Here you will find answers to some of our patients frequently asked questions, along with some general information to help you prepare for your appointment.

Why am I being seen by the Sussex MSK Partnership?

Sussex MSK Partnership (Central) is the local NHS organisation responsible for treating patients with bone, joint and muscular problems, including rheumatism, arthritis and chronic pain. MSK stands for ‘musculoskeletal’. We aim to get patients on the right course of treatment as soon as possible, through self-management advice, physiotherapy, medication, surgery or other medical interventions.

We want to make your care as straightforward as possible, by providing one point of contact as close to your home as possible. We believe you should be in control of what happens, get choice of where to go, be involved in decisions about care and treatment and supported to better manage your condition.

All patients across Brighton and Hove, Crawley, mid-Sussex and Horsham with a musculoskeletal (MSK) condition are referred to our service. Referrals are assessed (or ‘triaged’) by specially trained clinicians who are up to date on best practice. They look at the information in the referral and decide the best course of action.

Very often the next step will be an appointment at a local community clinic with the most appropriate clinician to deal with your health problem. This will be one of the following:

Physiotherapist

Doctor (Consultant, Registrar, GP who has been specially trained in MSK conditions)

Nurse Specialist

Podiatrist (if it is a foot problem)

Advanced Practitioner (AP) – this is a clinician with advanced knowledge and skills and will be from one of the following professional backgrounds: Osteopath, Occupational Therapist, Physiotherapist or Podiatrist.

Whenever you have contact with the Sussex MSK partnership, you should be treated fairly, regardless of race, sexuality, disability, age, gender or religion. We take the safety of all patients using services seriously and are committed to ensuring that all patients feel safe.

What help is available to get me to my appointment?

The Sussex Non-Emergency Patient Transport Service (NEPTS) is responsible for safely and effectively transporting eligible patients who are in receipt of NHS funded healthcare. NEPTS provides transport for treatments for patients who have a medical reason that means they are not able to travel by another method. It includes the following journeys:

  • To a planned outpatient appointment
  • To hospital for a planned admission
  • Home from hospital following discharge
  • Home to Sussex from hospitals in other areas of the country

Please not this does not include primary care appointments such as GP or dentist appointments, or visits to a pharmacy.

Eligibility:

To be able to use the Sussex NEPTS, patients must meet the eligibility criteria (see below). Patients will be asked questions about their eligibility (which have been developed in conjunction with clinical experts and patient representatives). If the patient is eligible for Sussex NEPTS, you will be offered transport regardless of distance and your circumstances.

Criteria for Non-Emergency Sussex Patient Transport Services

Patients are responsible for arranging and funding their own non-urgent transport to and from healthcare facilities, unless medical transport is required. The NHS is not required to fund, or provide, transport for patients without an applicable medical condition, for social or financial reasons, or to private patients. Patients on a low income who require financial assistance may be supported by the Healthcare Travel Costs Scheme (subject to their individual eligibility). See section below for further information on this.

The NHS expects patients to make their own way to and from healthcare facilities unless there is a clearly defined medical reason why they cannot use conventional transport options. This includes public (e.g. buses and trains) and private (e.g. cars, bikes and taxis) transport, and lifts from the patient’s support network (e.g. friends, carers, neighbours, relatives).

Principles

Not all patients attending a health facility will be entitled to patient transport. The principle for the entitlement is defined as:

  • The patient has a medical condition such that they require the skills of ambulance staff or appropriately skilled personnel on, or for the journey; and/or
  • Following a documented clinical decision, it has been determined that the medical condition of the patient is such that it would be detrimental to their condition or recovery if they were to travel by any other means.

Patient Transport will be provided to patients who meet one or more of the following criteria:

  • They cannot manage any journey in private or public transport for the activities of daily living due to current mobility issues or mental health condition;
  • They are unable to travel by private or public transport for the activities of daily living due to their disability, and are not in receipt of an enhanced mobility element of the Disability Living Allowance (DLA) or Personal Independence Payment (PIP) as this allowance covers the costs of their transport to and from healthcare appointments. However, these patients may be entitled if they have a temporary medical need (e.g. a leg in plaster) unrelated to the condition(s) for which they receive their mobility allowance, or if they are found eligible for PTS under any of other criteria. In these cases, eligibility will be assessed via the standardised process, applying the remaining criteria.
  • They are attending for active treatment which causes them physical side effects;
  • They attend frequent, reoccurring healthcare appointments for the same condition, who are deemed eligible for PTS by a clinician at their treatment centre; or
  • They are unable to travel via alternative means for the activities of daily living because it would be detrimental to their current medical condition.

Escorts

All requests for a patient to travel with an escort (e.g. a relative or carer) to provide support or supervision during their journey must be made at the time of booking.

