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Quality Improvement

Rapid Access Clinics for Musculoskeletal Care

Low Back Pain | Hip & Knee Arthritis

Rapid Access Clinics are expanding across Ontario to help people with musculoskeletal conditions quickly access care. They focus on hip and knee arthritis and certain types of low back pain.

Why are these clinics needed?

Because one in three adults live with musculoskeletal conditions – health conditions that affect muscles, bones or joints, and cause pain and mobility issues.

Yet patients with these conditions have waited months for imaging tests or an appointment to see a surgical specialist, often only to discover that they don’t need the tests or surgery. Plus, patients often receive limited support and guidance about their condition while they wait – or treatment options, or information on how to manage their pain.

And once treated, some patients may be prescribed opioids for any chronic pain related to their condition, although other treatment options may be more appropriate.

The solution? Rapid Access Clinics that provide the right treatment, faster.

How These Clinics Work

A referral is made and an appointment is scheduled, where patients are assessed and a care plan is made. This is followed up by further care as needed.


More appropriate care

  • Patients are assessed by a health care provider with specialized training in their condition.

Faster access to care

  • Patients are seen at a rapid access clinic within four weeks and provided with appropriate follow-up care. This helps to reduce the time it takes to see a specialist, begin treatment and if necessary, surgery.

Patient-centred care

  • Patients are involved in the development of their treatment plans, and their personal preferences are taken into account.

  • If surgery is required, the clinics will help patients select a surgeon of their choice or arrange the next available appointment for them with any surgeon.

Appropriate referrals

  • Surgeons receive patient referrals that are appropriate for surgical consultation. They also receive a detailed assessment of the patient’s condition. Surgeons say this makes for a more effective use of their time.

Referring Patients

  • Referrals to Rapid Access Clinics are processed through one central point of contact in each Local Health Integration Network (LHIN). Most LHINs are accepting referrals now, and all are scheduled to be accepting referrals by April 2019.

  • Family doctors and nurse practitioners interested in referring patients to Rapid Access Clinics can contact their LHIN. See how to contact your LHIN below under additional information.

  • The LHIN will give them standardized referral forms, including referral criteria after they submit this information to the LHIN.

  • The clinic contacts the patient in approximately two to five business days to schedule an appointment with a specially trained health care provider. The appointment will take place within four weeks from when the family doctor or nurse practitioner made the referral.

Patient Assessment and Management

  • Patients are assessed by a specially trained and regulated health care provider such as a physiotherapist, chiropractor or nurse practitioner.

  • Patients are asked a set of questions about their condition and medical history. A physical examination is then performed.

  • The clinic’s specially trained health care providers then work with patients to create personalized plans to help patients better self-manage their conditions and improve their overall physical function. These plans may include instructions for exercises and modified activities.

  • The clinic’s providers do not offer treatment (e.g., hands-on therapy), but will recommend that patients seek certain types of treatment to support their self-management plans. Patients may be scheduled for follow-up assessments to monitor their condition during this treatment.

  • Surgery may be recommended for some patients. If a patient is a candidate for surgery, they will first receive diagnostic imaging tests (e.g., X-rays, MRIs).  

  • Patients who need a surgical consultation will then be referred to the surgeon of their choice or the next available surgeon. 

Additional information

You can visit the websites of these Local Health Integration Networks (LHINs) for additional information related to Rapid Access Clinics in these regions:

For LHINs not listed here, please contact them directly. To find out which LHIN you live in, search with your postal code.

The Rapid Access Clinics for low back pain are based on a model known as ISAEC (Inter-professional Spine Assessment and Education Clinics).

For more information on this model, visit the ISAEC website.

Quorum is an online community dedicated to improving the quality of health care in Ontario.

A Musculoskeletal Rapid Access Clinics group has been created on Quorum.

Anyone interested in learning more about these clinics, and how they are being implemented across the province, is welcome to join.

To participate in the conversation, first register for a free Quorum account below.

Once you have a Quorum account, you can join the Musculoskeletal Rapid Access Clinics group.



Quality Standards outline for clinicians and patients what quality care looks like based on the best available evidence. New Quality Standards for osteoarthritis and low-back pain are coming soon.

Quality Standards for opioid prescribing for acute pain and opioid prescribing for chronic pain are available now.

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Wait Times for Surgeries and Procedures

Wait times are an important measure of how quickly care can be accessed. Learn about wait times for hip and knee replacement, and MRIs.

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Adopting Research to Improve Care (ARTIC) Program

The Adopting Research to Improve Care (ARTIC) Program accelerates the spread of proven care.

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Our Partners

Health Quality Ontario would like to thank all of our partners who generously shared their expertise in musculoskeletal care.

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