{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T19:40:01Z","timestamp":1756669201624,"version":"3.44.0"},"reference-count":19,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Sport Exerc Med"],"accepted":{"date-parts":[[2015,8,13]]},"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Musculoskeletal (MSK) symptoms are common within primary care but some general practitioners (GPs)\/family physicians do not feel comfortable managing these symptoms, preferring to refer onwards. We aimed to establish a reproducible GP-staffed MSK and sport and exercise medicine (SEM) clinic within primary care, in keeping with recent policy changes within the UK health system.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A monthly MSK and SEM clinic was held within a Belfast GP practice, staffed by 1 GP with a specialist interest in MSK\/SEM conditions, and its performance was reviewed over two 3-month periods. Parameters audited included diagnoses, patient satisfaction and secondary care referral rates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>83 patients, 36 males and 47 females, were reviewed in the clinic and the main presenting joint was the shoulder. Patient self-reported satisfaction with the service was high. Comparing referral rates between August and October 2013 and the same period in 2014, overall referrals from the practice were reduced by 147, orthopaedic and rheumatology referrals were reduced by 2 and 3, while physiotherapy and X-ray referrals were reduced by 47 and 90, respectively. Comparing the referral rates between January and March 2014 and the same period in 2015, overall outpatient referrals were reduced by 152, orthopaedic and rheumatology referrals were reduced by 9 and 4, while physiotherapy and X-ray referrals were reduced by 41 and 3, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>We present a novel, reproducible service model for managing MSK\/SEM symptoms in primary care which could be commissioned by local groups. This model can make sound economic sense and deliver high patient satisfaction within primary care, reducing waiting times and the secondary care referral burden.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsem-2015-000027","type":"journal-article","created":{"date-parts":[[2015,11,2]],"date-time":"2015-11-02T19:59:48Z","timestamp":1446494388000},"page":"e000027","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["A \u2018novel\u2019 model for integrating Sport and Exercise Medicine (SEM) and Musculoskeletal (MSK) management into primary care in the UK"],"prefix":"10.1136","volume":"1","author":[{"given":"Neil","family":"Heron","sequence":"first","affiliation":[{"name":"Department of General Practice and Primary Care, Queen's University Belfast, Belfast, Northern Ireland"},{"name":"Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland"},{"name":"UKCRC Centre of Excellence for Public Health (NI), Queen's University Belfast, Belfast, Northern Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,9,15]]},"reference":[{"key":"2025083112175105000_1.1.e000027.1","first-page":"7","article-title":"Measuring disease prevalence: a comparison of musculoskeletal disease using four general practice consultation databases","volume":"57","author":"Jordan","year":"2007","journal-title":"Br J Gen Pract"},{"key":"2025083112175105000_1.1.e000027.2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-11-144"},{"key":"2025083112175105000_1.1.e000027.3","doi-asserted-by":"crossref","unstructured":"Goff I , Wise E , Coady D , et al . Musculoskeletal training: are GP trainees exposed to the right case mix for independent practice? Clin Rheumatol 2014. Published Online First.","DOI":"10.1007\/s10067-014-2767-z"},{"key":"2025083112175105000_1.1.e000027.4","first-page":"1","article-title":"Norway: health system review","volume":"15","author":"Ringard","year":"2013","journal-title":"Health Syst Transit"},{"key":"2025083112175105000_1.1.e000027.5","unstructured":"Department of Health, Social Services and Public Safety Northern Ireland. Transforming Your Care\u2014a review of Health and Social Care in Northern Ireland. Transforming Your Care Report. December 2011."},{"key":"2025083112175105000_1.1.e000027.6","doi-asserted-by":"crossref","unstructured":"Heron N . Musculoskeletal (MSK) and sport and exercise medicine (SEM) in general practice (GP): a novel GP-based MSK and SEM clinic for managing musculoskeletal symptoms in a GP. BMJ Qual Improv Rep 2015;4. doi:10.1136\/bmjquality.u207172.w2905 doi:10.1136\/bmjquality.u207172.w2905","DOI":"10.1136\/bmjquality.u207172.w2905"},{"key":"2025083112175105000_1.1.e000027.7","doi-asserted-by":"publisher","DOI":"10.1136\/qhc.9.4.210"},{"key":"2025083112175105000_1.1.e000027.8","unstructured":"Arthritis Research UK. Patient information leaflets. Arthritis Research UK website, 2014."},{"key":"2025083112175105000_1.1.e000027.9","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092499"},{"key":"2025083112175105000_1.1.e000027.10","unstructured":"Belfast Health and Social Care Trust. Annual Report and Accounts 2013\/14\u2014Belfast Trust. Annual Report and Accounts 2013\/14 2014;1(1):1 ."},{"key":"2025083112175105000_1.1.e000027.11","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.amjmed.2011.08.022","article-title":"Safety of arthrocentesis and joint injection in patients receiving anticoagulation at therapeutic levels","volume":"125","author":"Ahmed","year":"2012","journal-title":"Am J Med"},{"key":"2025083112175105000_1.1.e000027.12","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1007\/s10067-013-2350-z","article-title":"Safety of joint and soft tissue injections in patients on warfarin anticoagulation","volume":"32","author":"Conway","year":"2013","journal-title":"Clin Rheumatol"},{"key":"2025083112175105000_1.1.e000027.13","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092700"},{"key":"2025083112175105000_1.1.e000027.14","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-13-138"},{"key":"2025083112175105000_1.1.e000027.15","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20100104-09"},{"key":"2025083112175105000_1.1.e000027.16","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512471299"},{"key":"2025083112175105000_1.1.e000027.17","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-13-229"},{"key":"2025083112175105000_1.1.e000027.18","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker303"},{"key":"2025083112175105000_1.1.e000027.19","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-093281"}],"container-title":["BMJ Open Sport &amp; Exercise Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsem-2015-000027","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T19:18:02Z","timestamp":1756667882000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopensem.bmj.com\/lookup\/doi\/10.1136\/bmjsem-2015-000027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2015,9,15]]},"published-print":{"date-parts":[[2015,9]]}},"alternative-id":["10.1136\/bmjsem-2015-000027"],"URL":"https:\/\/doi.org\/10.1136\/bmjsem-2015-000027","relation":{},"ISSN":["2055-7647"],"issn-type":[{"type":"electronic","value":"2055-7647"}],"subject":[],"published":{"date-parts":[[2015,9]]}}}