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Case study
Ten years ahead of the left shift
We have delivered the diagnostics for integrated musculoskeletal services in Central and East Sussex since 2014: community-based, shared decision making with patients, and fewer unnecessary interventions. The model the NHS is now moving towards is one we have been running for over a decade.
The service
Integrated musculoskeletal services bring assessment, diagnostics, physiotherapy and specialist opinion together into a single community pathway, so that a patient with back, joint or soft tissue pain is managed as one episode rather than passed between separate hospital departments.
Medical Imaging Partnership has provided the diagnostic layer of that service across Central and East Sussex since 2014. Imaging is requested directly within the pathway, delivered in the community, and reported by subspecialist musculoskeletal radiologists whose reports are written to guide the next clinical decision rather than simply describe what is visible.
Why it was ahead of its time
The NHS 10 Year Health Plan sets out three strategic shifts: hospital to community, analogue to digital, and sickness to prevention. Integrated MSK in Sussex was doing the first of those in 2014, a decade before it became national policy.
The pattern is the one the plan describes. Diagnostics sit at the front of the pathway rather than behind a consultant appointment. The scan happens near the patient rather than at an acute site. And the report enables a decision in primary or community care, so the hospital referral that would once have been automatic becomes the exception.
Shared decision making, not just faster scanning
The point of putting diagnostics early in an MSK pathway is not speed for its own sake. It is that a clinician and a patient can have an informed conversation sooner, with the imaging findings in front of them.
That conversation frequently concludes that conservative management is the right answer: physiotherapy, activity modification, pain management or watchful waiting rather than an intervention. A pathway that surfaces that earlier spares the patient an unnecessary procedure and returns the capacity to the people who genuinely need it.
What it means for partners now
Commissioners planning neighbourhood MSK provision are frequently asked to take the model on trust. In Central and East Sussex it does not need to be taken on trust: it has been running since 2014, through multiple contract cycles, with published quality reporting.
We bring the diagnostic infrastructure, subspecialist reporting network, clinical governance and operational delivery. Clinical leadership and the patient relationship stay with the partner. There is no capital requirement.
Planning a community MSK pathway?
We have been delivering the diagnostics for one since 2014. Let's talk about yours.