Update on MRI Access Criteria for Primary Care – Effective 17th November 2025
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Update on the MSK Transformation programme Implementation and upcoming changes in the next few months.
| Following the communication issued on 4th August (Use of MRI in Primary Care for MSK conditions – North East London) and 2nd October 2025 (MSK Transformation and MRI Direct Access – North East London), we can now confirm that the new MRI access criteria for Primary Care will come into effect from 17 November 2025. This change aligns with best practice guidelines and forms part of the ongoing MSK transformation work across NEL. Important Notice for All GPs The updated referral process applies only to Barking & Dagenham, Havering, Redbridge, Tower Hamlets, and Waltham Forest. The revised MRI access arrangements are already in place in Newham, so no further changes will be implemented in Newham at this stage. City and Hackney have local arrangements in place with the Homerton for MRI referrals and similar changes to access are being implemented within T-Quest. MRI Referral Process Updates MRI Referral forms have been updated to reflect this change and will be available on the CEG platform by 17 November 2025. GPs will have access to one MRI referral form, titled ‘Non-MSK MRI Referral Form.’ It is essential that this form is used only for non-MSK conditions to ensure patients are correctly triaged and do not experience unnecessary delays in diagnosis or treatment. Patients requiring assessment or diagnostics for MSK-related conditions should instead be referred into the Community MSK Service. MRI providers (InHealth and Cora Health) have been informed of these updates and will reject any inappropriate MSK-related MRI requests submitted directly by Primary Care. GP Portal Updates We are currently updating the GP Portal for all Places to ensure that the latest MSK pathways, including those for urgent referrals, are clearly reflected. First Contact Physiotherapists (FCPs) Based on national FCP guidance, FCPs will only be able to order MRI imaging where the following criteria are met: – FCPs are fully integrated with the existing Community MSK Service and MDT, working across primary and community settings, and attending regular peer support and supervision sessions. – FCPs have completed Stage 1 and Stage 2 of the FCP Roadmap, demonstrating Level 7 capability in areas such as advanced assessment, diagnosis, and treatment. – FCPs have access to present and attend specialist MDMs. Appropriate governance processes are in place, including regular audits, appraisals, patient feedback, and use of clinical observation tools, as outlined in: – FCPs in Primary Care: Contract Specification 2025/26 – MSK National Framework: Musculoskeletal Framework.pdf We are conducting FCP mapping across NEL to gain a comprehensive understanding of current service coverage. The governance of this initiative will be managed by the MSK NEL Clinical Leads, MSK Place Leads, and the Advanced Practice Workforce Lead at NEL ICB. Further guidance and supporting materials will be shared as they become available. If you have any queries, please contact shahnaz.begum5@nhs.net in the first instance. Thank you for your continued support and collaboration in implementing these changes, which aim to ensure patients receive the most appropriate and effective care through the MSK pathway. |