Muscle joint and bone concerns are very common and affect 1 in 4 adults in Wales. They involve the moving parts of your body and can affect your daily activities, work and hobbies.

They can result from an injury or develop gradually.

Often they are felt as pain, difficulty with movement and unpleasant feelings in your body.  They can feel better or worse with movement or rest.

You may have been told that you have low back pain, shoulder pain, knee pain, sciatica, frozen shoulder, tendonitis, osteoarthritis, a strain or a sprain. For many of these concerns simple self-management advice helps and is all that is needed.

Some people may be confused about why the form used on the MoveBetterGwent system is called a request for help form and not a self-referral form.

This is because the best way to help someone might not be to refer them to be seen by a health team. The decision is based on what people tell us about their condition and how it is affecting them. This is why it is important that you give as much information as you can within the form about when and where the bone, muscle or joint problem is affecting you and what this means to you.

We know that for some people, waiting to be seen by health teams is not helpful and can lead to further problems with their bone, muscle or joint problem. The best way to support someone might be to guide them to self-help information or to a community group. This might be all that is required or might be in addition to referral to a specific service.

Where appropriate, the request for help form will act as a referral to a specific health or care team and the information you provide will be passed to the relevant team to help plan your assessment and treatment.

A team of health professionals who work in a ‘hub’ will read the information you have provided about yourself.  They may also look at your previous health records and investigations to gain a full insight into your concern and your needs.

It is sometimes necessary for them to contact you for further questions.  This will be to help them understand how best to support you.

The health professionals are supported by an administration team to ensure your self-referral is processed efficiently and that you can access the support that you need.

There are a number of different ways that you can be supported to manage your muscle, joint or bone concern.  Below are some examples of the types of help that can be offered when you self-refer:

• Provide the right information and advice so that you can confidently manage your concern yourself
• Provide information on community support groups that you may wish to connect with
• Provide information on community-based activity/exercise groups that you may wish to attend
• Referral to a therapy team (e.g. Podiatry, Physiotherapy, Occupational Therapy, Dietetics)
• Referral to a community-based rehabilitation team
• Referral to the falls service
• Referral to a hospital-based team (e.g. Rheumatology, Orthopaedics, Radiology)

If you need an appointment, the service you are referred to will do this for you. 

Seeking further help – request for help process – movebettergwent

The clinical teams are interested to know what’s important to you in your life and want you to be involved in your healthcare decisions. We recognise that you are the expert of your own life and we are interested in your goals and best hopes for your treatment.

Questions for you

Rehabilitation is more successful when working towards specific activity or targets.  We refer to these as ‘goals.’

When thinking about your goals it may be helpful to consider what has changed or been affected as a result of your muscle, joint or bone concern.

You may wish to think about this from the point of view of:

• Your wellbeing
• Your daily activities
• Your work
• Your relationships

Questions for us

We want to encourage you to ask us questions and therefore make informed choices about your healthcare. During your appointments with us we will invite you to think about this.

We would like to invite you to think about these three questions with regards to your healthcare decisions:

1. What are my options?
2. What are the pros and cons of each option for me?
3. How do I get support to help me make a decision that’s right for me?

The Therapy Services are keen to support armed service veterans with their bone, muscle and joint health.

If you are completing a request for help form for a condition developed whilst in service, please identify this on the form. This will be taken into consideration if your request is passed to a health service for assessment or treatment.

If the condition you are contacting us for is not urgent but categorised as routine, your referral will be placed at the front of the routine waiting list. This means that you will be contacted to book an appointment by letter.

Not all MSK conditions require individual treatment from a clinician. Many people can successfully manage their own condition once they feel confident that they understand what is happening and how they can help it.

The MSK Teams will run sessions on a range of different conditions to provide you information on what that condition is, what the evidence says is helpful to manage it and what options you have.  The options will be different depending on each condition and the evidence base.

This information is applicable for face to face and virtual appointments.

During your assessment the clinician will need to ask you questions about your condition, as well as your general health and lifestyle. You may also be asked to complete questionnaires. The sort of questions you may be asked include:

• When and how your problem started?
• What makes your symptoms better and worse?
• What time of day are your symptoms better or worse?
• How the concern is affecting your day-to-day activities?
• What are you expecting from physiotherapy?
• What activities do you want to get back to doing?

Your clinician will need to examine you, so you may be required to partially undress. They will also need to find the positions or movements which give you difficulties and this may involve touching, moving or asking you to move a painful part.

The clinician will discuss and explain your treatment options. Due to the need to work on the area of your body that is painful, the treatments offered may be uncomfortable. If you find any part of the assessment or treatment too painful please inform the clinician immediately. If you are concerned about ongoing or new pain following an appointment, please contact the department to request advice as soon as possible.

We refer to a phone appointment or a video appointment as a ‘virtual consultation’.

