March 2013

Director's Update

Dear all,

The Easter break has meant it’s been more than 4 weeks since our last newsletter, so there are a number of things I wish to update you all on.

Firstly, the NHS Commissioning Board has announced the names of its newly-appointed National Clinical Directors (NCDs). The NCD for MSK is Prof Peter Kay, whom many of you will know. Peter is a former President of the British Orthopaedic Association, and has an excellent track record of working with stakeholders from across the MSK spectrum. We will be meeting Peter as an Alliance at the end of April, to understand his vision for MSK and determine how we can best support him in his new role.  

Next month will also see our new Project Manager for the MSK clinical networks project take up her post. Ann Clare is currently finishing a similar project for the DH on liver disease, and brings excellent experience to this post. We are delighted to have her with us.

As mentioned in our last newsletter, the recent new data on the UK from the Global Burden of Disease study provides us with important ammunition to influence the (increasingly important) public health agenda, and ARMA published an opinion piece in GP Magazine recently (our second in just over 6 months) on what this data means for the NHS’ understanding of “prevention” in particular. Contributing to the public debate on “big issues” like this one helps raise the profile of MSK with NHS opinion-formers and gives our Alliance an important platform from which to effect change.

Some of this change is already happening at the local level, e.g. the excellent PIER project by ARMA’s network in Stoke, which is a very good practical example of how even a relatively small initiative of this kind can make a big difference, and has plenty of potential for scalability.

Looking ahead, the highlight of April is without doubt the BSR Conference in Birmingham, where ARMA will be running a session on clinical networks – I look forward to seeing many of you there! I will also be chairing a session on work participation. A bit further down the line, ARMA is co-hosting a multidisciplinary seminar on integrated care alongside the NHS Alliance in June, which aims to be of real, practical value to a very broad range of clinicians and promises to be a very stimulating and thought-provoking event.

And last but not least, welcome to our latest member, the British Osteopathic Association.

Members' News and

Falls and Fractures Alliance Board meeting

The FFAEB (Falls and Fractures Alliance Executive Board) held its second meeting on 19 March 2013. 

It was agreed at the meeting that the Board would accept the invitation to become a stakeholder advisory group to the Falls and Fragility Fractures Audit Programme which brings together the National Hip Fracture Database and other streams of data in terms of falls and fractures.

The Board intends to engage with relevant new NCDs in its area including amongst others the Musculoskeletal, Spinal and Integration and Frail Elderly NCDs respectively.  Full minutes of the meeting will be made available on the National Osteoporosis Society’s website in due course.

NASS publications on exercise
and best practice

In the past month NASS were asked to write an opinion piece for the CSP magazine "Frontline" which goes out to 50,000 physiotherapists. In the article NASS highlights the importance of exercise for ankylosing spondylitis and the challenges of making sure the exercise message is getting across to people with A.S. as early as possible.

You can read the Frontline article online here.

In addition, GP magazine (which has a circulation including 34,500 GPs) published an in-depth article by NASS about their Looking Ahead guide to best practice. NASS would like to pass thanks to Dr Louise Warburton for her help with the following:  Managing ankylosing spondylitis -

New MSK core skills for GPs

Working with the Royal College of General Practitioners, Arthritis Research UK has funded and jointly developed a new training programme to improve GPs’ and GPSTs’ core skills in diagnosing and managing musculoskeletal conditions. The training project consists of e-learning modules, face to face workshops focused on clinical skills, and an ‘impact toolkit’ which contains practical resources for GPs.

Conditions covered include:

• gout and polymyalgia rheumatica (PMR)
• osteoarthritis (OA) – supported self-management and behaviour change
• fibromyalgia syndrome (FMS) – explanation and signposting
• common upper and lower limb conditions
• spinal conditions – bio psychosocial approach, discussions around work

To access free e-learning modules go to or to find out more about the project go to Arthritis Research UK website.


The call for proposals to further develop and validate a generic Musculoskeletal Patient Reported Outcome Measure (M-PROM) is fast approaching its closing deadline of 29th March 2013. We’re delighted this has generated such interest in the community and hope this interest will increase even more as the M-PROM starts to take shape. Over the next couple of months, all received applications will go through an external peer review process.

Musculoskeletal Calculator

In an information exercise to develop the Musculoskeletal (MSK) Calculator, Arthritis Research UK have been speaking with various end users to better understand how data drives design, and to ensure the MSK calculator meets people’s needs. Public health practitioners, general practitioners, orthopaedic and rheumatology consultants, local councillors and commissioners all contributed their thoughts on what data is needed and what data would be desirable.

New Policy Officer at Arthritis Research UK

Arthritis Research UK are delighted to welcome Amy Forbes to their team.

The BOA are Recruiting

The British Orthopaedic Association (BOA) Patient Liaison Group (PLG) is seeking to recruit a number of new lay members.

