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We’re helping to route 50,000 patients to the right clinician and make sure all their data is available to support faster treatment. It’s saved 3,000 hours of GP admin too – enough for 13,000 appointments.


The North East London MSK Alliance spans the boroughs of Barking & Dagenham, Havering and Redbridge. It was formed to offer equal access to all kinds of musculoskeletal care, as patients could previously wait between six and 26 weeks for a physio appointment depending on where they lived.

The Alliance includes Barking, Havering and Redbridge NHS Trust (BHRUHT), North East London CCG, North East London NHS Foundation Trust (NELFT), together with voluntary service leads and a patient representative.

They chose to implement our NEC Rego referral management platform to support their ambitious improvement journey and went live in July 2022. Rego uses clinical algorithms to route patients to the right place and ensure that clinicians have all the information they need to triage and treat effectively.

“We were rejecting about 3,000 referral requests annually just because clinicians couldn’t access enough information for effective triage. We also saw a lot of consultant-to-consultant referrals because patients hadn’t quite made it to the right clinic. It was frustrating for consultants and GPs and ultimately meant patients waited longer.”

Marie Loizides, Associate Director of Performance Analytics at Barking, Redbridge and Havering NHS Trust


The North East London MSK Alliance chose to implement  NEC Rego in five pathways: Therapies; Rheumatology; Neurosurgery; Pain Management and Orthopaedics.

The algorithms that route patients to the right clinic were developed by NEC Rego, working alongside physios, GPs and consultants from across the Alliance plus a patient partner. Having redesigned the clinical pathways to meet all users’ needs, patient and referral data is now available securely to everyone that needs it, regardless of Trust or Borough boundaries.

Now, referrals that would previously have taken 24 hours to complete can now be done in just three minutes. There’s no longer any need for GPs to fill in a triage form as well as an e-referral – they can complete the process in 1.5 minutes during the patient’s consultation. Importantly, they also have confidence that all the patient’s data, history and scans will be accessible by the service they’ve been referred to.

“[The hospital triage team] have been able to halve the processing times for referrals received. There is also the considerable time saving achieved by avoiding unnecessary appointments and getting patients to the correct service first time”.

Marie Loizides, Associate Director of Performance Analytics, Barking, Redbridge and Havering NHS Trust

Key stats

  • 50,000 referrals a year

  • 3,000 hours saved

  • 70% reduction in rejected referrals

  • 1.5 minutes per referral, compared to  24 hours before