Medically unexplained symptoms

Medically unexplained symptoms (often referred to as MUS) are poorly understood and costly to both the patient and services. Patients currently have no clear pathway and end up being frequently referred to secondary care seeking a solution. Many patients with MUS first present to the general practitioner (GP) or practice nurse and can consume a disproportionate amount of resources and consultation time, with little evident benefit to the patient.

Following a significant review of research, Commissioning Support for London’s mental health team supported a pilot to understand the management of medically unexplained symptoms in primary care. Over six months, the pilot provided a detailed piece of work that:

  • Identified the prevalence of MUS within small number of pilot sites in London
  • Tested out the MUS model of care in a number of GP practices (there is currently no consistent pathway with MUS)
  • Provided evidence of the cost of MUS to primary care within pilot sites

The project has provided a better understanding of the prevalence of MUS in London GP practices and identified associated costs to primary care. This will enable better management of MUS, leading to both improved outcomes for the patient and cost savings for the NHS.

The project utilised products developed by the Improving Access to Psychological Therapies (IAPT) programme to support implementation.

MUS project implementation report

The mental health team published the MUS project implementation report following a pilot in a small number of GP practices. The pilot utilised the MUS whole systems approach as its foundation.

The following documents were published in relation to this report:

MUS whole system approach

The MUS whole system approach provides examples of a range of approaches across the whole system and those used by services to manage MUS.

Stakeholders from across the system contributed to this document, including patients, clinicians from a range of service providers (including primary and secondary care) and commissioners.