Musculoskeletal Physiotherapy

Referral inclusion criteria

• Patients must be registered with a Barnet GP and with a musculoskeletal condition.
• Patients must be able to attend the clinic.
• Patients must be able to engage and be medically stable.
• Spinal and Peripheral joints problems
• Following surgery or out of brace following fracture
• Acute sports and soft tissue injuries

Referral exclusion criteria

• Patients not registered with a GP in the London Borough of Barnet
• Serious pathology/ Non-urgent “red flag” conditions should be referred directly to secondary care.
• Lumps and bumps including ganglions.
• Inflammatory conditions e.g. Rheumatoid arthritis,
• Heritable Connective Tissue Disorders (HCTDs) e.g. gout, polymyalgia rheumatica, Ehlers Danlos syndrome (conditions with a background of fibromyalgia or hypermobility can be seen unless a diagnosis is required, or systemic features are prominent).
• Non-musculoskeletal conditions (respiratory/ neurology/vestibular/ falls)
• Emergency referrals may be sent to emergency department i.e. acute fractures, suspected cauda equina requiring immediate care.
• Patients seen in the service within the last 6 months for the same condition.
• Housebound patients

Referral inclusion Criteria

• Aged 4-17 years
• Patients registered with a GP in the London Borough of Barnet
• MSK issues (e.g. ankle sprain, anterior knee pain, Osgood Schlatter, Severs disease, back pain.
• Simple hypermobility with single joint pain. No systemic/extra-articular features of Ehlers Danlos.
• Simple tip-toe walking/ in-toeing gait in children with no additional needs.

Referral exclusion criteria

• Over 17 years
• Any child under the age of 4. (These should be sent to Barnet Children’s Integrated Therapies)
• Any child with more complex needs e.g. ASD, LD, neurodevelopmental issues (these should be sent to Barnet Children’s Integrated Therapies)
• Chronic fatigue syndrome (these should be sent to UCLH)
• Systemic/extra-articular features of Ehlers Danlos.
• Symptomatic pes planus (this should be referred to CLCH podiatry) Foot conditions can go to orthotics for review.
• Diagnosed with scoliosis, multiple joint involvement, hypermobility with other systemic symptoms/signs, requiring multi-disciplinary input or other complex presentation. No post operative or post fracture. (speak with a senior clinician), refer back to the GP advising the following: Please refer the patient to the Stanmore scoliosis centre for scoliosis or other specialist paediatric services in Barnet

Referral inclusion criteria

• Aged 18 and over and registered with a GP in the London Borough of Barnet
• Pelvic floor dysfunction (weakness, overactivity, poor coordination)
• Urinary incontinence (stress, urge, mixed types)
• Faecal incontinence or bowel dysfunction
• Pelvic organ prolapse (mild to moderate, non-surgical cases)
• Antenatal and postnatal issues (antenatal pelvic girdle pain, postnatal recovery up to 6 weeks)Pelvic pain syndromes (dyspareunia, chronic pelvic pain, vulvodynia
• Sexual dysfunction related to pelvic floor
• Post-surgical rehabilitation (after gynaecological/urological procedures)
• Coccyx pain
• DRA

Referral exclusion criteria

• Under 18 years (should be referred to paediatric continence service)
• Patients not registered with a GP in the London Borough of Barnet
• Pregnancy-related pelvic/back pain beyond 6 weeks postpartum (to be seen in MSK)
• Extensive or complicated surgery requiring specialist intervention
• Neurological conditions (e.g., multiple sclerosis, spinal cord injury)
• Housebound patients (need community or home-based services)
• Active infections, malignancy, or unexplained bleeding
• Erectile dysfunction

Referral inclusion Criteria

• Patients aged 18+ and registered with a Barnet GP with an MSK condition.
• Patients who have failed to respond to conservative management, including physiotherapy.
• Complex presentation which may not be suitable for routine physiotherapy due to diagnostic uncertainty.

Referral exclusion Criteria

• Paediatric patients aged <18 years
• Patients with suspected red flag pathology such as cauda equina or suspected malignancy.
• Patients with suspected fractures
• Inflammatory presentation or persistent pain management
• Patients with lumps and bumps including ganglions/baker’s cyst.
• Patients with Dupuytren’s contractures