadership model will be implemented to embed team working, service improvement enabling all staff the opportunity to contribute to the service development.
A re-evaluation of the work programme and staff feedback will be undertaken at 12 months.
Funding acknowledgements: This work was not funded.