P037 MSK Physiotherapy and Rheumatology: evaluating four years of a collaborative multidisciplinary meeting

Background/Aims The Musculoskeletal (MSK) Physiotherapy & Rheumatology multidisciplinary meeting (MDM) was established in May 2021, as a monthly forum bringing together MSK Physiotherapy and Rheumatology teams to discuss complex or unclear MSK cases with potential rheumatic diagnoses. The MDM aim was to reduce diagnostic delays, support timely and appropriate rheumatology referrals and promote collaborative learning between the services. Direct referral pathways to rheumatology remained available for appropriate cases. This service evaluation aimed to assess the impact and effectiveness of the MDM in improving diagnosis, management and resource utilisation for patients with suspected inflammatory conditions. Methods A retrospective service evaluation was conducted for all patients discussed at the MDM between May 2021 and December 2024. Data was collected on MDM utilisation and outcomes, rheumatology diagnoses, onward referral to alternative specialities, diagnostic timelines (mean number of appointments before rheumatology diagnosis) and financial resource use. Results Over the evaluation period, there were 44 MDMs involving 35 unique MSK clinicians, 10 unique rheumatology consultants and discussion of 153 patients (mean 3.47 per MDM). Seventy-four patients (48.3%) were referred to rheumatology following MDM, of whom 26 (35.1%) were diagnosed with inflammatory disease. The most frequent diagnoses were spondyloarthropathy (24%), rheumatoid arthritis (20%) and polymyalgia rheumatica (16%). Of the 48 patients referred to rheumatology who were subsequently diagnosed with a non-inflammatory condition (64.9%) - including fibromyalgia syndrome (FMS), osteoarthritis and other MSK disorders - the mean number of appointments was 1.76. Twelve of these patients were referred to other specialties (e.g. pain clinic, foot health and orthopaedics). Seventy-nine patients (51.6%) were not referred to rheumatology following MDM. Of these, 40 (50.6%) received investigation or management recommendations and 17 (21.5%) were referred to other specialties (e.g. orthopaedics, hand therapy and foot health). The most frequent non-inflammatory diagnoses following MDM or rheumatology referral were MSK conditions (30.7%), osteoarthritis (29.1%) and FMS (20.5%). Based on the GIRFT (getting it right first time) report, cost-benefit analysis demonstrated a saving of £28,914.00 from avoided rheumatology referrals (n = 79), calculated using GSTT rheumatology tariffs. Additional non-financial benefits included reduced MSK physiotherapy follow-up burden, earlier rheumatology referral with potential for lower disease severity and treatment costs, and strengthened collaborative working between MSK Physiotherapy and Rheumatology services. Conclusion The MDM improved diagnostic efficiency, optimised rheumatology referrals and strengthened multidisciplinary collaboration. This integrated model streamlined pathways for inflammatory and non-inflammatory conditions, reduced unnecessary referrals and delivered notable cost savings. Future work will focus on fast-track pathways for clear inflammatory presentations, assessing educational impact on MSK referrers and incorporating clinician & patient feedback to refine the MDM. Disclosure J. Grodon: None. L. Barry: None. M. Osman: None. R. Pickford: None. R. Byng-Maddick: None.