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Meet the Team

Dr Alan Nye

Executive Director

I qualified in Sheffield in 1983 and after completing my GP training became a principle in an inner city practice in Oldham.  I helped set up a Rheumatology “Tier 2” in 2002 which became Pennine MSK Partnership Ltd in 2006.  I also work for AQuA, leading for shared decision making.

Anne Browne

Nurse Consultant Rheumatology/Executive Director

I qualified as a Nurse in 1982 and worked in Orthopaedics and Accident and Emergency Nursing until 1993.  I started Rheumatology nursing in 1993 and during my career have completed my Diploma in Nursing, Further Education Teaching Certificate, BA (hons) in Health Studies and an MSc in Clinical Practice.  I have been part of a strong cohesive multidisciplinary team and my main interests lie in nursing leadership, care of the chronically ill and service redesign.  I became a Nurse Consultant in Rheumatology in 2001 and jointly led a successful Tier 2 Rheumatology service.  I also lecture on the leadership module of the MSc in Rheumatology.  I joined my two GP Partners to develop an ICAT in 2006. My main focus at the moment is to ensure that our service delivers on the 18 week pathway, whilst maintaining high quality patient focused care.

Dr Hugh Sturgess

Executive Director

I have been a GP in Oldham since 1986 and a GP with Special Interest in Musculoskeletal Medicine since 2005.  My interest in musculoskeletal medicine began when I undertook post graduate training in Orthopaedics for one year in 1982-1983.  I also have interests in continuous quality improvement and also the commissioning of NHS services.

Ann Todd

Finance and Business Development Director/Executive Director

I have worked in NHS Finance since 1977 in a number of different roles and organisations. I am a member of the Chartered Institute of Public Finance and Accountancy.  I joined the Oldham Trust in 1987 and held the posts of Financial Accountant, Deputy Director of Finance and then Acting Finance Director for the twelve months prior to the merger of the Oldham Trust into the Pennine Acute Hospitals Trust.  In the merged Trust I held the post of Head of Financial Management and Performance.  I joined Pennine MSK Partnership Ltd in June 2007 and have responsibility for the provision of business information, the financial modelling and the liaison with other agencies and contractors to ensure delivery of the service including the 18 week RTT pathway.

Ruth Holden

Director of HR & Operations

I joined Pennine MSK Partnership Ltd in May 2009 having had a long career in the banking sector as a Branch Manager, Area Manager for Resource Development and Recruitment Consultant.  I am responsible for the operational management of the Administrative Division at Pennine MSK Partnership.  I lead our customer-care programme and lead on all HR issues including recruitment.  I am also responsible for the development of our workforce training policy.

Dr Ian Watson

GP with Special interest in Rheumatology

I have been an Oldham GP since 1997 working in Saddleworth. I joined Pennine MSK Partnership Ltd in 2014 as a GP with special interest in Sports and Exercise and Musculoskeletal Medicine.  I hold a MSc (distinction) in Sports and Exercise Medicine, a Post Graduate Diploma in Sports and Exercise Medicine (distinction) and a Diploma in Mountain Medicine. In addition I am also Associate Medical Director at Pennine Care NHSFT and chair Primary Care Oldham LLP. Outside of work I am a keen active sports person: mountaineering, rock climbing, long distance running, mountain/road biking and karate.


Julie Bedford

Business Operations Manager

I joined Pennine MSK Partnership Ltd in November 2012.  I have previously worked in both the public and private sectors within management, customer care and HR.  My role at Pennine MSK Partnership Ltd is to support the Director of HR & Operations in the day to day operational running of the service.  I provide line management and leadership support to the Data & Information Manager and the administrative Team Leaders.  I also assist in the development of business and improvement plans for the administrative division.

Melanie Taylor

Personal Assistant to Senior Management Team

I joined from my previous role as Project Co-ordinator for the Tier 2 Rheumatology Service which commenced in 2003 and later merged with the Tier 2 Orthopaedic Service to form Pennine MSK Partnership Ltd in 2006.  In March 2009 we were awarded The Government Standard Customer Service Excellence and I took on the role of Customer Care Manager ensuring that we maintained these standards by monitoring, improving and continuing to provide high quality patient focused care.  Following return from maternity leave in November 2013 I now provide personal assistant and administrative support to the Senior Management Team.

