August 2013

Director's Update

Dear all,

I hope you’ve all had a good Summer break, and are refreshed and ready for the very busy and exciting Autumn ahead of us.

Firstly, I’m sure you’ve all heard the recent news from Bedfordshire, where the CCG has awarded “preferred bidder” status to a consortium which includes the Pennine MSK Partnership, NRAS and Arthritis Care for delivering the first fully integrated MSK service in the new NHS structure (see below for more on this). As noted by the HSJ , “Bedfordshire is the most advanced CCG in introducing this type of system but HSJ has identified a raft of similar deals in the pipeline.” Congratulations to the ARMA members that were involved. Incidentally, here is an interesting reflection from Paul Corrigan from over a year ago – but which I think is still very relevant today - which had already identified the Bedfordshire MSK service redesign as representing a new, groundbreaking approach to commissioning whole-pathway care centred around patient outcomes, as opposed to processes.

Public health is an increasingly important area of health with a very strong element of MSK. Arthritis Research UK’s Public Musculoskeletal Health: A Lifecourse approach seminar on 29 August was a very well-attended and productive event which explored the linkages between Public Health England’s current priorities and MSK, and how MSK can provide a means to address many of these effectively. The opportunities for embedding MSK more into the public health agenda, particularly in the light of the Global Burden of Disease, are certainly great.

For many of us, Autumn is, among other things, conference season. One of the most recent and perhaps most intriguing additions to the already long list of events over the coming months is NHS England’s Future of Health Conference on 3rd and 4th October, focusing on long-term conditions. The programme is still being finalised, but we are hopeful that it will include at least some examples of best practice in MSK. That same week, ARMA will be presenting on the ongoing MSK clinical networks project at the BOA Annual Congress , followed the week after by the CSP Annual Conference.

Regarding the MSK clinical networks project, we are currently planning a national MSK “learning event” for late November in partnership with the MSK National Clinical Director, Peter Kay. This event will be a key opportunity to both discuss the main findings of the project to date and to explore in more detail the key challenges in delivering coordinated, high-quality, patient-centred care in MSK in the new NHS in England. More to follow on this in due course.

This year Autumn also appears to be consultation season, and there are currently several consultations which ARMA is planning to respond to, and which you may also wish to respond to separately. First up is the NHS Hospital Data and Datasets: consultation, which closes on 16th September, followed by the Vulnerable older Peoples plan  and Refreshing the NHS Mandate , which close on the 27th September, and then the Commissioning on the Future of Health and Social Care in England: A Call for Evidence , which closes on 30th September. Finally, NICE are consulting on the Osteoarthritis (update)  clinical guideline up to 11th October.  Please send any comments or submissions on any of the above which you might like ARMA to endorse to

Finally, there is still time to apply for the role of ARMA Treasurer (deadline: 11th Sep), so please do share the link with anyone who you feel may be interested.

Best Wishes,

Season of mists and mellow fruitfulness,
Close bosom-friend of the maturing sun;
Conspiring with him how to load and bless
With fruit the vines that round the
                                             thatch-eves run.

To Autumn, John Keats

Members' News and

Winning Integrated MSK care

Winning Integrated MSK care

NRAS and Arthritis Care are part of a consortium that has just won preferred bidder status for a five year prime contractor contract to run integrated musculoskeletal services in Bedfordshire. Negotiation over the detailed terms of the proposal are now taking place with Bedfordshire Clinical Commissioning Group.

The consortium is being led by Circle Holdings Limited, the employee co-owned hospital group and Pennine MSK, the developer of the original integrated model of musculoskeletal services in Oldham.

The consortium is the first of its kind and is focused on improving quality and integrating care for Bedfordshire’s 440,000 patients through clinical leadership. The bid means MSK services within Bedfordshire Clinical Commissioning Group, which were previously handled by more than 20 separate contracts, will now be organised by one Prime Contractor, Circle. Other partners involved in the consortium include Horizon Health Choices, a local healthcare provider of a range of NHS services, including MSK, in a variety of community settings across Bedfordshire, and Luton and Dunstable NHS Foundation Trust, a local NHS Foundation Trust and provider of secondary care and community services who will be working with Circle to develop the model of care in Bedfordshire.


