How can Clinic 360 help NHS Commissioners?

It is no secret that the NHS needs to continue delivering high quality clinical care whilst making financial savings.
A better service for less money. Can this really be achieved?

Clinic 360 is a clinician led service and as such holds expertise in the management of MSK / physiotherapy and orthopaedic patients.

From extensive involvement in many different NHS working environments it has been possible to identify significant gaps in service provision and develop a clinical process that avoids these common mistakes.

Common clinical mistake

The main problem in financial and time inefficiency is the lack of clinical diagnosis at the onset of the patient’s journey.

Within this website Clinic 360 discusses ‘Understanding pain’ and details how a description of pain is not diagnostic. Therefore, any clinical pathway that solely uses a measure of an individual’s pain experience to determine treatment or onward referrals will suffer inefficiencies.

Furthermore, a referral pathway that relies heavily on investigation to make a diagnosis will also increase expenditure and lengthen most patients’ time to treatment. It has been observed during extensive NHS work that the majority of patient investigations fail to change treatment pathways. Consequently, for many clients, the investigation is an unnecessary time delay and an unnecessary expense for the Commissioners.

A practical solution

With an appropriate clinical examination that includes sonography, the vast majority of MSK pathology is identified during the first visit. This enables appropriate treatment to be initiated without delay.

With a tissue-based diagnosis, supported by ultrasound images the client can often see the true nature of their problem.  This level of visualisation, where the client observes in real time the movement and potential dysfunction of their own tissues,  helps generate a clear understanding as to what is wrong.

Once a diagnosis has been made then many clients can follow online instruction to optimise their own home based self management rehabilitation programme. Please visit MSK360.co.uk , for an insight into how the prescribed programmes of rehabilitation provide essential follow up care that is freely accessible any time.

MSK 360 therefore provides a viable and cost free alternative to face to face appointments, telephone consultations and printed exercise sheets. ‘Instead of prescription medication, MSK 360 is prescriptive physical rehabilitation’.

It works because the clients have confidence in their diagnosis and the rehabilitation is accessible any time of the day.

It works for commissioning organisations because it is equitable, accessible, evidence based and provides a significant cost saving without compromising clinical care.

Proven record of clinic care

On average, previous NHS MSK work by the clinical team resulted in 80% of patients receiving definitive care with less than two appointments. No additional Physiotherapy, no additional tests, no repeat prescriptions.

The other key benefit delivered by Clinic 360, is that all practitioners are skilled in ultrasound guided injection therapy and pharmacology. As discussed in ‘Understanding pain’, most MSK problems are inflammatory and mechanical. With high levels of inflammatory activity, ultrasound guided injections supress the inflammation and then the muscle activation exercises (MSK 360) correct the mechanical dysfunction.

Appropriate seamless integration with other providers

Clinic 360 recognises that not all mechanical abnormalities can be corrected with a modification of movement and therefore surgery needs to be considered. With ten years of close working partnerships with Orthopaedic Consultants, previous NHS work resulted in a 95% surgical conversion rate. More important for Commissioners is that only 8% of all referrals into MSK were referred into secondary care. The cost savings on eliminating inappropriate secondary care activity are significant.

By establishing a tissue based diagnosis or, as important, by the exclusion of tissue damage, Clinic 360 can accurately identify patients for whom their experience of pain is the main problem. For these individuals, best management needs to include Pain Management services.

The high cost of inappropriate referrals.

The money spent on patients referred to Orthopaedics, when the individual actually has chronic pain, and the number of persons referred to pain management when they actually have significant tissue damage, is an unnecessary financial cost to the commissioners and time of frustration that the individual should not have to suffer.

This financial waste is significant and occurs on a daily basis because of a failure to make an accurate diagnosis at stage one of the clinic pathway.

In summation

Clinic 360 will assess, diagnose, and treat 80% of all MSK referrals in less than two visits. No additional expense, no time delays, short waiting lists and a clinical approach helps to construct a future health empowered population.

The remaining 20% of patients are accurately referred for either surgical intervention, rheumatology or Pain Management.

This winning formula has been proven in the NHS workplace. This is not wishful thinking, it is a demonstration of how the application of evidence based practice can and should be operating within National Health Service.

In case you need more convincing

Clinic 360 determine tissue based pathology within a framework that understands the multiple complexities that construct chronic pain.

Clinic 360 deliver on treatments proven to resolve tissue-based problems. We then provide the client with appropriate education, support and motivation and then monitor as the individual helps to restore their own very best health.

With physical health improvements and decreased psychological concerns and appropriate knowledge on self-management, both pain and financial expense are significantly reduced.

If your Commissioning organisation need a clear financial reason as to why Clinic 360 should be part of your service delivery, then please review our price list and compare with your current provider.

Assessments
Assessment £65
including ultrasound investigation and patient education
Typical NHS contract fees: 1st Appointment physiotherapy £39
1st Appointment orthopaedics £143
Ultrasound scan £80-120
Treatments
Ultrasound guided injections £75
Typical NHS contract fees: £200-1200+
With advanced Ultrasound equipment and injection skills Clinic 360 also deliver intra articular hip and spinal facet joint injections. These have an excellent outcome when diagnosis is correct. Unfortunately for patients, with a high cost of £600+ many Commissioning bodies have stopped payment for hip and spinal injections. At Clinic 360 we administer by Ultrasound guidance and therefore avoid hospital theatre prices. This is welcomed by many clients.

With Clinic 360 and MSK 360 many follow up appointments aren’t required because the patient has an established diagnosis and access to video guidance for their rehabilitation. This provides 24 hours access every day of the year and further enhances self-management and patient empowerment.

Appointments
Clinic 360 follow up appointments Free-£40
Typical NHS contract fees: Physiotherapy £29
Orthopaedics £79

If there is still any doubt as to how Clinic 360 can help your Commissioning organisation please contact us and to discuss further.

Your pathway to better physical well-being

Our team

Josh Wheatley
MSc Phys, MCSP, HCPC, PgC med ultrasound

Chris Creaghan
BSc(Hons) Phys MCSP , HCPC, Dip Ortho Med, Dip Inj Therapy, Independent Prescriber