The Central East Local Health Integration Network (Central East LHIN) is committed to providing timely and appropriate access to quality health care for residents in our seven sub-regions. To improve access for patients with musculoskeletal (MSK) concerns, the Ministry of Health and Long-Term Care has developed a Comprehensive MSK Access to Care Program. This program has been used to plan and implement proven MSK service delivery models within the Central East LHIN.

A Central Intake and Rapid Access Clinic (RAC) pathway is now available for residents in the Central East LHIN who have hip or knee osteoarthritis. Residents with low back pain will be able to access the pathway on March 31, 2019. 


Patient care is central to the implementation of the MSK initiative. Shorter wait times to access care for patients experiencing pain from hip or knee osteoarthritis or low back pain is essential to well-being and overall function. 

MSK Care Steering Committee members come together on a monthly basis to provide support for planning and implementation of the MSK initiative. A MSK project team and four separate working groups with broad membership report into the MSK Care Steering Committee. 

How will Central Intake work?

A referral to access specialized care is sent to Central Intake by the Primary Care Provider (PCP), in collaboration with the patient. The referral is sent from the PCP using a standard referral form for hip or knee osteoarthritis and for low back pain. From Central intake, the referral will be routed to one of several RACs located in communities and hospitals across the Central East LHIN. Within four weeks, the patient will visit with a regulated health professional (assessor) for assessment, education and self-management support. A need for surgeon consult will also be confirmed at that time.

Hip and Knee Rapid Access Clinics (RACs)

A standard Hip and Knee Referral Form is now available for hip and knee referrals:

The PCP will indicate on the referral form the patient’s choice of first available assessment, first available surgeon, preferred surgeon, preferred hospital, or closest to home. Once Central Intake receives the referral, it will be routed to the appropriate RAC based on the patient’s choice.

Hip and knee RACs are located at the following locations:


Low Back Pain Rapid Access Clinics (RACs)

The low back pain pathway is part of the Rapid Access Clinic for MSK care and stems from the Inter-professional Spine Assessment and Education Clinics (ISAEC) model of care– a successful pilot program for low back pain. The objectives of the program include:

  • Improved outcomes and satisfaction for patients with persistent or unmanageable recurrent low back pain
  • Decreased prevalence of chronic unmanageable low back pain
  • Reduced opioid initiation through early non-pharmacological management
  • Decreased utilization of lumbar spine imaging (e.g., MRIs)
  • Reduced unnecessary emergency room visits for low back pain
  • Reduced unnecessary referrals to low back pain-related specialists
  • Improved access to specialist care

A standard LBP Referral Form will be available for low back pain referrals. Once Central Intake receives the referral, it will be routed to the community based RAC closest to the patient's home. At the LBP RAC, the patient will be provided with an explanation as to the probable causes of low back pain. The patient will also be provided with education and a self-management plan to better manage pain, improve mobility and overall function. Assessment findings will be communicated back to the PCP including recommendations for referrals. Patients who are possible surgical candidates will be provided access to spine specialists and diagnostic imaging (x-ray, MRI) as required. A Spine Practice Lead based out of the Scarborough and Rouge Hospital works closely with spine surgeons within the Central East LHIN.

Low Back Pain Rapid Access Clinic Location Contacts*

*Low Back Pain Contacts will be available after April 1, 2019. All referrals must go through Central Intake.

PCPs may learn more and can register to refer to the LBP pathway. Registration can be initiated now on any computer, tablet or smartphone, via this link: http://www.isaec.org/isaec-registration.html

Contact Information

If you have any questions or concerns regarding Transforming MSK Care, please contact the Central East LHIN at Toll Free: 1-800-263-3877 or TTY Line: 1-877-743-7939 or centraleast@lhins.on.ca.


Patients, Families and Caregivers

Health Care Providers 

Additional Links and Resources