2166 consecutive patients referred from primary care to a musculoskeletal Clinical Assessment and Treatment Service (CATS) at the primary-secondary care interface were recruited at their CATS appointment. Self-administered questionnaires were completed at baseline and after 6 months and 12 months. At the baseline appointment, the assessing clinician recorded clinical diagnosis, investigations and interventions. Consent was obtained from participants to access their medical records to obtain information about primary care and CATS consultations. 

Chief Investigator:     Professor Elaine Hay 
Principal Investigator:  Dr Ed Roddy
Study Coordinator: Irena Zwierska 
Funding:   Arthritis Research UK Clinical Arthritis Centre Grant (17684, 2007); Arthritis Research UK National Primary Care Centre Grant (18139, 2008)

Study Design

This study was a 12-month prospective cohort study.

Primary Objective

The study aimed to describe the characteristics, management, and clinical and health-economic outcomes, of patients with a wide range of musculoskeletal conditions referred from primary care to an established musculoskeletal Clinical Assesment and Treatment Service at the primary-secondary care interface.


  • Roddy E, Zwierska I, Dawes P, Hider SL, Jordan KP, Packham J, Stevenson K, Hay E. The Staffordshire Arthritis, Musculoskeletal, and Back Assessment (SAMBA) Study: a prospective observational study of patient outcome following referral to a primary-secondary care musculoskeletal interface service. BMC Musculoskeletal Disorders 2010;11:6; link

  • Roddy E, Zwierska I, Jordan KP, Dawes P, Hider SL, Packham J, Stevenson K, Hay EM. Musculoskeletal clinical assessment and treatment services at the primary-secondary care interface: an observational study. Br J Gen Pract 2013;63(607):141-8; link

  • Roddy E, Jordan KP, Oppong RA, Chen Y, Jowett S, Dawes PT, Hider S, Packham J, Stevenson K, Zwierska I, Hay EM. Re-consultation, self-reported health status, and costs following treatment at a Musculoskeletal Clinical Assessment and Treatment Service (CATS): a twelve-month prospective cohort study. BMJ Open 2016;6(10):e011735; link
  • Hill JC, Afolabi EK, Lewis M, Dunn KM, Roddy E, van der Windt DA, Foster NE. Does a modified STarT Back Tool predict outcome with a broader group of musculoskeletal patients than back pain? A secondary analysis of cohort data. BMJ Open 2016;6(10):e012445; link