We have received a referral for your MSK (musculoskeletal) condition – the problem you are having with your muscles, joints, or bones.
Every referral is carefully reviewed by our expert MSK clinicians to decide the best way to support you. This can sometimes differ from what your GP or FCP told you to expect (for example a particular treatment or scan, or how quickly you need to be seen), but please don’t worry if so.
We are changing how we look after patients to keep up with new ways of working in the NHS. We now use a digital-by-default approach to help patients access care quickly and conveniently, including online options like video calls or apps. The image below illustrates the pathways we offer:
*N.B. self-referral is not available in South and West Hertfordshire
**Not all of our MSK services include Chronic Pain management
Digital MSK Care
We include a question in our referral forms to ask if digital care could be a good option for you (or you can let us know yourself). If digital care is not appropriate for you, we will arrange an alternative form of support.
For many people, digital care through health apps or video consultations provides effective treatment with shorter waiting times and greater flexibility.
Some benefits are:
- You can start getting help quickly (often within 1–2 weeks)
- You receive care that is designed just for you
- The care works just as well as seeing someone in person
- It’s easier because you don’t need to travel
Depending on what you need, we may offer one of these options:
- Less complex problems: a video call with a physiotherapist (“Physioline”), who will send you exercises afterwards
- Ongoing physiotherapy: using an app called the Joint Academy, where you have a video call with a physiotherapist who sets exercises especially for you via the app, which you can do whenever it’s most convenient for you
- More complex problems: a video call with a specialist MSK clinician ("Virtual APP") who can look more closely at your condition
For more information on each of our digital options, please click here.
Group Physiotherapy and Education
For those who can’t use online care (for example, if you don’t have internet access, or you don’t feel comfortable using a phone, tablet, or computer), many will do really well with exercise classes in person, especially for problems like mild joint pain. If we think this would help you, we will invite you to a class near you. Many people also enjoy meeting others there.
A small number of people may need to see a specialist MSK clinician in person or have a test carried out (such as an X-ray), and some may need to be referred to hospital. We will arrange this for you if needed.
We often use digital care first because it can make things easier for you.
Easy and flexible
- You can have your appointment from home or wherever you feel most comfortable
- You can pick a time that suits you, like your lunch break
- You can do your exercises whenever you like, even in the evening or at weekends
Quick help
- You can usually start your care within 1-2 weeks
- This is often faster than waiting for an in-person appointment
- We can change your treatment plan quickly if needed
- Getting help sooner often means you recover faster
Personal support
- You will get one-to-one support from a specialist who understands your condition
Works well
- Digital care is safe and has been shown to work just as well as in-person care for many problems
Helps you help yourself
- You’ll get clear advice and exercise plans where appropriate
- This helps you stay active and take control of your recovery
- Some apps can even remind you to do your exercises every day
“I’m not confident with technology”
- We keep things simple and easy to use
- We give step-by-step instructions
- People of many ages use these services successfully
“I don’t think it will work”
- Many patients have used our digital pathways
- Results from digital care are as good as those from in-person care
- We check your progress often and make changes if needed
“I want to see a clinician in person”
- Our specialists are experts in muscle and joint problems
- They are experienced in helping people through video or online appointments
- If you are eligible for an in-person appointment, we will arrange it for you
“How can you check me without touching me?”
- Most MSK problems can be diagnosed without a clinician needing to examine you by touch
- We can watch how you move and may ask you to do certain movements to help identify what’s going on
- If needed, we will arrange an in-person appointment
“I don’t have the right device or internet”
- Let us know and we can explore other options if needed
Effective, safe and guided exercise
- Positive outcomes consistently reported by attendees
- Sessions are led by trained professionals
- Exercises are safe and suited to you
- The structure helps you stay on track
- Exercising in a group can feel more fun
Meeting others
- You can share experiences with other people
- It can feel good to see you’re not alone
- You may even make new friends
Motivation and confidence
- Being in a group can help you stay motivated
- It can encourage you to keep going
Privacy and comfort
- You might feel shy sharing personal information in a group
- You can always talk to staff privately
- You might feel unsure about exercising in front of others
- You can always ask for help
- Everyone else is in the same situation as you
- You can always go at your own pace
Confidence worries
- You might worry it won’t suit you
- Our clinicians will adapt exercises to suit each person
- You can always give feedback to your clinician to help make you more comfortable
- You might wonder if it will help your problem
- The advice and exercises you are given are all designed specifically to help your condition
- We have consistently positive outcomes from our group classes
Time and commitment
- You need to attend regularly
- This helps build a routine
- Your condition will only get better with regular exercise, and attending classes help to keep you on track
Emotions and worries
- You might worry about being judged
- Groups are friendly and supportive
- If you feel uncomfortable, let your clinician know and they should be able to address your concerns
- You might worry about keeping up
- Everyone goes at their own speed
- There is no pressure to match others
"Virtual phone call, very helpful, compassionate and patient."
Circle Integrated Care patient, about their virtual appointment
"The staff have been supportive and the exercises I have learned have helped my arthritis pain. I have enjoyed attending the classes."
Circle Integrated Care patient, about their group class
"Very easy to use and having a virtual appointment was a great way to do it."
Circle Integrated Care patient, about their virtual appointment
"The service is very helpful. The exercise class was excellent and the clinician was very understanding."
Circle Integrated Care patient, about their group class
"The service offers a very efficient referral process with excellent communication. I was offered a virtual appointment within a few days and the early time slot fitted in with my work pattern. The physio explained everything clearly and emailed links to exercises."
Circle Integrated Care patient, about their virtual appointment