Louise Hanson

Accounts Manager

I have previously worked in the manufacturing industry and joined Pennine MSK Partnership Ltd in July 2006.  I am responsible for the accounts and wages.

Rachel Chrisham

Patient Care Manager

I started working for Pennine MSK Partnership Ltd in April 2010, having previously worked for Greater Manchester Police and Oldham MBC.  My main role is to lead on all Customer Care and Service Improvement within the service, dealing with all compliments and concerns received and collating and reporting on all survey results from staff, patients and GP’s. I also provide comprehensive administrative support to the Directors and Senior Managers of the service and manage the staff HR files, co-ordinate recruitment and ensure records are maintained and updated.

Data Team

Marie Clegg10-marie

Data Analyst

I started working for Pennine MSK Partnership Ltd as a Secretary in November 2010 and then joined the Data Team in December 2013.  My position is extensive and varied; however the principal part of my role is to support the Data Team and to ensure all analysis of the company’s productivity is accurate and ready for our organisation’s monthly activity submissions.


Linda Ashton

Data Team Leader

I joined Pennine MSK Partnership in Jan 2009 having previously worked for British Gas as a Payments Process Analyst.  My main responsibilities include monitoring patients 18 week Referral to Treatment pathways, providing statistical analysis, audits and reports on a monthly basis.  I also create/cancel and make changes to clinician’s clinics as and when required.

Administration Team 1

Psychological Medicine/Orthopaedics/Persistent Pain/Podiatry

Rachel Holden

Secretarial Team 1 Leader

I am currently the Team Leader for Persistent Pain, Psychological Medicine, Podiatry and Orthopaedics. I provide line management and support to a team of 7 secretaries while also dealing with patient and clinical queries on a day to day basis.

Hannah Doherty


I started working for Pennine MSK Partnership Ltd as a Medical Secretary in June 2016.  I previously worked in a GP Surgery for 7 years in a Reception/Secretarial position.  My current role on Team 1 involves typing clinic letters from clinics in Persistent Pain, Psychological Medicine and Orthopaedics, dealing with queries from patients, GPs and hospital clinicians and processing referrals and all other admin tasks.

Elizabeth Hulme


I joined the Pennine MSK Partnership Ltd in October 2007, having previously worked as a Secretarial Support Officer in the Oldham M.B.C. Mayor’s Office.

Administration Team 2


Tracy Appleby


I joined the Partnership in September 2007. I previously worked for the Physiotherapy Department at The Royal Oldham Hospital for 3 years.

Doreen Cliff


I joined Pennine MSK Partnership Ltd on the 15th March 2010 after returning from residing in Spain. I have been office based since leaving school covering many varied aspects of office work.  I previously worked as a Motor Claims Handler for 15 years for Royal and Sun Alliance.  My role as a Secretary on Team 2 involves typing patient clinic letters for Consultants, Clinicians, GP’s and Nurse’s, dealing with patient queries which includes making new, follow up and re-scheduling clinic appointments and also booking transport and Interpreters.

Julie Connolly


I joined the Company in November 2009 as a Secretary on Team 2. Prior to this, I was Company Secretary and PA to a local Funeral Director.

Sandra Cruz


I joined Pennine MSK Partnership Ltd in November 2012 and am a Secretary for Team 2. 

Rosemary Fullerd


I have worked for Pennine MSK Partnership Ltd since February 2007.  My current role is Secretary on the Psychological Medicine and Orthopaedic Team.  I previously worked in the Physiotherapy Department at the Royal Oldham Hospital in an admin role.

Debbie Gilbert


I am a Secretary for Team 2, I joined Pennine MSK Partnership Ltd in February 2009 and was previously employed by NHS Oldham.

Julie Kenny


I have worked for Pennine MSK Partnership Ltd since August 2009 and love the varied workload of this fast growing company.  I have previously worked as a Legal Secretary.

Rachel Marsh


I started my role as a Medical Secretary for Pennine MSK in June 2015 and cover Rheumatology, Physiotherapy, Podiatry, Pain Management and Orthopaedic Service.  My previous experience comes from a background history of working in HR and Charities for a local hospital.


