BCHC staff treating an adult patient

Services

Adults' Services

Orthopaedic Triage Service

OTS provides an assessment and treatment service within Primary Care and the community for patients with musculoskeletal (MSK) conditions.

About our service

The Orthopaedic Triage Service (OTS) provides an assessment and treatment service within Primary Care / Community for patients with musculoskeletal (MSK) conditions, referred by; their GP, a First-Contact Practitioner (FCP) or a Physiotherapist. Our aim is to provide an effective, evidence-based ‘one-stop-shop’ service for all patients with MSK conditions.

 

The term MSK refers to;

  • Muscles
  • Bones
  • Joints
  • Soft tissues e.g. ligaments, cartilage and fascia

 

The Orthopaedic Triage Service is made up of a large team of experienced Advanced Clinical Practitioners (Physiotherapists and Podiatrists) who will assess, diagnose and help you to manage your condition at health centres spread across the local community. The aim of the service is to ensure that patients with MSK conditions are seen by the right clinician at the right time to facilitate a timely recovery.

 

 

Who works in the service?

Our expert team is staffed by Advanced Musculoskeletal Practitioners (Extended Scope Physiotherapists and Podiatrists).

 

Our practitioners are up to date with the latest research findings and can provide a thorough assessment and management programme tailored to each individual's needs. We also help our patients to understand their condition, prevent recurrences and learn how to actively manage it.

 

 

Services and treatments

All referrals that come in to this service are reviewed by one of our extended scope practitioners. They will then decide who you will see depending upon your condition.

 

We will book you an appointment with either the clinician in the Orthopaedic Triage Service or, in some cases, we may need to refer you directly to the local hospitals or, to another NHS service, the Multidisciplinary Pain Service or back to your GP with guidance.

 

The Orthopaedic Triage Service is a service for patients who typically have more complex musculoskeletal conditions or those who may require surgery. Our team team consists of Extended Scope Physiotherapists and Podiatrists (ESPs), who will provide an assessment, request investigations, provide a range of treatments including joint/soft tissue injections as well as refer to hospital services if required.

 

 

How can I access the service

Members of the public who are registered with a Birmingham GP practice can access our community orthopaedic triage service by referral from your doctor.

 

 

Referrals

From 1 April 2025, we require that all GP referrals to the OTS are made and managed via the NHS e-Referral Service (e-RS).

 

OTS will be visible on e-RS as:

  • Orthopaedics - MSK Hub - Spine - BSol - BCHC Orthopaedic Triage - RYW
  • Orthopaedics - MSK Hub - Lower Limb - BSol - BCHC Orthopaedic Triage - RYW
  • Orthopaedics - MSK Hub - Upper Limb - BSol - BCHC Orthopaedic Triage - RYW

All relevant clinical referral information will need to be attached to the referral before we are able to complete clinical triaging.

 

To avoid rejection,  please ensure the following information is included:

  • Complete and up-to-date patient details and contact details
  • Summary of problem and rationale for orthopaedic opinion
  • Details of physical examination (particularly neurological exam for spinal patients)
  • Results of relevant investigations (and previous interventions if applicable)

For any queries, OTS is contactable via email: BCHNT.Orthopaedics@nhs.net.

Orthopaedic Triage Service Specification

Referrals for an elective MSK or orthopaedic opinion will be accepted for any adult patient who meets the following criteria:

  • Registered with a GP within Birmingham CCG;
  • 16 years of age or over;
  • Not following acute trauma;
  • Without suspicion of sinister or inflammatory pathology (i.e. displaying red flags).


Procedures Performed

  • MSK Orthopaedic assessment for disorders and injuries of the neuro-musculoskeletal system: bones, muscles, tendons, ligaments and nerve related problems;
  • Consideration for diagnostic investigations (X-ray, USS, MRI, NCS, Bloods);
  • Onward referral to appropriate service e.g. physiotherapy, orthopaedic clinic, Pain management;
  • Joint and soft tissue corticosteroid injections where clinically indicated (under restrictions of local PGD).

 

Exclusions

  • Non-spinal patients (in South localities);
  • Patients who are housebound/requiring hospital transport (refer to secondary care);
  • Any acute MSK trauma such as suspected fracture, dislocation or major soft tissue rupture (refer to A&E or fracture clinic);
  • Patients with Red Flags (GP should exclude sinister pathology first);
  • Signs of infection and acutely unwell;
  • Patients under 16 years of age (refer to Birmingham Children’s Hospital);
  • Post-operative patients (refer back to operating team);
  • Suspected /potential non-MSK cause of symptoms;
  • Atypical mass or swelling;
  • Signs of acute cord compression/bilateral sciatica (refer to A&E);
  • Radicular pain with new (<7 days) neurological deficit (anti-gravity weakness);
  • Previously assessed as suitable for surgery (refer directly to secondary care);
  • New (<2 week) suspected CES (refer to A&E);
  • Ankylosing spondylitis with new pain;
  • MSK pain not needing further investigation (consider physiotherapy referral).

 

Orthopaedic Triage Service Specification [pdf] 602KB



Additional information

Attending your appointment

If you need to change your appointment or no longer want an assessment, please call the service at least 48 hours prior to your appointment so that your appointment can be offered to someone else.

 

Please arrive on time so that you get the maximum benefit from your allocated appointment. If you arrive late for your appointment it may need to be rescheduled for another time.

 

If you do not attend your appointment without notifying us in advance you may be discharged from this service. Attending your appointment or informing us in good time if you need to cancel keeps waiting times low and reduces NHS costs.

 

If you need a translator please contact the service prior to your appointment and state the language you require.

What should I wear?

During your assessment you might be required to carry out a number of movements to determine the cause of your pain.

 

We therefore recommend you wear suitable loose fitting clothing, such as a T-shirt, shorts, jogging bottoms and underwear that you are comfortable being assessed in.

Our patients and their carers and families are the reason we're here, so we want to hear your views about the Trust and our services.