You can tell the healthcare professional about your concern and your progress over the telephone or video call and discuss your management. Video calls give you the opportunity for you and your healthcare professional to see each other without you having to travel to appointments.

Many people are successfully supported by virtual consultations without them ever needing to attend for a face-to-face appointment.

If you have particular preferences about how you are supported you can discuss this with your healthcare professional.

Yes. Help can be provided for anyone with specific needs e.g. wheelchair use, hearing or sight impairments, autistic spectrum disorder, non-English speaking etc. Please contact us before your first appointment if you think you may require additional help.

• A list of medication you are currently taking
• A pair of shorts (if you have some) if you have a back, leg or mobility problem
• You may also wish to bring or wear a vest if you have an upper back, neck or arm problem
• Reading glasses (if you need them)
• If you are pregnant please bring your maternity notes with you
• Lightweight clothes and soft soled shoes for classes

Most initial appointments are between 20-60 minutes long. This will depend on your particular condition and circumstances.

You should be advised how long your appointment will be when you agree your appointment when you book.

Appointments usually run on time. On occasions your appointment may be a little late due to unforeseen complications. If this occurs, a member of staff will speak to you and explain the delay.

Please be on time for your appointment. If you are late there may not be enough time for your appointment and your appointment may have to be rebooked.

Under normal circumstances you are welcome to bring someone. This may have to change depending on infection prevention processes in use at the time of booking. This means that you may not be able to bring anyone with you into the clinic room. This will be explained to you as part of the appointment booking process. If you are unsure, please ask the team.

If you need an interpreter or wish a chaperone to be provided, please let us know in advance and we will try our best to make one available.

Please let us know on your request for help form or as soon as possible and we will do our best to arrange this.

All clinicians working in the Health Board registered with the relevant professional governing bodies (e.g. GMC, NMC, HCPC). Clinicians may delegate some aspects of your care to a clinical support worker who has been trained to assist in delivering elements of your care. Please feel free to ask to speak with your clinician if you would like to discuss your case.

You may be asked if you are happy to be assessed and treated by a student. All students will have a senior clinician supervising their work, though the visibility of the supervision will vary dependent on the student’s experience. Please ask to talk with the supervisor if you would like to discuss your case or have any concerns. If you prefer not to be treated by a student, this will not affect the quality of your treatment in any way.

Yes, it is your choice to consent. You are always free to say no, or to ask for more information before you make up your mind.

We would like to invite you to always think about these three questions with regards to your healthcare decisions:

1. What are my options?
2. What are the pros and cons of each option for me?
3. How do I get support to help me make a decision that’s right for me?

Missed appointments within health departments means wasted treatment time which could be used for other patients. We therefore follow a strict policy for managing this situation.

If you are unable to attend for your first or any subsequent appointments please contact the department as soon as possible before your appointment date so the appointment can be offered to another patient.

If you fail to attend an appointment without prior notification or cancel two consecutive appointments you will be discharged. Only in exceptional circumstances that are outside your control will you be offered another appointment.

We are always grateful for feedback from patients and welcome your ideas to improve the service.

We would encourage you to use the experience questionnaires as the services use this as a way to monitor experience and identify areas for improvement.

If you have any concerns we encourage you to raise them at the time either with your clinician directly or with the local department manager. The contact telephone number is available on the appointment letter or card. They will do all they can to help you.

If you would prefer to speak to someone independently you can contact the Health Board call centre 01495 745656. There are also leaflets available in departments which explain the Health Board complaints procedure ‘Putting Things Right’.

Aneurin Bevan University Health Board aims to provide safe, high quality services to all service users. The Health Board has a zero tolerance approach towards violence and aggression against our staff and on our premises and may utilise CCTV and/or audio recording devices whenever personal safety is threatened. Evidence obtained will be used to secure sanctions against perpetrators.

To request help or self refer to the MSK hub, you need to be a resident of the Aneurin Bevan University Health Board catchment area or have a GP within the Health Board area.

The boroughs covered by the Health Board are:

• Blaenau Gwent
• Caerphilly
• Monmouthshire
• Newport
• Torfaen

If you are not eligible but need advice about a MSK problem, please speak to your GP or review the web pages for your Health Board area to find out if you can refer yourself to a local MSK service.

We use outcome measure and experience questionnaires to help us

• identify which service or approach might be the most appropriate for you
• understand whether the services we are providing are helpful for you and you found them easy to use
• understand the advice or treatment you are following is effective
• map needs for the population of Gwent

These questionnaires may be asked at the start, at points through your journey and following your discharge. The questionnaires or surveys may be electronic or paper based and it is your choice to complete them. You are always free to say no, or to ask for more information before making a decision.

Our Health – Our Knowledge is a short web course is designed to help people who are thinking about choices in healthcare. That includes patients, family members, carers, healthcare students, healthcare professionals, and policy makers.