The PLG is committed to achieving improvements for patients needing orthopaedic treatment. It does so by advising the BOA of areas of patient concern, providing information about the needs and aspirations of patients requiring treatment and promoting constructive dialogue between orthopaedic surgeons and patients.

More information can be found on the BOA website:

To apply please send your CV accompanied by a covering letter to before 5 April 2013.

PSALV at Holyrood

On 20th February PSALV held a ‘patients voices’ event in Holyrood.

The event was attended by more than 50 people, with patients telling the audience and MSPs about their own experience of living with Psoriatic arthritis and skin psoriasis. Drs D Kemmett and Dr Hilary Wilson gave informative presentations. Dr Wilson is an expert on this condition and was on the 121 Sign guideline group – the national NHS Scottish guideline for PsA/Psoriasis.

Are NHS Staff Fit Enough?

The CSP has provided the Fit enough for patients? report, an audit of workplace health and wellbeing services for NHS staff.

The drive to deliver quality services to more patients whilst reducing costs in the NHS requires a healthy, productive workforce. The Chartered Society of Physiotherapy (CSP) welcomed the recommendations to improve staff health, and therefore reduce costs, which were made in 2009 by Dr Steve Boorman in his NHS Health and Wellbeing Review. Yet, three years on from the report’s launch, progress in reducing sickness absence rates across the NHS has stalled. For example, from 2009/10 to 2011/12 staff sickness absence rates fell by 0.28%2. However, rates fell by just 0.04% from 2010/11 to 2011/123.

Read more about report the on the CSP site or download the full report from our website.

ARMA members may also be interested in the CSP's Workout @ Work Day initiative, which is taking place on 12 June.  More information is available from the CSP website.

NRAS Report on RA for Atos

NRAS has recently authored a short report on rheumatoid arthritis for Atos to help improve their assessor’s knowledge about the disease when they undertake face-to-face Personal Independence Payment assessments. The disease is one of a number of ‘Health Condition Insight Reports’ which Atos has requested from third sector organisations.

The six page document outlines a range of sensitivities that assessors need to be aware of when undertaking the assessment and recommends some effective approaches towards communicating with RA claimants.

Prescription Charges

NRAS continues to be a member of the Prescription Charges Coalition and helped to produce a major report on the impact of charges on people with long-term conditions, which was published in March. NRAS commented on the draft report, provided media case studies, wrote two political blogs, drafted text for e-campaigning tools and also drafted a submission to the Labour Party Health and Social Care Policy Commission. The report can be downloaded at: Paying the Price report. There is also an e-action on the website which we are encouraging people from across the musculoskeletal sector to sign up to.


Rheumatoid Arthritis Awareness Week

The very first Rheumatoid Arthritis Awareness Week in the UK will be taking place between the 24th and 30th June 2013, a week dedicated solely to raising awareness of Rheumatoid Arthritis. Many people with RA have said that a common response to mentioning their Rheumatoid Arthritis is “my granny gets a bit of that,” so the aim of the week is to dispel the myth that Rheumatoid Arthritis is a disease of the elderly caused by a lifetime of wear and tear. Instead we want to emphasise that it is an autoimmune disease with no age barriers. Most people are still of a working age when onset occurs so it truly is a life changing disease. Events and activities will be planned throughout the week so watch this space to find out more.

Sky Diving and merchandise in the full NRAS post.

PIER Review Room

By Stephen Tatton of ARMA Stoke:

In the January Newsletter I mentioned that we were given the go ahead for a project that we have been working on for quite a number of years. We have been working on what we call a Patient Information, Education and Resource (PIER) Room.

The idea behind this “room” is that clinicians within the hospital are extremely busy, so much so that they may not always have the time to answer all the questions that patients may want to ask them, or that patients may not think of questions until after they leave their consultation. This is where the PIER comes in: patients new or existing can come along to ask for advice concerning not only their condition, but also about support groups, aid or anything else they may be concerned about.

We realise that we cannot give medical or financial advice etc., but we can steer patients in the right direction. I know that this may not sound like anything new, and that there are a lot of advice centres up and down the country, but what we think is unique is that this centre will be run by patients (all volunteers) for patients.

We do have a lot of work in front of us, not only in gathering all the required information and compiling a database from which we can work, but also in sourcing any literature that we may need. There is a core group of 3 volunteers who are putting in as much time as possible to make this work, and we are hoping to be open by August or September 2013.

Scot PHN report on Rheumatoid Arthritis

A very constructive meeting in Edinburgh was addressed by Dr Philip Mackie of the Scottish Public Network.

The Scot PHN report identifies key issues, including the need to shift practice towards early diagnosis and treatment, access to the multidisciplinary team, managing the cost pressures associated with RD drug prescribing, reducing work disability due to RA, and auditing and improving outcomes.

The report is accessible here from the Scot PHN site.

Expand full article.

