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Advance Clinical Practitioner (ACP), Laura Gotting who is involved in triaging patients referred to Surrey iMSK for treatment, describes her typical day when she is on triage.

A patient is normally referred into the system by their GP and each referral is then triaged to help direct the patient to the right part of our service.

We have triage twice a week – one morning and one afternoon session. The sessions will be attended by myself, a consultant and a GP with a special interest in orthopaedics or pain management. Consultants will rotate depending on the Service Planner.

Triage is also very much done with our biopsychosocial model in mind and pathways considered which will fulfil the medical, psychological and social needs of each patient.

One of our meeting rooms has been equipped with large screen televisions on which we can access, each of the referrals with their case notes and patient record. It is at this point where we decide what the priority is for the patient and use a description that tells the patient and clinical team what happens next. If a patient needs more imaging we say “Straight to test” or if at the triage stage we feel that the best option is surgery then they go to a consultant for expert assessment and surgical opinion.

Sometimes patients may go straight to test so that we can establish what the best next steps are for them and when the imaging comes back to the triage team we can see where next the patient will need to go. Each of these steps is also discussed with the patient to ensure they understand what is happening and how it will positively affect their treatment.

We have a number of clinics where other ACPs work from and they are:

  • Lower Limb clinic
  • Upper Limb clinic
  • Spinal clinic
  • Rheumatology clinic
  • Hand clinic
  • Pain clinic

We have monthly MDT meetings for each of these disciplines and at these we also discuss some of the complex cases giving us an overview and how we can treat patients in a more integrated way. Patients benefit from our process because they are seen in a more effective way that provides them with the most appropriate treatment in the shortest time possible.

I am a trained physio and work in a mix of Advance Practitioner Clinics and am currently undertaking training to assist with the Rheumatology discipline of the service.