Escort requests will be approved for eligible patients who meet the following criteria:

  • Aged 16 or under;
  • A disability that prevents them travelling alone on private or public transport, where the escort will provide an enhanced level of care not available from the PTS crew, both during the journey and at the destination;
  • A current mental or physical health problem that prevents them travelling alone; or
  • A medical condition that requires constant supervision for their safety or the safety of others.

Escort requests for patients to travel with a dependent who does not meet the criteria above will be reviewed by exception.

Community Transport Services

If the patient is not eligible for patient transport services or need transport to a GP, the patient will need to contact their local community transport service. If you would like to find what community transport services are available in your area please click here (please note this is not an exhaustive list and other transport services may be available) or contact your local council who have details of alternative transport options in your area. The Healthcare Travel costs Scheme may also provide help with the cost of fares: see here.

Community transport can be used by everyone in the community. Some operators only carry selected groups, but you should contact operators in your area to see if you could use the service.

Each transport operator sets their own fares. These are usually based on distance and whether a single or return journey is required. Some operators may accept Concessionary Travel passes, but you should always check with them before your journey. To find out more about a service, please contact the individual operator

Healthcare Travel Costs Scheme

http://www.nhs.uk/NHSEngland/Healthcosts/Pages/Travelcosts.aspx

If a patient has been referred to hospital or other NHS premises for specialist NHS treatment or diagnostic tests by your doctor, dentist or another health professional, they may be able to claim a refund of reasonable travel costs under the Healthcare Travel Costs Scheme (HTCS).

This section explains who's eligible for the scheme and how they can make a claim.

Who can claim?

To qualify for help with travel costs under the HTCS, you must meet three conditions:

  • At the time of your appointment, you or your partner (including civil partners) must receive one of the qualifying benefits or allowances listed below, or meet the eligibility criteria for the NHS Low Income Scheme.
  • You must have a referral from a healthcare professional for a specialist or to a hospital for further NHS treatment or tests (often referred to as secondary care).
  • Your appointment must be on a separate visit to when the referral was made. This applies whether your treatment is provided at a different location (hospital or clinic) or on the same premises as where your GP or another health professional issued the referral.

Children and other dependants

You can claim travel costs for your children if you're eligible for any of the benefits described under condition 1 and your child has been referred for treatment as outlined in condition 2 and condition 3.

If your child is aged 16 or over, they may make their own claim under the Low Income Scheme.

Carers and escorts

You can claim travel costs for an escort if your health professional says it's medically necessary for someone to travel with you.

Some clinical commissiong groups (CCGs) may accept claims for help with travel costs if you're the parent or guardian of a child under the age of 16 who you have to bring to your appointment with you.

These payments are made on the basis of the patient's eligibility for the scheme, irrespective of the escort's eligibility.

Who can't claim help with travel costs?

You can't claim help with travel costs if:

  • you're visiting someone in hospital – but if you receive one of the qualifying benefits listed below, you may be able to receive assistance from your local council
  • you're visiting your local GP, dentist or other primary care service provider for routine check-ups or other services, such as vaccinations or cervical cancer screening, as these are excluded from the scheme – urgent primary care services during out-of-hours periods (between 6.30pm and 8pm weekdays, at weekends or on bank holidays) are also excluded

What are the qualifying benefits and allowances?

You can claim help with travel costs if you or your partner (including civil partner) receive any of the following benefits:

  • Income Support
  • Income-based Jobseeker's Allowance
  • Income-related Employment and Support Allowance
  • Pension Credit Guarantee Credit
  • you receive Universal Credit and meet the criteria

You can also claim for help with travel costs if:

  • you are named on, or entitled to, an NHS tax credit exemption certificate (if you don't have a certificate, you can show your award notice) – you qualify if you get child tax credits, working tax credits with a disability element (or both), and have income for tax credit purposes of £15,276 or less
  • you have a low income and are named on certificate HC2 (full help) or HC3 (limited help) – to apply for this certificate, you should complete form HC1 claim for help with health costs (PDF, 218kb), which is available from your local hospital, Jobcentre Plus offices, or the NHS print contract order line on 0300 123 0849

What form of transport can I use?

The NHS organisation handling your claim will base any refund on the basis of what would have been the cheapest suitable mode of transport for your circumstances, which can include your age, medical condition, or any other relevant factors.

This means you should use the cheapest, most appropriate means of transport, which in most cases will be public transport.

If you travelled by car and your claim was approved, you'll be reimbursed for the cost of fuel at the mileage rate used by your local clinical commissioning group (CCG). You'll also be able to claim for unavoidable car parking and toll charges.

When using a taxi for transport, it's recommended that you agree this in advance with the hospital or CCG before you travel. Find your local hospital.

Patients in London may be able to claim congestion charges – get more information on the Congestion Charge NHS Reimbursement Scheme operated by Transport for London.