Mr Mohammed Bari

Consultant Orthopaedic Surgeon (Lower Limb)

I specialise in all aspects of knee surgery and also primary hip replacement. My NHS practice is based at Tameside General Hospital near Manchester.  My knee practice covers all aspects of knee surgery, from sports injuries to arthritis of the knee. I  perform arthroscopic (keyhole) surgery, cruciate ligament reconstruction and both total and partial knee replacements. My specialist areas of interest include cruciate ligament injuries,cartilage injuries, osteochondral defect resurfacing and tendinopathies around the knee.

I graduated from Calcutta and started postgraduate training in England in 1990.  I had extensive training in Trauma and Orthopaedics in the UK.  My specialist interest has always been the practice of knee surgery and joint replacements.
I am a Fellow of the Royal College of Surgeons, a member of the British Association for Surgery of the Knee, the British Orthopaedic Association, American Association  of Orthopaedic Surgeons and founder member of the British Indian Orthopaedic Society(BIOS)

Throughout my career I have regularly been involved in research, audit and teaching. I has presented this research in publications and at national and international meetings.  At Tameside , I have been the Audit Lead and contributed to the improvement of elective services.  I am also a Royal college examiner and Royal College Tutor.  I train Orthopaedic Specialist Registrars from the northwest deanery.  I have been regularly appraised and revalidated .

Clare Cullen FRCS, MSc

Consultant Orthopaedic Surgeon (Lower Limb)

I have been a Consultant Orthopaedic Surgeon specialising in knee and hip surgery since 2010. My higher surgical training took place in Manchester and I completed a fellowship in specialist Knee and Hip surgery at the University of Toronto in 2009.  During my training I completed the Fellowship of the Royal College of Surgeons exams and gained a Master of Science in Applied Biomechanics.  I specialise in primary and revision knee arthroplasty (replacement) and primary hip arthroplasty.  I also perform arthroscopic (key hole) knee surgery.  I have a passion for teaching and am an Honorary Senior Lecturer at the University of Salford.  My hobbies include cooking and music.

Mr Muthu Jeyam

Consultant Orthopaedic Surgeon (Upper Limb)

I am a Consultant Orthopaedic Surgeon specialising in shoulder & elbow surgery.  I was awarded the Fellowship of the Royal College of Surgeons in 1995.  Following this I did full time research at the University of Manchester & obtained a research degree of M-Phil.  I then completed my higher surgical training in Trauma & Orthopaedic Surgery from Manchester for which I was awarded the Fellowship of The Royal College of Surgeons in Trauma & Orthopaedics in 2004.  I have been a dedicated fellow in learning the art of Shoulder & Elbow Surgery from the prestigious Nottingham Shoulder & Elbow Unit.  I also gained valuable experience from a further Fellowship at The Harvard Shoulder Service and The Boston Sports Injury Service, Boston, Massachusetts, USA.  I specialise in arthroscopic (key hole) shoulder and elbow surgery.  My practice includes management of patients with upper limb sports injuries. In addition I perform open surgery including arthroplasty (Joint Replacement Surgery) and specialise in complex upper limb trauma and fracture management.  I am  a member of the British Shoulder & Elbow Society (BSES).  I am an honorary clinical lecturer at Salford University.

Mr Henry Maxwell

Consultant Orthopaedic Surgeon (Lower Limb)Mr Henry Maxwell

I graduated from the Victoria University of Manchester in 1983 and was appointed as Consultant Orthopaedic Lower limb Surgeon at Hope Hospital Salford, a teaching hospital, in 1995.  During training I undertook a two-year research fellowship at the Centre for Hip Surgery at Wrightington Hospital.  I have completed specialist training in trauma and orthopaedic surgery.  In 1995 I was awarded the higher degree of Master of Surgery (ChM) and the Fellowship of the Royal College of Surgeons in Orthopaedic Surgery.  Following my formal training, I undertook a lower limb fellowship in Boston, USA.  Approximately 30% of my practice is foot and ankle surgery, 50% knee surgery and 20%  hip surgery.  In April 2013 I elected to provide NHS services solely in the independent sector consulting at various sites around the Manchester conurbation including Salford, Oldham, Bolton, Denton, Longsight though basing my surgical practice solely at the Ramsay Oaklands Hospital in Salford.


Dr Neil Snowden

Consultant Rheumatologist and Clinical Director

I trained in General Medicine, Rheumatology and Clinical Immunology in Cambridge, London and Manchester.  I am currently Consultant Rheumatologist and Clinical Director and previously worked in a similar role in local hospitals.  Until recently I was Chair of the Project Working Group for the National Clinical Audit for Rheumatoid and Early Arthritis, the first comprehensive study of what happens to people with early arthritis in the NHS.

