MSK Transformation and MRI Direct Access
Dear Colleagues,
Following our recent communication regarding the ICS programme of transformation for community MSK services across North East London, we would like to update you on the latest decision agreed at the September Delivery Board.
It was agreed that, from mid November 2025, the Primary Care access arrangements for MRI requests related to MSK conditions will be restricted. This change reflects best practice guidelines and recognises that the cost of an MRI is equivalent to the average patient being assessed and treated within a physio-led MSK community service.
There were concerns raised about MSK waiting times and where to refer patients with MSK problems instead of MRI. We are pleased to say that all APP/ESP (tier 2) services in NEL are at 2 weeks for urgent and 6 weeks for routine referrals. In addition, 50 new staff are being recruited into the MSK community service across NEL, expanding capacity and supporting timely access. Patients will be triaged into the appropriate service and reviewed in a timely manner by a senior clinician. If MRIs are clinically indicated, they will be requested by the clinician.
We are working on the steps towards this now, with providers, including your local MSK services. We will update you over the next six weeks on the changes to referral forms, FCP ordering and confirm pathways for MSK related conditions in each place, including urgent referrals.
Your local MSK community services are preparing for this change and recruiting additional staff to manage all appropriate MSK referrals in the community.
To further support patients, the ICS has recommissioned the getUBetter app across North East London (this is now also available to City and Hackney patients). This digital self-management tool supports patients with common muscle, bone, and joint conditions. Configured to local care pathways, the app provides safe, personalised, and targeted recovery management tailored to each stage of the patient journey. GetUBetter – North East London
Please note that the above access arrangements for MRI requests are already in place in Newham. Therefore, no further changes will take place for Newham GPs at this stage.
If you have any queries, please contact shahnaz.begum5@nhs.net in the first instance. Thank you for your support in implementing these changes.