Thank you for organising the MRI of Ms Mackintosh lumbar spine. I understand that she was recently refused assessment by the MSK team at Chelsea and Westminster Hospital. I appreciate that her symptoms are complex. However, they have worsened recently resulting in her reporting that sitting is painful so too is walking for extended periods, which have impacts on both her ability to work and participant in her hobbies.

I am concerned as she requires multifactorial investigation and management she may get bounced around from one apartment to another. Could I be so bold as to make some suggestions, and would be grateful for your expert opinion on whether these would be appropriate next steps

Referral to Simon Stapleton at St Georges Hospital;