Dr Vinodh Devakumar

Consultant Physician and Rheumatologist

I am a Consultant Physician and Rheumatologist jointly appointed by Pennine MSK Partnership Ltd and Pennine Acute Hospitals NHS Trust in a substantive role since May 2009.  In Pennine MSK Partnership Ltd I look after general rheumatology patients, work alongside the multidisciplinary team and provide support and training to rheumatology and GP trainees.  I am a British Society of Rheumatology (BSR) regional chair, sit on the BSR Education and Training committee and am presently Training Programme Director for General (Internal) Medicine for the North West.  I am an Advanced Life Support Instructor and Course Medical Director.  I am a fellow of the Royal College of Physicians and MRCP PACES Clinical Examiner.  I am External Clinical Advisor for the Care Quality Commission and Specialist Advisor for the Parliamentary Health Services Ombudsman.  I am patron for the North West Polymyalgia Support Group.  I am Regional Specialty Advisor for the Royal College of Physicians and member of the North West Rheumatology Peer Review Steering committee.

Dr Mehnaz Mehboob

GPwSI Rheumatology

I completed my GP training from Glasgow in 2009 before moving to Manchester.  I am a member of both Royal College of General Practitioners and Royal College of Physicians, UK.  I developed a Special Interest in Rheumatology while serving the community in Greater Manchester as Urgent Care GP.  I worked as part of the Rheumatology teams in Wrightington Hospital and Manchester Royal Infirmary between 2010 – 2015 and I also acquired a Post Graduate Diploma in Rheumatology from Kings College London during this period.  Since joining Pennine MSK Partnership Ltd in 2016, I have further developed interest in MSK medicine and gained membership of the Society of Musculoskeletal Medicine, UK.


Jill Firth

Consultant Nurse Rheumatology/Director for Service Improvement

I qualified as a Nurse in 1989 and have specialized in rheumatology since 1997.    After completing a PhD and working as a Senior Research Fellow at the University of Leeds, I joined the Pennine MSK Partnership Ltd team in 2010.  I now combine clinical practice with service and staff development, risk management, audit and research.  I am currently the President of the British Health Professionals in Rheumatology, a section of the British Society for Rheumatology.

Sarah Critchley

Lead Nurse/Rheumatology Specialist Nurse

I qualified in adult nursing in 1998 and have worked as a Rheumatology Specialist Nurse since 2002, initially at The Royal Oldham Hospital and then joined Pennine MSK Partnership Ltd in 2008.  My role incorporates patient education, disease management and assessment.

Kath Kinsey

Research Nurse

I qualified as a Nurse in 1996 when I began working at The Royal Oldham Hospital. I then worked as an Osteoporosis Nurse for a number of years.  I joined Pennine MSK Partnership Ltd in 2008 as a Rheumatology Nurse and more recently I am involved in research within the service.  This involves facilitating and co-ordinating participation in a variety of clinical research, educating patients and professionals regarding research opportunities and recruit to studies and facilitate the collection of data.

Karen Partridge

Rheumatology Specialist Nurse

I qualified in 1988 from North Manchester School of Nursing.  My background is General Surgery, Orthopaedic Trauma, ICU, HDU, District Nursing and later went on to do my Specialist Nurse Practioner degree.  I joined Pennine MSK Partnership Ltd in July 2006 undertaking the Osteoporosis/Fracture Liaison Service role and developed into Rheumatology.

Danielle Whitmore

Outpatient Nurse Co-ordinator

I qualified in 2003 from Salford School of Nursing and worked as a Staff Nurse on the Elective and Trauma Orthopaedic wards at Salford Royal Hospital until joining Pennine MSK Partnership Ltd in May 2010 as a Clinical Assessment Nurse.  My role mainly involves the running and delivering of patients’ Biologic treatments in our IV Infusion clinics, managing the team of Health Care Assistants, telephone triaging patient referrals through to an Orthopaedic Surgeon, triaging from the Choose and Book system from the GP referral through to listing for an Orthopaedic/Rheumatology Opinion and covering Orthopaedic, Rheumatology and Specialist Physio Clinics which we run from the ICC in Oldham.

