When to use the MSK standards

Unsure about when to implement the CSP's guidance and when to use that of other organisations? Find out which standards and guidance to use when.

The CSP service standards are a tool to help clinicians and service leads, demonstrate high quality patient care and service delivery.

However there are many other similar documents in existence, that also aim to provide service and clinical improvement initiatives.

Below is a summary of other national standards or guidance and information as to when they would be most applicable to use and with what purpose. The CSP service standards can be implemented in conjunction with any of the other guidance and documents below.

CSP MSK physiotherapy service standards (UK wide)

Main purpose: service evaluation and improvement

Our standards are a tool for services to demonstrate the value of MSK physiotherapy services with the aim to drive continuous quality improvement.

The patient version aims to improve patient understanding of expectations within their MSK journey. The audit tool supports the service to evaluate gaps and then use the appropriate standards to improve quality of care.


When do I used this as a service lead?

  • An MSK service would implement these standards to provide a consistent review of areas for improvement.
  • When a particular area is proven to be below a set standard or highlighted through audit.
  • When members of the public raise concerns about the service, these can be used to evaluate areas for improvement.

When do I use this as a clinician?

  • Any level of clinician including support workers within MSK services

MSK Advanced Practice Standards (UK wide)

Main purpose: professional and service development

These standards were developed to reduce unwarranted variation in education and practice at advanced practice level across all professions and sub-specialties


When do I used this as a service lead?

  • Any MSK service which has Advanced Practitioners working within.
  • If areas have been identified that demonstrate variation at advanced practice level between different professionals.

When do I use this as a clinician?

  • Advanced practice level clinicians in MSK.

MSK core capabilities framework (England focused)

Main purpose: service evaluation and improvement

This framework supports the improvement of services, placing skilled MSK practitioners earlier in patient pathways. It aims to ensure expert diagnosis, prevention, supported self-management advice, early treatment and onwards referral, where needed, is available to anyone presenting with an MSK condition.


When do I used this as a service lead?

  • When there is a need for clear expectations for individuals and teams regarding transferable skill and role requirements.
  • To help determine any formal or informal training needs.
  • To help compare current skills and knowledge of individuals, with aim to achieve consistency within MSK therapy. 
  • To support career progression, planning and continuing professional development. 
  • To improve the core capabilities of individuals who are the first point of contact within an MSK pathway.

When do I use this as a clinician?

  •   First contact practitioners in MSK

Transforming elective MSK and orthopaedic services (England focused)

Main purpose: service transformation

This handbook has three key themes, demonstrating the potential interventions that a service might consider when looking at areas of service transformation. 

It aims to illustrate how to improve the management of rising demand for elective care services, improve patient experience and access to care, and provide more integrated, person-centred care.


When do I used this as a service lead?

  • To review and re-think referral processes
  • To improve the access to care, patient journey and ongoing management in the community
  • Improve the self-management support for patients
  • Improve patient outcomes
  • Offer more flexible options for follow-up therapy

When do I use this as a clinician?

  • This guidance can be utilised by any allied health professional working in MSK services

MSK minimum standards framework (Scotland focused)

Main purpose: service transformation and improvement

This framework outlines minimum standards for NHS Boards providing musculoskeletal services to help guide organisations in meeting national musculoskeletal and orthopaedic improvement initiatives.

It also help identify those service gaps and support the case for additional resource, where necessary, and details the expectations on referrers to AHP services, the expectations on AHPs and their role in the work up of patients who require onward referral.


When do I used this as a service lead?

  • To help identify service gaps and build a case for additional resource.
  • Guidance as to the expectations of professionals wanting to refer and access AHP services.
  • To achieve less of the unwanted variation across MSK services
  • This guidance should be used alongside professional and regulatory standards.

When do I use this as a clinician?

  • This can be implemented by any allied health professional working in MSK services

NHS England guide to adopting remote consultations in adult musculoskeletal physiotherapy services (England specific)

This guide supports adult MSK physiotherapy services – delivered by providers across primary community and/or secondary care – to implement evidence informed remote consultations. 


When do I used this as a service lead?

  • Any service lead wanting to support the design of a new service. 
  • Review of an existing service that offers remote consultation.
  • The guide offers evidence based information and the inclusion of lived experience and importance of co-production in remote consultation.

When do I use this as a clinician?

  • Any clinician can use this guide in conjunction with local resources, especially if they want to review an existing service or look at introducing remote consultations as a project for service and/or quality improvement.

Musculoskeletal health: applying All Our Health (England focused)

This resource helps health and care professionals prevent ill health and promote wellbeing as part of their everyday practice. It will help frontline health and care professionals use their trusted relationships with patients, families and communities to lower the risk of developing musculoskeletal health (MSK) conditions.


When do I used this as a service lead?

  •  A service lead might want to promote this framework as a whole in developing further knowledge on how to prevent illness, promote wellbeing and have a wider understanding of the important of population health within local regions. Although this framework encompasses many areas for skills development, MSK health is one of these, with specific recommendations for managers within the framework.

When do I use this as a clinician?

  • The framework can be used by any clinician and the specific resources, to increase knowledge and awareness of different elements of preventative healthcare and how to embed this within practice.

IFOMPT (World Physiotherapy sub-group) standards (UK wide)

Main purpose: professional and service development

These educational standards detail learning outcomes which guide towards standards of education acceptable to IFOMPT.

The standards focus on the orthopaedic manipulative therapy (OMT) approach.


When do I used this as a service lead?

  •  To ensure there is a clear description of the skills and knowledge expected

When do I use this as a clinician?

  • These can be used by MSK physiotherapists, specifically those who are OMT trained.

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