GPs and referrers

Also in this Section for GPs and referrers


What is the Surrey Integrated Musculoskeletal Service?


The Surrey iMSK service is a new integrated service that provides rapid, comprehensive MSK assessment and treatment services for all adult patients registered with a North West Surrey CCG GP Practice who have an MSK condition requiring specialist assessment and management including hand therapy and physiotherapy. The service will include triage within 48 hours of the service receiving the referral and first contact with the service within a 3 week period. There will also be a dedicated helpline for advice and guidance on the services.


How do I refer to the Surrey iMSK Service?


Referral to the Surrey iMSK Service will be through the completion of a referral form and sent through to the North West Surrey Referral Support Service. Please ensure the following when you refer:

  • That you use the Surrey iMSK Service referral form as this will assist in ensuring that your patient is seen by the most appropriate initial assessor
  • Give the patient the link to the Surrey iMSK Website and/or the Patient information leaflet (Patient information leaflet is for patients referred into the service only)
  • Address referral to the Surrey iMSK Surrey Service and not to a specific consultant
  • Ensure that the patient is aware that following assessment of the referral they will be contacted by the service to make an appointment to see one or more of a range of professionals or for diagnostic tests
  • Ensure that the patient can be seen in a short space of time and if they can’t (e.g. they are going on holiday) please refer when they are able to be seen (this is due to local and national targets such as 18 weeks)
  • Ensure that all demographic information is up to date – importantly a telephone number that the patient can be contacted on to make an appointment


What happens when a referral is received?


All referrals will be triaged by an expert team which includes consultants, senior nurses, extended scope practitioners and GPs with special interests. Once the appropriate course of action is decided the patient will be contacted by the service for an appointment to be made (see pathway for further information)

The quality of the triage depends on the information submitted on the iMSK Referral Form. Please give as complete a biopsychosocial account of the presenting complaint as possible, and include investigations already done and therapies already tried.

The triage will take place within 48 hours and first contact with the service within a 3 week period and may include any of the below management options.


Management options


There are a range of potential options (see pathway) but these will include:

  • Physiotherapy
  • Occupational therapy
  • Exercise classes
  • Pain management group sessions
  • Psychological therapies
  • Hand Therapy
  • Further diagnostic tests
  • Surgical interventions
  • Clinical Podiatry
  • Orthotics
  • Consultant review
  • Hydrotherapy
  • Rheumatology
  • Pain
  • Orthopaedics


Advantages of the new service


  • Single point of access for all referrals for MSK
  • Promoting self-management and the Biopsychosocial model of care
  • Fast access to the most appropriate clinic and professional
  • Referral for tests and diagnostics
  • Referral straight to conservative therapies including Exercise-on-Referral
  • Access to comprehensive information for staff and patients via the Surrey iMSK website
  • Range of services available at geographical locations across the North West Surrey area running six days per week
  • Booking of appointments managed through the Surrey iMSK Service
  • Dedicated department focussing on all aspects of MSK
  • Clinically led board to ensure that the service meets the requirements
  • Evidence based practice ensuring up-to-date care and treatment
  • Alternatives to surgical intervention
  • Education and training for Primary care in the management of patients with MSK conditions
  • Clinician and patient helpline for advice and support, information about referrals and appointments




The service will provide a range of information and support to promote self-management of common MSK conditions. The aim will be that patients can access this information at any time.

The primary route will be via this website.

Please add a link to this website on your own practice website if possible.

This site will be continuously reviewed and updated to ensure that it contains resources and advice for patients and their families.







The service will be provided from 3 main hub sites:

  • St Peter’s Hospital, Chertsey
  • Ashford Hospital, Ashford, Middlesex
  • Woking Nuffield Hospital, Woking

These sites will provide a full range of outpatient services and diagnostics and where required in-patient procedures (dependant on the procedure required).

Further services will be provided at ‘spoke’ sites. These sites will not have all the services offered at the hubs but will provide outpatient assessment and treatment appropriate to the venues. The number and sites will change to meet the demand for the service. For further information on the sites please see the Surrey iMSK website.




In line with the NHS constitution patients will be offered choice of provider if a secondary care consultant assessment is required. PLEASE NOTE THAT ALL REFERRALS SHOULD BE SENT VIA THE NORTH WEST RSS. The referral will still be required to go through triage and then the referral will be forwarded to the chosen provider. Choice will be offered at all stages along the pathway to allow patients to choose the most suitable times and venues.

Choice also encompasses shared decision making with the patient being provided with comprehensive information about their treatment choices and options available to them.


Biopsychosocial Model


The Surrey iMSK service will promote a Biopsychosocial (BPS) model of care.

The BPS model takes into account factors such as emotions, activities, sleep, work, cognition, medication and an individual’s social circumstances to support a patient-centred approach to care that aims to improve patient outcomes. The model will encourage patients to be active participants in their care working in collaboration with their healthcare professionals.

Patients will be able to access self-management advice and support via the iMSK website at the earliest stage.

The BPS model will be included at initial assessments and throughout the patient pathway.

Tools used will be appropriate for the patient and repeated to assess effectiveness of interventions (e.g. EQ5D outcome measure).

All staff will be trained in the use of this approach to care with the service aim to address ‘what matters to you’ not just ‘what is the matter with you’.


Information Leaflets


GPs can order more leaflets by calling Charlotte Batchelor (our GP Liaison Co-Ordinator) on 01932 723940.


Key Contact Numbers and staff


GP Liaison Co-coordinator Charlotte Batchelor 01932 723940
07584 600817
GP Clinical Helpline Monday – Friday 8am -6pm 07584 600817
Patient Helpline Monday – Friday 8am -6pm 01932 722730
GP help email address – for non-urgent queries Response within 1 working day


North West Surrey CCG Referral Support Service

Tel. No: 01372 232500




Rheumatology Guidelines for General Practice

Adult Rheumatology referral guidance

BSR has created UK wide referral criteria guidance, in response to recommendations in Getting It Right First Time (GIRFT).

Fibromyalgia latest guideline for fibromyalgia

NWSCCG iMSK Referral Form

Cick here to download the NWSCCG iMSK Referral Form (MS Doc)

Rheumatology iMSK Triage Pathway – Inflamed one joint, Multiple joints, inflammatory spinal pains, and widespread body pains

Download this illustration (PDF)

Rheumatology iMSK Triage Pathway - Inflamed one joint, Multiple joints, inflammatory spinal pains, and widespread body pains.

Rheumatology iMSK Triage Pathway – Rheumatology Appointments Only

Download this illustration (PDF)
Rheumatology iMSK Pathway - Rheumatology Appointments Only