Help with travel costs before your appointment

In most cases, you're expected to pay for your travel and claim back the costs. The majority of payments are made on the day of your appointment by the cashier. If a cashier isn't available, it's possible to claim in advance of travel or retrospectively using the HC5 (T) claim travel charges (PDF, 35.5kb).

The HTCS also allows advance payments to help you attend your healthcare appointments – for example, if you don't have the money to get to your hospital appointment and you're on a low income or benefits.

Advanced payments may also be issued if you're attending a hospital or NHS clinic that doesn't have a cashiers' office. Contact the hospital or relevant CCG to check.

How do I claim a refund?

You should take your travel receipts, appointment letter or card, and proof that you're receiving one of the qualifying benefits to a nominated cashiers' office to claim your travel costs.

Nominated cashiers' offices will be located in the hospital or clinic that treated you. They're responsible for assessing your claim and making the payment directly to you.

In some hospitals, the name of the office you need to go to may be different – for example, the General Office or the Patient Affairs Office. If you aren't sure, ask reception or Patient Advice and Liaison Services (PALS) staff where you should go.

If the hospital or clinic doesn't have a cashier facility, you can complete a HC5 (T) claim travel charges (PDF, 35.5kb) and post it to the address stated on the form. You can make a postal claim up to three months after your appointment has taken place.

Important numbers

  • Call 0300 330 1343 for the Low Income Scheme helpline
  • Call 0300 330 1341 for queries about medical exemption certificates
  • Call 0300 330 1349 for the prescription services helpline
  • Call 0300 330 1347 for queries about tax credit certificates
  • For all other queries, call 0300 330 1343

Brighton and Hove:

Bluebird patient transport

This community partnership provides patients with door-to-door independence if they have restricted mobility.

If they need to visit either the Princess Royal Hospital or Royal Sussex County Hospital sites the patient should call 01444 471919 (Mon-Fri from 9.30-11.30am). For an urgent request, please call 07711 034519 (Mon-Fri from 8.30am – 5pm).

For more information email bluebird253133@btopenworld.com.

Who will I see at my appointment?

You have an appointment with a clinician who is best able to deal with your condition. Please allow about 30 minutes for your appointment (this may be longer or shorter depending on your clinical need). During the consultation you will be able to discuss your history and symptoms and the clinician will assess your condition.

You will get a chance to talk about different options for treatment, and receive information that will help you manage your condition.  The clinician will explain any medical treatments available, including risks and benefits.

Medical students or other trainee clinicians or colleagues may be observing in the consultation, as part of their training or supervision. The clinician will ask your permission for this to happen and it will only happen with your consent.

How long can I expect to wait for my appointment?

Waiting times vary accross the service, but we aim to see all patients within 8 weeks of the referral having been recieved.

For the most up to date information please visit our waiting times page.

How can I prepare for my appointment?

Here are some questions that might be helpful in getting you to prepare for your appointment:

What are my current symptoms?

What things worry you most about your condition or your symptoms?

What are the most important questions you would like to ask?

What are your expectations following your appointment?

At the end of my appointment

It may be a good idea to write down the most important things discussed at your appointment, they following are some suggestions:

What is your understanding of your condition?  What has caused you symptoms?

What treatment options are available?  What are the pros and cons of each option?

What can you do to look after yourself?

What should I bring? What else do I need to know?

Please bring a list of your current medicines, including prescribed and non-prescribed medicines (e.g. over the counter medicines and supplements). You do not need to bring your medicines with you.

If you have had a scan or X-Ray outside your local NHS provider, please send us your CD and contact us to arrange for these to be available at your appointment. Please bear in mind that it can take a long time to get hold of these, so the sooner you can let us know the better.

If appropriate, you may be offered a steroid injection during the appointment. Your clinician will always discuss this and ask for your consent first. If you do have an injection, you will be advised to rest for 30 minutes afterwards, and then consider whether you are safe to drive home.

Depending on your condition, you may need to expose your shoulder(s), so you can be examined properly.

You are welcome to bring a relative or a friend to your appointment. Alternatively, we can arrange a chaperone if you would like someone to be with you. This is an independent person specially trained to support patients. Please let our team know on 0300 303 8063 before the appointment if you would like a chaperone.

I need an interpreter, how can I arrange this?

If you need an interpreter, please contact our team on 0300 303 8063 and we can arrange for one to be at the appointment with you. We can also arrange for interpreters for telephone appointments.

What will happen after my appointment?

You will be able to discuss with the clinician what will happen next which may be one or a combination, of the following things:

You may be discharged from the service.

You may be sent for further tests, such as a blood test, x-ray or MRI scan. For more information on tests within our service, please visit our Diagnostics page.

You may be offered a follow-up appointment, either on the telephone or face-to-face.