Rheumatology 2013 keynote speakers announced

Mr Bob Ricketts, CBE, Director of NHS Provider Transition (Department of Health) and Director of Commissioning support strategy and Market Development (NHS Commissioning Board) will deliver a keynote address at this year's Rheumatology 2013 conference in Birmingham.

Read details online.

Pain management at BSR conference

A number of presentations at Rheumatology2013, the British Society for Rheumatology (BSR) conference, will cover the important topic of pain.

Leading experts will discuss how people think about pain, and how fear of pain affects their lives and their conditions, how musculoskeletal pain has an impact on society as a whole, and how changing the way people think about pain can actually reduce their pain.

Another presentation will discuss the latest research genetic differences in people’s sensitivity to heat pain, and how people feel pain, which may contribute to developing new painkillers.

In addition, poster presentations will cover research into assessing arthritis pain, and an online forum for people with chronic pain which could benefit patients and clinicians.

The conference, which will be attended by over 1,300 health professionals, including GPs, nurses, physiotherapists, occupational therapists, academics and consultant rheumatologists, will take place from 23 – 25 April in Birmingham. For more information, see .

Read more detail online.

Launch of “Save our Joints” campaign


The BSR has launched a SKY Sports campaign which will run at leading rugby and cricket sports events in 2013 to raise awareness that musculoskeletal (MSK) disease is the second greatest cause of disability in the UK and worldwide.

Read expanded post online.

Fibromyalgia FiT Newsletter for March

March's newsletter from the FiT Support Group for West Kent includes notes from the group co-ordinator; advice on cognitive impairment; tips for coping with memory issues; and there's a list of the speakers for this year's events.

Click here to read the FiT Newsletter.

Report from BIMM

by Dr John Tanner (BIMM President)

There are some developments I would like ARMA membership organisations to be aware of:

The first is the credentialing pilot commissioned by the GMC 2 years ago to see if there was a way of recognising the competencies of MSK physicians which would be valid, relevant and robust. So far our efforts at the British Institute of Musculoskeletal Medicine have met with good support from the GMC and they are looking at ways of regulating the process. . .

The future of MSK medicine lies in obtaining general agreement from all the disciplines that address MSK disorders in training, specific and generic competencies and their assessment so that the patient can be assured of receiving a standard of care from doctors who deliver such services in whatever context.

Read full report online.

MSK Commissioning Project

After a half-day meeting with the commissioning leads earlier in March, NRAS, BSR and Arthritis Care (in partnership as the Rheumatology Commissioning Support Alliance) have had confirmation that Wiltshire CCG have agreed to be the pilot area for development of the proposed MSK commissioning support tool.

This brings to an end a long wait to identify a crucial component of the project and we can begin to make definite plans for the rest of the year. A colleague from NRAS and Phil Baker from Arthritis Care will be involved in a range of engagement activities with local stakeholders in Wilts, to begin to build a more comprehensive needs analysis and feedback system, which will help shape the more technical aspects of change in MSK commissioning.


Stene Prize Competition Results

We'd like to share the final results of the EULAR Edgar Stene Prize Competition. The results are introduced in a letter from Maria Batziou, Chairperson of the EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE) and Neil Betteridge, EULAR Vice President, representing PARE and the Stene Prize Jury 2013.

Read the winning essay online.

Essay with Honorable Mention

Following on from the announcement of the Edgar Stene Prize results, ARMA is happy to to pass on EULAR's honourable mention for the UK entry by Caroline Howson.

The judges "convey their warmest regards to Ms. Caroline Howson for having shared her personal story". Read online.

Policy Items

GP-Online: MSK in the media

In March, The Lancet published UK-specific data drawn from December's landmark Global Burden of Disease study

Following on from the release of the GBD data, GP-online has published an article co-authored by ARMA's Federico Moscogiuri and GP Dr Tom Margham of Arthritis Research UK, in which they look at the UK's burden of disease through the differing lenses of DALY (disability-adjusted life years) and years lived with disability (YLD).

Living longer is clearly a good thing. But living longer with debilitating arthritis is another matter, and this has a big impact on a person’s quality of life. From the NHS perspective, providing care for someone with more than one complex condition over many years can be very costly and resource-intensive.

You can read the whole piece, titled "Viewpoint: What global burden of disease tells us about real challenges facing the NHS", by clicking here.

ARMA Calendar

ARMA CEO Meeting                                         17th April

Board Meeting                                                   19th April

Rheumatology 2013 Conference                 23-25 April

ARMA Clinical Networks Meeting               30th April

Networks Meeting                                            10th May

Medicine and Me - Aberdeen                         10th May

Policy Leads Meeting                                       16th May

NHS Alliance Specialist
Network Conference                                        18th June

Medicine and Me - Cardiff                              19th June

ARMA CEO Meeting                                         3rd July

Board Meeting                                                    5th July

Policy Leads  Meeting                                       16th July

Board and AGM meetings                               17th October

ARMA CEO Meeting                                         31st October

Check our website calendar for meetings and events.

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