Checklists and resources to support teams in establishing successful Community Appointment Days (CADs) have been added to GIRFT’s updated Further Faster handbook for community MSK.
CADs aim to provide holistic health and wellbeing support in a community setting by bringing together health services, social care and community partners in one accessible location, such as a community centre. The focus is on ‘What Matters to You’ conversations, enabling the patients who attend to discuss their priorities and make informed choices.
In recent years, CADs have become a useful tool for many community MSK providers in England, helping to reduce barriers to care, improve access and enhance the patient experience.
A new appendix added to the GIRFT handbook offers a checklist outlining principles and good practice for providers implementing or exploring CADs, including themes such as de-medicalising and humanising care, building the right multi-disciplinary team and designing CADs with and for communities. It also contains useful case studies, guidance and templates, enabling providers to develop a local version of CADs which reflect their demographic and priorities.
MSK conditions affect over 20 million people in the UK (around one in three of the population) and up to 30% of GP consultations in England are for MSK complaints.
GIRFT began work on a £3.5m programme of activity in December 2024 – funded by the Government’s Joint Work and Health Directorate – working with 17 integrated care systems (ICSs) with the highest waiting lists for elective community MSK services. The focus has been on reducing waiting times for community MSK appointments and improving access to MSK treatment.
The programme is being delivered using the principles and methodology of GIRFT’s Further Faster 20 programme, which is working with systems and NHS trusts to go ‘further and faster’ in transforming patient pathways to reduce waiting times in areas of high economic inactivity.
The GIRFT handbook was produced to offer checklists against which community MSK leads and ICSs could assess their practice and delivery of services. It signposts to resources that support practitioners to:
- Optimise referrals to community triage and therapies services.
- Ensure appropriate triage is in place to recognise urgent conditions requiring onward referral to secondary care.
- Deliver rehabilitation and self-management.
- Reduce number of ‘did not attend’ (DNA) incidences and implement patient- initiated follow-up (PIFU) appointments.
The update for December 2025 contains the CAD checklists, a new CAD case study and a digital checklist.
