High Impact Intervention

There is a lot of good innovative practice across the NHS which isn’t always taken up across the sector. Our High Impact Interventions work is aimed at identifying good, evidence based practice and collating it into simple service specifications. This will allow all CCGs to transform their services where there are opportunities to ensure that patients see the right person in the right place, first time.

Musculoskeletal Triage

Musculoskeletal (MSK) conditions affect approximately 9.6 million adults in the UK.

MSK clinical triage services provide specialist clinical review of GP referrals for MSK conditions. They can involve a review of the referral or a face-to-face appointment with the patient in a community setting. This review by an MSK specialist ensures that patients are seen in the most appropriate setting across the primary, secondary and voluntary sectors.

MSK triage services can also reduce demand for secondary care services which often face large annual increases in referrals. Triage schemes can reduce referrals by 20-30%. That is equivalent to a reduction of 2-3% in all GP referrals.

This means that those patients who need to be seen by a hospital consultant are seen as quickly as possible.

Additionally, the NHS England RightCare programme has identified that 31% of all elective care appointments involve musculoskeletal pathways.

Clinical Peer Review

Clinical peer review (CPR) involves GPs reviewing each other’s new referrals to provide constructive feedback to the referring GP. This ensures that all options are explored and that patients get access to the optimum care which means they see the right person in the right place, first time.

Published evidence suggests CPR can create sustainable changes in referrals behaviour through knowledge sharing. It can also:

  • reduce the overall number of referrals to outpatient services
  • increase the likelihood of GPs referring when necessary
  • improve the quality of referral letters
  • increase the likelihood of GPs referring patients to the most appropriate care setting, first time.