Musculoskeletal (MSK) conditions account for 30% of GP consultations in England. There are around 200 different conditions which affect the bones, muscles and joints.

Most of the following conditions can be treated in the community, but some will require hospital care:

  • Rheumatism (pain in the joints caused by a variety of factors)
  • Osteoporosis (weakening of the bones)
  • Arthritis (disease of the joints)
  • Back and neck pain
  • Ligament injuries (the soft tissue which connects bones to each other)
  • Sprains, strains and over-use injuries
  • Chronic and persistent pain (can derive from many different conditions, including MSK)


Symptoms can include pain, stiffness, swelling, muscle weakness, numbness or pins and needles. They can affect people at home, at work, or through daily activities and sport.

Surrey Heartlands has a number of system priorities which endeavor to improve patient experience, clinical quality and system sustainability. We want to establish a single, evidence based, best practice treatment pathway for musculoskeletal (MSK) conditions which focuses on empowering patients to self-care and on prevention to ensure clinical interventions are delivered at the right time in the right setting. The pathway will drive a shift in culture for both our citizens and clinicians by empowering patients to manage their health better and reduce the need for clinical interventions in both community and hospital care. Since we are committed to the Surrey Heartlands citizen-led co-design communications and engagement initiative, patients and the public will be closely involved in developing these plans.


MSK Services in Surrey Heartlands

MSK services account for the largest treatment pathway spends in each of the four areas that make up Surrey Heartlands CCG and we commission the following in relation to MSK:


East Surrey

Patients can self-refer to the musculoskeletal (MSK) outpatient physiotherapy community service. Visit the First Community Healthcare website to see if your practice is involved and read more about self-referrals. If you are registered with an East Surrey GP practice you can book an appointment to see a First Contact Physiotherapist at your local GP surgery without needing to see a GP first. Please contact your local GP practice for more information.


Guildford and Waverley

Adults can be referred to the Musculoskeletal Service (MSK) at the Royal Surrey Foundation Trust Hospital for the triage and assessment of conditions relating to joint, muscle, tendon structures of the arms, legs or spine.

The Musculoskeletal (MSK) physiotherapy community service is a GP direct access or consultant referred service, operating out of Haslemere community hospital and Cranleigh village hospital. The purpose of the service is to provide assessment, diagnosis, treatment and self-management advice for adults and children with musculoskeletal conditions.

A women’s health service is also provided for pregnancy and incontinence related musculoskeletal conditions.


North West Surrey

Surrey iMSK is an NHS service provided by Ashford and St Peter’s Hospitals NHS Foundation Trust. The service includes a comprehensive range of complementary disciplines including orthopaedics, podiatry, orthotics, rheumatology, chronic pain services, occupational therapy and musculoskeletal physiotherapy. These services are delivered by a wide range of professionals, all working together. There is a focus on supporting patients in understanding their condition / what's causing their pain or discomfort, whilst encouraging them to take more responsibility for their condition where that's appropriate.


Surrey Downs

At Epsom and St Helier University Hospital, we offer rheumatology which covers general rheumatology clinics, acute back pain management, inflammatory arthritis including rheumatoid arthritis and psoriatic arthritis, various auto-immune conditions, such as SLE, scleroderma and polymyositis and vasculitic conditions. We offer a monthly paediatric rheumatology clinic and a weekly bone clinic for metabolic bone disorders and osteoporosis. Nurse-led clinics support the management of patients with inflammatory arthropathies and those using biologic agents such as TNF alpha therapy and rituximab. Clinics are provided at both Epsom and St Helier hospitals. We can usually provide urgent appointments if requested by your GP.


More information about local services is available on the Surrey Information Point - Health Matters website.



Review Date: 2020-07-31
Review Due: 2021-01-27
Model Publication Scheme Class: Class 9: Services Commissioned