Improving hip/knee and low back pain care through Rapid Access Clinics

April 30, 2019

London, ON – Health system partners are working together to improve hip/knee and low back pain care in the South West Local Health Integration Network (LHIN) through the implementation of Rapid Access Clinics (RACs).

Prior to implementation, patients referred to orthopedic and spine surgeons were placed on a wait list to be seen. Some people often waited many months for a surgeon consultation only to find out they were not surgical candidates. Rapid Access Clinics will improve access and avoid unnecessary utilization of resources by focusing on getting a patient assessed quickly and on the right treatment path.

Primary care providers, including family doctors, now have one point of contact to refer patients with moderate to severe hip/knee osteoarthritis and low back pain. As part of this new centralized model, patients will be triaged to receive a timely assessment from an Advanced Practice Provider, who is typically a physiotherapist, nurse practitioner, occupational therapist or chiropractor with specialized skills and training. Once Advanced Practice Providers have worked through the current wait list in the South West, newly referred patients will be assessed within four weeks. If a patient is a surgical candidate, they will be offered the option of “next available” appointment or can choose their preferred surgeon. If a patient doesn’t need surgery, they will be provided a self-management plan to manage their condition at home with simple exercises or connected with local care supports.

To refer patients to Rapid Access Clinics for low back pain, primary care providers are required to complete a short online on-boarding and registration module. Completion of this module, which takes approximately 15 minutes, will allow primary care providers to seamlessly refer qualified patients to the Rapid Access Clinics for low back pain. Primary care providers can go here to get started: There is no module required to refer patients with hip/knee osteoarthritis.

Implementation began on April 15, 2019.


“This initiative is a great example of getting patients faster care and providing primary care doctors with simplified centralized referrals that taps into the system capacity. It provides alternative solutions to patients to improve their mobility and quality of life. The program builds on the principles of the healthcare transformation currently taking place by embracing tighter integration, better navigation and faster care.”

- Renato Discenza, CEO, South West LHIN


“The Advanced Practice Provider is wonderful! You make sure you hang on to her! I wish I could take her home with me! She is a wealth of knowledge and I’m so much better off having seen her.”

“Thank you so much, this has been so helpful and I feel much less anxious about the whole process. I understand what the surgery process is like and what to expect so I feel much better about the whole thing. I think I’ll have better questions when I see the surgeon.”

“I’m so relieved I don’t need to worry about surgery at this point, and glad I didn’t have to wait months to find out that I didn’t need surgery. Now I can go get to work on something that WILL help me!”

Health Service Providers:

” With the new Central Intake process, family physicians will no longer need to track or find out which surgeons are still in practice or how long wait times for a particular surgeon are. It will be great to see this important work come to life, including more standardized wait times for surgeons across the South West LHIN.

- Dr. Tatiana Jevremovic, Family Physician with focus practice in sport and exercise medicine, Fowler Kennedy Sport Medicine Clinic

“I am very excited for the implementation of the musculoskeletal rapid access clinics not just in our LHIN but across Ontario as I feel this is a big step forward in providing the evidence informed care that our patients deserve in a timely manner. This initiative is not only fiscally responsible but will help in reducing the anxiety and the disability associated with low back pain, experienced by the patient and their families. Using this Inter-Professional approach I hope we can demonstrate this initiative as the gold standard for low back care and a model for others to adopt in the future.”

- Ravi Rastogi, Advanced Practice Leader, Low Back Pain, MSK Rapid Access Clinics

Visit the South West LHIN website for additional information on this important strategy.


For more information:

Faadia Ghani
Communications Business Partner
South West LHIN