Paediatric musculoskeletal triage in the community RightPath: A pilot study

Referral pathways for children and young people (CYP) are often complex, protracted and inefficient, with evidence of variation in access to care. Specialist hospital-based services are under pressure, with increasing numbers of referrals and long waiting times. Right Path was developed as a CYP community-based triage, based on an adult musculoskeletal (MSK) model developed by Pennine MSK Partnership Ltd (PMSKP).

RightPath supports allied health professionals with paediatric expertise to promptly identify referrals for CYP with MSK pathology and triage them to the appropriate service (rheumatology, orthopaedics, neurodisability or urgent care), and to manage those who do not need specialist referral appropriately within the community (by physiotherapists and podiatrists). Triage and referral guidance were developed in partnership with MSK specialists and primary care, and build on Paediatric Musculoskeletal Matters (pmmonline.org), a website that aims to increase awareness and knowledge to facilitate care of CYP with MSK conditions. The RightPath pilot study in 2017-2018 tested safety, feasibility, acceptability and transferability of triage in two UK localities with emphasis on the educational requirements of the triage guidance for healthcare professionals who may not be expert in CYP MSK disease. Work was undertaken at PMSKP in primary care with iteration of triage guidance and process followed by roll out at second site South Tyneside NHS Foundation Trust (STFT) to test for transferability of the model.

RightPath is a model that aims to go beyond finding solutions locally, and has excellent transferability potential in other healthcare contexts, both in the UK and internationally. Since the pilot we have developed a live website www.rightpath.solutions which provides resources to allow services to integrate the model. NICE have also commissioned RightPath as the basis of their Clinical Knowledge Summary – Developmental Rheumatology in Children. RightPath has also been nominated for a Health Service Journal Award, in the category of Primary Care Innovation Initiative. For further information please see the links below.

http://www.rightpath.solutions                                                 http://cks.nice.org.uk

Contact us: http://rightpath@newcastle.ac.uk