Opportunities for community and DHB physiotherapists to gain further skills and qualifications in advanced musculoskeletal practice to become equivalent of nurse or ‘specialists’ ‘practitioners’. 4.2 Effective triage & assessment of secondary level DHB referrals requires: Expansion and recognition of the value of the expert clinician in the triage role within the DHBs, supported by funding and staffing including expansion of the DHB GP liaison role. The position of GP liaison doctor working between primary and secondary care has shown to be an effective way to achieve change in the GP workforce if there is active support and commitment in the secondary service. (This way of operating does not only apply to musculoskeletal conditions). Develop a workforce of non-operative pediatricians/GPs/physicians interested, and expert, in conservative management of minor musculoskeletal disorders in children or adults but with skills to refer appropriately for expert surgical / rheumatological advice. Integrated access to electronic information across different DHBs, particularly digital radiology, clinician dictations with rationalisation of IT services across different DHBs. Clear agreed regional referral guidelines. 4.3 To enable physiotherapists and nurse specialists to undertake first assessments and early treatments of many patients with musculoskeletal conditions requires: Development and consolidation of advanced scopes of practice for physiotherapists by the Physiotherapy Board and recognized by ACC. Better integration between DHB-funded community physiotherapy services and DHB clinicians. A funding model that incentivises virtual FSAs and use of allied personnel to assess secondary level referrals rather than current model which drives use of consultant specialists to carry out FSAs for patients with minor complaints. Extending musculoskeletal training to clinical nurse specialists, ensuring there is an appropriate career path into this area, developing
Opportunities for community and DHB physiotherapists to gain further skills and qualifications in advanced musculoskeletal practice to become equivalent of nurse ‘specialists’ or ‘practitioners’. 4.2 Effective triage & assessment of secondary level DHB referrals requires: Expansion and recognition of the value of the expert clinician in the triage role within the DHBs, supported by funding and staffing including expansion of the DHB GP liaison role. The position of GP liaison doctor working between primary and secondary care has shown to be an effective way to achieve change in the GP workforce if there is active support and commitment in the secondary service. (This way of operating does not only apply to musculoskeletal conditions). Develop a workforce of non-operative pediatricians/GPs/physicians interested, and expert, in conservative management of minor musculoskeletal disorders in children or adults but with skills to refer appropriately for expert surgical / rheumatological advice. Integrated access to electronic information across different DHBs, particularly digital radiology, clinician dictations with rationalisation of IT services across different DHBs. Clear agreed regional referral guidelines. 4.3 To enable physiotherapists and nurse specialists to undertake first assessments and early treatments of many patients with musculoskeletal conditions requires: Development and consolidation of advanced scopes of practice for physiotherapists by the Physiotherapy Board and recognized by ACC. Better integration between DHB-funded community physiotherapy services and DHB clinicians. A funding model that incentivises virtual FSAs and use of allied personnel to assess secondary level referrals rather than current model which drives use of consultant specialists to carry out FSAs for patients with minor complaints. Extending musculoskeletal training to clinical nurse specialists, ensuring there is an appropriate career path into this area, developing
musculoskeletal-workforce-service-forecast.docx