Many foot and ankle problems are, of course, treated by GPs, podiatrists and physiotherapists in clinics and sports clubs. If these professionals feel they cannot treat your problem, they will usually ask one of our team to see you. Traditionally this was done by referring you to an orthopaedic consultant at a local hospital. You would then be seen by the consultant, but often you would then be sent to a physiotherapist, podiatrist or orthotist for treatment. This caused lots of delays. There have been some big changes in how care for foot and ankle problems is organised, to reduce delay and improve quality. People sometimes find these changes confusing, so this page aims to explain:
At the beginning of 2000 our team started to arrange for each patient to be seen first of all by the team member who was most likely to be able to help them, even if the GP’s letter had been sent to the consultant. So the podiatrist saw people with ingrowing toenails, physiotherapists saw people with ankle injuries and orthotists saw people who need special shoes and some insoles. This allowed us to reduce waiting times from nearly a year to 12 weeks within a few months, and waiting time has continued to fall since. All our team members were trained to diagnose relevant conditions, and our agreed evidence-based treatment policies enabled each team member to start the appropriate treatment straight away without having to wait for a doctor to check it. This was part of the NHS’s modernisation policy.
In the last couple of years a lot of this care has been moved out of the hospitals into health centres and local treatment centres. Several of our team who used to work in the hospitals now work in community teams called Musculoskeletal Services, but we still meet regularly and work on keeping our treatment and advice up-to-date and consistent.
The community Musculoskeletal Services now see most of the patients who used to come to hospital, but use the same treatment plans as the hospital service. They check all letters sent by GPs to hospital consultants. If the problem is one that can be treated in the Musculoskeletal Service clinic, an appointment would be made there with the podiatrist, physiotherapist or specialist GP. If the problem looks as if it needs an operation, or can only be dealt with by the consultant at the hospital, an appointment will be arranged with a consultant through the Patients’ Choice system. The decision whether to see a patient in the Musculoskeletal Service or send them to hospital is taken by the Musculoskeletal Service team on the basis of the joint treatment plans. We have found that about 70% of people with foot and ankle problems who would traditionally have been sent to hospital can be treated successfully in the Musculoskeletal Service, 10% have treatment in the musculoskeletal Service first and are then sent to hospital, and 20% go straight to the consultant clinic at the hospital.
So, if your GP (or physiotherapist or podiatrist) decides to get a specialist opinion, you will probably see one of the Musculoskeletal Service team first, and they will probably give you all the care you need. Remember, they are part of the whole foot and ankle service group along with the hospital consultants. If your problem looks like it needs an operation or can best be sorted out by one of the hospital consultants, you can use Patients' Choice to make an appointment that is convenient for you. We hope you will choose to make that appointment at Burnley General or Royal Blackburn Hospitals. Our page on patients’ choice explains why we think the local service would be a good choice for you.
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