Health Care Assistants

We have a team of HCAs who help run or busy clinics providing clinical and clerical support to the Doctors and Nurses.

Shamiya Ghani

Health Care Assistant

I gained my Level 3 Diploma in Health and Social Care in July 2018 and  also completed a Health Care Assistant Apprenticeship which I started in December 2016.  My main aim and role is to support the Doctors and Nurses within the clinics and assist in patient care.  I undertake triage of patients, patient observations, investigations such as phlebotomy and also clerical duties.

Occupational Therapist

Charlotte Critchley

Occupational Therapist

I qualified as an Occupational Therapist in 2009 from York St John University.  I worked at the Royal Oldham Hospital for 3 years before joining Pennine MSK Partnership Ltd in 2013 as a Rheumatology Occupational Therapist.  My main role is working with patients who have Inflammatory Arthritis supporting them to cope with and manage their conditions.  I also assess and treat patients with a variety of hand conditions.  Since starting here at Pennine MSK Partnership Ltd I became more involved in self-care and have therefore taken on the lead role for this.

Clinical Specialist Physiotherapists

Steve Young

Consultant Physiotherapist in Spinal conditions, MCSP MSc (Manip Phys) Dip MDT SOM

I work as a Consultant Physiotherapist in spinal conditions and have worked with Pennine MSK Partnership Ltd since 2008.  Now semi-retired, my work consists mainly of clinical assessments and consultancy as needed.

Dave Pilbury

Lead Physiotherapist & Clinical Specialist Physiotherapist in Rheumatology

I qualified as a Physiotherapist in 2003 after gaining an Honours Degree at Manchester University.  In March 2015 I completed my MSc. in Musculoskeletal Physiotherapy at Manchester Metropolitan University.  I have also achieved diplomas in orthopaedic medicine and completed an additional MSc. module in Assessment and Diagnosis of Musculoskeletal Conditions and Chronic Pain Management in 2010 at Manchester Metropolitan University.  I have 8 years of experience running pain management programmes for patients with chronic pain.  My focus has been on the education of clinicians and patients on the management of long-term conditions speaking at the University of Manchester, Manchester Metropolitan University and North-West Special interest groups.  I joined Pennine MSK Partnership Ltd in March 2015 to work as a Clinical Specialist Physiotherapist in Rheumatology.

Cathie Bamforth

Clinical Specialist Physiotherapist

I work mainly with lower limb conditions. MCSP, HPC registered with an injection therapy diploma.

Danielle Burke

Clinical Specialist Physiotherapist

Since qualifying from Manchester Metropolitan University with an honours degree in Physiotherapy in 2006, I have worked in various roles at Tameside and Glossop PCT and spent the majority of my NHS career working at the East Lancashire Hospitals Trust as a Senior Physiotherapist .  Alongside my NHS work I work as a Hand Specialist at Spire Hospitals in Manchester and also have experience working in professional and semi-professional sport.

I have gained a wealth of experience working in many different areas but my main passion has been working as a Musculoskeletal and Hand Specialist Physiotherapist for 7 years and also worked within Accident and Emergency at Royal Blackburn Hospital treating Musculoskeletal conditions and injuries before taking up this role as an Upper Limb Clinical Specialist here at Pennine MSK Partnership Ltd in 2017.

I deliver clinics at the Integrated Care Centre and Royton Health & Wellbeing Centre assessing and diagnosing Musculoskeletal conditions. I specialise mainly in upper limb and spinal problems but see a variety of patients. Alongside my clinical work I am currently completing modules towards my Masters degree in Trauma and Orthopaedics at Salford University and am also training towards my injection therapy competency.

Dave Carter

Musculoskeletal Physiotherapist, (B.Sc.(Hons) MCSP HPC Grad Dip injection Therapy)

I gained a B.Sc (Hons) degree in Physiotherapy from Manchester Victoria University.  I am an Extended Scope Practitioner in physiotherapy, have trained to masters level and also hold a post graduate diploma in injection therapy. I have been treating patients in the Oldham and Tameside areas for over 15 years and am HPC and MCSP registered.

Lucy Clough

Clinical Specialist Physiotherapist, Grad Dip Phys, MCSP

Clinical Specialist Physiotherapist with interest in spinal and upper limb musculoskeletal problems.

