Integrating Muscular Skeletal therapy services in Cornwall

South West PeninsulaMusculoskeletal
Start Date: 1 Oct 2016 End Date: 2 Feb 2017

PenCHORD - Integrating Muscular Skeletal therapy services in Cornwall


Royal Cornwall Hospital Treliske (RCHT) and Cornwall Partnership NHS Foundation Trust (CPFT) have been operating separate outpatient services for Muscular Skeletal therapy and there is now a process of integration to operate the two services together. These services have been operated at different sites throughout Cornwall with some variation in what therapy services are provided and the staff providing them. This project brought together the data on both services to determine a set of optimal locations from which to operate the services and ensure that the service can cope with increased demand.

Project aims

The aim of this project was to determine how many sites and staff are required to ensure current activity levels can continue and where they should be located to minimise patient and employee travel time.

The research objectives were to:

  • Assess where patients using MSK therapy services currently are
  • Assess where people using MSK services are currently accessing those services and what their travel times are
  • Determine how many sites would be required to provide MSK therapy services for the current level of activity (plus 5%, 10% and 15% activity scenarios)
  • Determine how many staff would be required at each site to provide sufficient appointment capacity to meet the current level of activity (plus 5%, 10% and 15% activity scenarios)
  • Determine where the services would need to be placed to minimise patient and clinician travel time

Outputs and impact

A set of three maps was created which described where demand for MSK therapy services was coming from: one showing RCHT (Royal Cornwall Hospital Treliske) patients, one for CPFT (Cornwall Partnership Foundation Trust) patients, and one for the combined patient data. The project team calculated activity levels for each site and mapped out travel times from each postcode sector in Devon to each site. 

This data was used to inform a geographic optimisation model which enabled the PenCHORD team to test out different locations for the combined sites and demonstrate their impact on patient travel time and numbers of appointment slots. Using this model, the team provided a set of best locations for the combined services, to make the best use of resources and minimise patient travel time. 

These recommendations are anticipated to inform the review of the RCHT and CPFT integrated MSK therapy service provision for Cornwall, which will begin in April 2017. 

Sally Kennedy, Strategic Lead for Therapies at RCHT/CPFT, said the modelling project had "been invaluable to this integration project and will enable us to go ahead with plans which have a good evidence base.” 

Dr Sean Manzi