Musculoskeletal Advanced Practitioner Service

(formerly Orthopaedic Practitioner Service)

What is the Musculoskeletal (MSK) Advanced Practitioner Service?

Gloucestershire Hospitals NHS Foundation Trust provides a specialist musculoskeletal assessment service; known as an interface service; supporting the patient to see the right person in the right place at the right time.

We offer a specialist service for patients and GPs offering the following:

  • Clinics for Spine// Shoulder// Elbow, Wrist and Hand// Hip// and Knee conditions
  • Understanding your symptoms and listening to how your problem affects your life
  • An opinion and explanation on Diagnosis and Prognosis
  • Appropriate investigations and referral
  • A discussion about the choices and options, risks and benefits for treatment
  • A choice of non-surgical interventions including joint and soft tissue injection
  • Advanced Physiotherapy/Hand Therapy opinion 
  • Access to specialist advice and information about the risks and benefits on a range of non-surgical treatments
  • Access to community exercise and lifestyle programmes

How does this service offer quality and value for patients?

  • Rapid access to specialist assessment :-  2 weeks urgent and 4 weeks routine
  • An excellent patient experience with joined up, seamless, effective care
  • Strong Clinical Governance with support from the multi disciplinary team for patient safety
  • Specialist services are brought closer to home
  • Patients are supported to make shared decisions about choices and options for treatment


The team is led by Susie Durrell, Consultant Physiotherapist and comprises Advanced Practice Physiotherapists and Advanced Practice Occupational Therapists (in upper limb clinics).


Our team’s close working with Consultant Orthopaedic Surgeons, Pain Medicine Services, GPs and Consultant’s in Radiology means there are strong integrated systems for training and education ensuring clinical excellence and governance.


Musculoskeletal Advanced
Practitioner Service (GHT)

Administration Base:

MSK Advanced Practitioner Service
c/o Physiotherapy Department
Gloucestershire Royal Hospital
Great Western Road

Telephone: 0300 422 8127
Fax: 0300 422 8543 

Clinical Lead

Susie Durrell
Consultant Physiotherapist              
Tel: 03004 228127


Operational Leads

Jill Ham 
Advanced Practitioner


Manager: Julie Shepherd



Where are MSK Advanced Practitioner Service clinics available?

Clinic locations by Patient Choice:

Cheltenham General Hospital

Gloucestershire Royal Hospital

How is the MSK Advanced Practitioner Service accessed? 

We accept referrals from GPs, Physiotherapists, Occupational Therapists or other health care professionals.

GP Referral Processes

GP referral process for spinal cases via the Spinal Assessment and Treatment Service

GP referral process for non-spinal cases: 

 If the GP and patient’s choice is referral to the Gloucestershire NHS Foundation Trust Musculoskeletal Advanced Practitioner Service at consultation:-

  • Your GP generates a referral letter. N.B. NO appointment can be booked or offered to the patient at this stage.
  • The NHS e-Referrals system is entered as normal through “Shoulder/elbow/hand/hip/knee” route.
  •  Available clinic choices can be filtered by the distance in miles (greater miles will capture more choices).
  • Scroll down and search for MSK Advanced Practitioner Service (Formerly Orthopaedic Practitioner Service) Gloucestershire Hospitals NHS Foundation Trust
  • Choose the MSK Advanced Practitioner Service (Formerly Orthopaedic Practitioner Service) Gloucestershire Hospitals NHS Foundation Trust
  • A ‘dummy’ or ‘false’ patient appointment is generated (confirming entry into the service).
  • Accept / book the ‘dummy appointment’ and attach the referral letter and any additional required patient information. 
  • This completes the referral from the GP practice.

How is the referral processed within the Service?

  • Clinical staff read and review all new referral letters received each working day.
  • Where patients may benefit from our service the referral is accepted and the patient is allocated to the most appropriate clinic within our Service.
  • Our administrators input the appropriate clinical decision into the NHS e-Referrals system.
  • Letters are generated and sent to you, the patient, enabling you to book your appointment including a list of suitable clinic choices and locations; a system password; and an explanatory letter about the service.
  • You, the patient, can book your own appointment by accessing the system to choose the date, time and location of your clinic appointment.
  • Once you, the patient, book your appointment, our administrators send appropriate confirmation information to you.

    Where clinicians recommend a different service your referral will be either:

    1. Redirected to Physiotherapy/Hand Therapy or
    2. Rejected back to the GP for a new referral directed to a different service e.g Trauma & Orthopaedic Consultants.


    Useful Patient Information

    Health information Managing persistent pain Shared decision making

    NHS Choices

    Arthritis Research UK

    Let's Talk service for Mental Health

    Pain Toolkit

    Pain Concern

    Shared decision making for osteoarthritis of the knee

    Shared decision making for osteoarthritis of the hip