Digital self-management and self-referral for musculoskeletal complaints in London
Common musculoskeletal (MSK) conditions often do not need specific or specialist treatment and may resolve if people follow simple, evidence-based advice.
Digital technology can provide immediate day-to-day support while connecting people to their local MSK pathway and support services across an integrated care system (ICS). By using technology, people can access trusted, evidence-based advice in a consistent and standardised way.
Patients lack appropriate digital resources to actively self-manage their condition.
Also, waiting times to see a clinician can be long.
Using digital technology to provide immediate day-to-day support whilst connecting people to their local MSK pathway and support services across an ICS. It has the potential to deliver trusted, evidence-based advice in a consistent and standardised way.
Solution and impact
South West London Health and Care Partnership used getUBetter, a MSK self-management app , for patients with common MSK injuries and conditions.
getUBetter provides digital self-management support across the entire care pathway. This helps patients:
- trust their recovery
- manage their condition
- use fewer healthcare resources
getUBetter is available at all GP practices, physiotherapy services and from some A&E departments.
getUBetter can be accessed through patients on their own or prescribed during a consultation by:
- first contact physiotherapists
- nurse practitioners
- non-clinical staff
It can also be used by physiotherapy providers to support waiting lists.
getUBetter can be provided wherever a patient interacts with the system. This could be a self-referral or in:
- primary care
- minor injury units
- secondary care
getUBetter promotes safe self-management.
It also automates referrals for treatment appropriately.
getUBetter is at level C of the NICE Digital Health Technology Evaluation Framework.
The app has recognised techniques to change behaviours and maximise impact.
getUBetter is an app that can be used on a number of devices.
- It’s suitable for all common new, recurrent and long-term MSK injuries and conditions.
- The app provides self-management advice.
- It features video exercises.
- Patients receive advice on what to do if their symptoms get worse and where to get help.
- The app gives users advice when to seek further help.
- Users can connect to their local health service.
- Users have access to local public health, social care, and third-party support.
- The app makes automated referrals.
- Clinicians receive updates through medical records.
- supports the entire care pathway
- supports remote healthcare
- has a symptom tracker
- includes stratification and outcome measures to guide patients
- has safety netting
- virtually connects users with a healthcare practitioner
- promotes behaviour change
- promotes self-management
- reduces healthcare utilisation
- lets patients access local self-management clinics
- includes an end-to-end integrated care pathway
- can refer users back into the system when needed
- can be prescribed or people can refer themselves
- lets patients manage their progression at their own pace
- helps users access and directly book local treatments such as physiotherapy and wellbeing services
- No patient should have to wait for access to local self-management support.
- getUBetter is provided at the first opportunity.
- Local MSK self-management support is available 24 hours a day, every day of the year.
- Easily accessible, targeted and personalised self-management information to help patients day-to-day and step by step.
- Exercises based on patient’s stage of recovery and the ability to self-progress.
- Reassurance and support to self-manage.
- Supports recovery, prevention, and re-occurrence.
- Standardised care.
- For every £1 spent, getUBetter saves £4.20.
- Reduces physiotherapy referrals by 20%.
- Reduces GP appointments by 13% (Wanless B., McClellan C., 2019).
- There was a 50% reduction in prescribed medication for MSK conditions.
- getUBetter demonstrated behaviour change.
- Early data shows 66% reduction in A&E attendances.
- ORCHA review results are 91% in 2021 to 2022.
- an improved ability to self-manage
- an improved confidence to self-manage
- a better understanding of their condition and recovery
86% of patients would recommend to family and friends. 73% felt the app would provide a better GP service (none disagreed). 100% of patients felt the app would help recovery.
“I think it is a fantastic resource on its own but also because patients can then be referred on through the Wandsworth pathway directly”.
Dr Ali Hassas, GP, Wandsworth
“We see the ever-expanding app as a major part of our service redesign going forward”.
Jim Fenwick, CEO, Battersea Healthcare
Find out more
Ben Wanless, consultant MSK physiotherapist, St George's University Hospital NHS Foundation Trust
Carey McClellan, clinical director, getUBetter
These case studies summarise user and patient experiences with digital solutions along the relevant care pathway. Unless expressly stated otherwise, the apps and digital tools referenced are not supplied, distributed or endorsed by NHS England or the Department of Health and Social Care and such parties are not liable for any injury, loss or damage arising from their use.
All playbook case studies have either passed, or are currently undergoing the Digital Technology Assessment Criteria (DTAC) assessment.
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