You may be referred to a hospital of your choice if further advice or treatment is required.

Whatever happens, you will receive advice on how best to look after yourself and manage your condition. If you have any other questions, please let us know by contacting 0300 303 8063 where our team will be pleased to help you.

How can I look after myself while I’m waiting to be seen?

Our specialist clinicians have compiled a selection of resources to help you manage your symptoms while you are waiting to be seen.

Foot & Ankle

Hand & Wrist

Shoulder

Elbow

Hip

Knee

Pain Management

Rheumatology

Spine 

Physiotherapy

You can also find further information about general health and other services on our Looking After Yourself page

How long will I need to wait to be seen?

You can find the latest wait times available on our waiting times page

I have been booked for an injection, what do I need to know?

Steroid injections are known to be a useful treatment for pain, swelling and stiffness within a joint or the area around the joint. The joint is injected with a preparation of local anaesthetic and corticosteroid. The anaesthetic aims to reduce the pain initially for 30 minutes and the corticosteroid aims to reduce the inflammation and therefore it may take up to 2 weeks for the effects of the injection to start working. The response to the injection varies from person to person but can last from several weeks to many months. There is some research to suggest that steroid may be harmful to tendon tissue so your clinician will discuss the risks and benefits for your condition on an individual basis.

There are some health conditions for which an injection of steroid and anaesthetic is restricted.

Please let us know of any of the following before you attend the clinic for an injection and your clinician will discuss these with you:

- Any open wounds such as leg ulcers or cellulitis at the site of the injection

- An artificial joint present in the area to be injected

- On any antibiotic treatment for an infection or within 48 hours of stopping

- Allergy to local anesthetic or steroid

- On immunosuppressant drugs e.g. for HIV or arthritis

- Are receiving any chemotherapy treatment for the management of cancer  

- Taking a blood thinner e.g. warfarin

- You have uncontrolled Diabetes Mellitus

- You are pregnant or breast feeding

- You have had a live vaccine within the past 4 weeks

- You have or have had Tuberculosis (TB) in the past

- You have had an adverse reaction to a steroid or anaesthetic injection in the past

 

What should I expect after my joint injection?

We advise you spend 30 minutes resting quietly in the clinic waiting area and make sure you feel well before you leave. Report to reception if you feel unwell.

- Avoid strenuous activity for the rest of the day.

- The injected area may be numb for up to 24 hours.

- The injected site may be sore for one to two days as explained in the side effects.

- Do not use heat pads or any other form of heat on the injection site for two days following the injection. You may however choose to use an ice pack on the injection site for pain.

- For a weight bearing joint we recommend that you rest and gently potter at home for 2 days after your injection to improve the likelihood of a good response.

- You may develop a bruise at the injection site.

Most people notice improvement in their pain in 2 weeks. Maximum improvement of your pain may take up to 6 weeks following your injection.

If you are having a vaccination within 4 weeks of your injection please contact your GP

IMPORTANT: If you develop a rash or if the injection site is red, hot, swollen or painful, you may be developing an infection. Please contact the musculoskeletal team, or your GP. If you are unable to contact either of these and continue to have concerns, please go to A&E.

Follow up after injection is not required in most cases. If you do not benefit from your injection or you have any queries contact SMSKP for reassessment. Your records are kept open for 6 months should you need to contact us.

Are there any side effects to having an injection?

Side effects of a steroid injection are rare. Your clinician will discuss the side effects with you at the time of the injection.

What are the potential side effects?

Flare Up: Affects about 1 in 10 people. Occasionally people notice a flare in their joint pain within the first 24 hours after an injection. This usually settles on its own within a couple of days. Take your usual pain killers to relieve symptoms.

Infection: Very rarely infection might be introduced into the joint at the time of an injection (estimated as 1 in 23,000 people). If the joint or area becomes more painful and hot, red, or swollen you may be developing an infection. You should see your doctor immediately or if this is not possible go to A&E

Thinning of skin: Occasionally some thinning of the skin or dimpling skin colour change may occur at the injection site. This is more likely to happen if you have a higher dose of steroid,

Facial flushing: Steroid injections may sometimes cause facial flushing or interfere with the menstrual cycle making them irregular temporarily. You should consult your GP if concerned, or if it persists.

Mood change: Treatment with steroids may cause changes in mood – either elation or depression. This may be more common in people with a previous history of mood disturbance. If you have concerns please discuss this with your doctor

Change in glycemic control: People with diabetes may find that the steroid injection affects their blood sugar control; you may notice a temporary blood sugar rise. It is recommended that you check your blood levels more regularly; it may take between 1-3 weeks for them to settle.

What do you do with my information?

Your records are held by Here as the prime contact holder for the Sussex MSK Partnership Central.  If you would like to find out more please click here