Ann Ellison

Clinical Specialist Physiotherapist, Grad Dip Phys MCSP

I qualified from Withington School of Physiotherapy in 1987.  From there I have had the privilege of travelling around the country and also the USA, in a variety of Physiotherapy roles specialising in Musculoskeletal Medicine.  I gained a number of MSC modules in 2000, including injection therapy and Orthopaedic Medicine.  In the last 10 years I have worked in an advanced physiotherapy role in a number of NHS and private settings specialising in back, knee and shoulder pain.  I have worked alongside my Pennine MSK Partnership Ltd colleagues since 2012.

Stuart Heron

Clinical Specialist Physiotherapist

I qualified as a Physio in 1993 after gaining an Honours Degree at Manchester University.  I have since completed my MSc. in Musculoskeletal Physiotherapy in 2007 at Manchester Metropolitan University.  I have also achieved diplomas in Orthopaedic Medicine and injection therapy and completed an additional MSc. module in Assessment and Diagnosis of Musculoskeletal Conditions in 2011 at Salford University.  I have 15 years of experience running pain management programmes for patients with chronic pain and fatigue and gained a certificate in CBT in 2009.

I have been delivering clinics based at the Royal Oldham Hospital for Pennine MSK Partnership Ltd since 2011 focusing on the assessment and diagnosis of musculoskeletal conditions.  I began working as an Extended Scope Practitioner in 2004 and have previous experience working in secondary care, tier 2 and ICAT clinics within Orthopaedics and Rheumatology at North Manchester and Bury.  I have particular interests in research, evidenced based practice and service development.

Kath Spencer

Clinical Specialist Physiotherapist,  Grad Dip Phys. MCSP.  HPC.  Grad Dip Injection Therapy

I qualified as a Physiotherapist in 1985 from Manchester Royal Infirmary.  I worked at the Royal Oldham Hospital for several years as an Extended Scope Practitioner in A&E and Orthopaedics.  I have been working within Pennine MSK Partnership Ltd since it started in 2006.  I am now employed by Pennine MSK Partnership Ltd delivering clinics at the Integrated Care Centre assessing and diagnosing a variety of musculoskeletal conditions.  I tend to specialise in lower limb problems but see a variety of patients.


Ian Marshall

Clinical Specialist Musculoskeletal Podiatrist

I am a Specialist Podiatrist and have worked in the field of musculoskeletal podiatry since my qualification in 2001.  I have worked with Pennine MSK Partnership Ltd since 2007.  My main role is the assessment, diagnosis and treatment of foot and ankle disorders.  This is often aided with direct referral for further diagnostic investigations and treatments often involving advice, manufacture and provision of orthotics and injection therapy.  I also deal with many referrals for knee, hip and lower back pain where gait abnormalities may be a contributing factor and orthotics indicated.  I also act as a triage to other services where necessary, such as Orthopaedics and Rheumatology.

Paul Tennant

Podiatrist, BSc (Hons ) Podiatry HPC Registered (Including Local Anaesthetic & Prescription of Medicine) MChs

I have experience in all aspects of Podiatry. I spent several years in London working for NHS treating almost exclusively high risk patients. Now practicing privately at R.C & G.M Tennant Ltd, Oldham with a broad scope of practice including biomechanics and nail surgery.

Persistent Pain Service

Paula Bragg

Clinical Nurse Specialist in Pain Management.

I have been a Clinical Nurse Specialist in pain management since 2002. MSc in pain management from University of Leicester awarded in 2006.  I commenced my Nursing career within operating theatres in 1993 following qualifying as a registered General Nurse.  I achieved a Diploma in Critical Care (operating department nursing) before becoming a Clinical Nurse Specialist in Pain Management in 2002.

In my role before early retirement as Lead Pain Nurse I developed a passion for the Persistent Pain service at Oldham and feel very privileged to have been able to resume a role as Clinical Nurse Specialist again within the team, where my role allows me to focus on delivering specialist advice and support to people who live with persistent pain.

Andrew Swan

Clinical Specialist Physiotherapist

I qualified as a Physiotherapist in 2008 from Manchester Metropolitan University.  I completed the Spinal Trauma and Orthopaedic Masters Module at The University of Salford in 2017.  I have 5 years experience running pain management programmes for patients with chronic pain and fatigue.  I have worked with Pennine MSK Partnership Ltd since 2015 in the Persistent Pain Service.