1. What do SWIMS appointments involve?
SWIMS appointments are specialist musculoskeletal (MSK) assessments carried out by highly trained clinicians, including Advanced Practice Physiotherapists. These appointments are typically longer than standard physiotherapy sessions and involve a thorough assessment, clinical diagnosis, and a management plan. Depending on the patient’s needs, this may include advice and education, further investigations, referral to imaging or surgical teams, or joint injections.
2. Where should MSK podiatry be referred?
MSK podiatry referrals should not be made to SWIMS. Instead, they should be directed to the MSK Podiatry Service, which is accessible via the Single Point of Access (SPA) referral process used by GP practices and community services.
3. Can Core Physiotherapy refer into SWIMS?
Yes, core physiotherapy teams can refer into SWIMS if a patient requires a more specialist MSK opinion. Referrals should be made via the standard referral pathway and include relevant clinical information and details of previous physiotherapy input. Please ensure the reason for specialist review is clearly stated.
4. Do SWIMS offer ultrasound-guided injections, and for which joints?
Yes, SWIMS offers ultrasound-guided injections where clinically appropriate depending on presentation. The decision to offer an injection is made following a comprehensive assessment within the service.
5. Where should fibromyalgia patients be referred? (Widespread chronic pain with normal connective tissue disorder blood tests)
Patients with widespread complex pain and a diagnosis or suspicion of fibromyalgia should be referred through SWIMS with the potential for onward triage to the Pain Service.
6. My patient needs a non-urgent spinal MRI. Should I just refer to radiology?
No, non-urgent spinal MRI requests should be directed through the SWIMS service. This ensures appropriate clinical assessment and imaging justification, in line with national best practice guidelines. SWIMS can assess the patient, determine if imaging is required, and request it directly if needed. Swims clinicians will have tome to go through the scans in depth with the patient helping them understand their care and treatment pathway.
7. Where should I refer urgent MSK conditions?
Urgent MSK conditions should not be referred to SWIMS. These patients require immediate assessment via A&E. Examples include suspected fractures, locked knees, septic joints, or acute tendon ruptures. SWIMS is not an emergency service and cannot provide same-day assessments.