BSR President running for NRAS

This year NRAS have a team of 22 runners taking part in the Great North Run, including our very own Leo Watson, Government Affairs Officer.  They will  run the 13.1 mile course from Newcastle to South Shields on the 15th September, come rain or shine, flying the flag for NRAS! This year we are lucky enough to have Dr Chris Deighton, Dr Amjad Jilani and Kelly Robbins (who works at Leighton Hospital in their Occupational Therapy Department) running for us.  If you would like to support Chris, Amjad or Kelly please visit Chris’s Justgiving page at  or contact Val at or call  501547 to sponsor Amjad or Kelly. We also have one remaining place for this year’s Great South Run which takes place in Portsmouth on the 27th October.  This is a 10 mile race and is a great course for an experienced runner or someone who is taking on a run for the first time. If you would like any further information on any of the above please contact Val at or phone 01628 501547.

BSR - Photos and Simple Tasks

BSR - Photos and Simple Tasks

Do you have any photos BSR could use?

Send in a photograph and you could win John Lewis vouchers and the chance to showcase your work on BSR’s next membership campaign.

The competition is open to anyone with an interest in rheumatology. Please send photographs in the following four categories:

  • Rheumatology as a science
  • Rheumatologists help patients
  • Rheumatology professionals never stop learning
  • The rheumatology team

Each category winner gets a £30 John Lewis gift voucher, and there will be £10 awards for highly commended photos. For more information, please see


Support the BSR’s Simple Tasks campaign on Twitter

The British Society for Rheumatology is launching the Simple Tasks campaign in October to point out that ‘Simple tasks can be impossible for people with rheumatic conditions.’

We want to make more people aware of the scale and impact of rheumatic disorders, the work of rheumatology health professionals, and the importance of treating people with rheumatic conditions within the window of opportunity – the first three months after their symptoms start. Effective treatment in this window of opportunity ensures the best chance of remission, and prevention of permanent joint damage that leads to pain, disability, and inability to do Simple Tasks such as brushing teeth, getting dressed or walking to the shops.

Support the Simple Tasks campaign by signing up to the BSR thunderclap:

Thunderclap is a bit like an online flashmob. If you sign up, it will tweet the message: “Rheumatic conditions are more than aches and pains - they can make the simplest tasks impossible. #SimpleTasksUK” from your account on 3 October.

You can also show your support in advance of campaign launch by liking the BSR Facebook page .

EDS UK One-Day Conferences

EDS UK Conferences

EDS UK One-Day Conference for Hypermobile EDS

Saturday October 12th 2013.

Speaker Details:
9am – Registration and Tea and Coffee
9.30am – Dr Adam Farmer – The Gastro System and EDS
10.30 – Break
11am – Prof Rodney Grahame – Hypermobility EDS 2013
12pm – Lunch
1.30pm – Lara Bloom – EDS UK, your charity and introducing our new Chief Medical Advisor Dr Hanna Kaz Kaz
2pm – Anthony Vandersteen – The EDS Diagnostic Services and Rarer Types of EDS
3pm – Break
3.30pm – Workshops with Genetic Nurses
5pm - End

Staverton Park De Vere Hotel, Daventry Road, Northamptonshire,
Staverton, Daventry, NN11 6JT


EDS UK One-Day Conference for Vascular, Classical, Kyphoscoliotic and Type 7 EDS

Saturday October 5th 2013

Speaker Details:
9am – Registration and Tea and Coffee
9.30am – Glenda Sobey – The EDS Diagnostic Services and Rarer Types of EDS
10.30 – Break
11am – Dr  Neeti Ghali – Vascular Ehlers-Danlos Syndrome
12pm – Lunch
1.30pm – Lara Bloom – EDS UK, your charity.
2pm – TBC
3pm – Break
3.30pm – Workshops with Genetic Nurses
5pm - End

Lupus Awareness Posters

Lupus Awareness Posters

LUPUS UK has recently released two new posters for Lupus Awareness Month in October. The puzzle poster was designed by one of our members with lupus and is aiming to highlight the difficulty many people with lupus have in getting diagnosed because of its many symptoms and doctors frequently not looking at the whole picture.

The other blue poster is aimed more towards hospitals and newly diagnosed patients in an effort to highlight the charity and let them know that we have support and information that we can offer. Both posters are available to download or order at

These posters are also available in full-size, large images on the LUPUS UK site.

BAcC Conferences

BAcC Conferences

The British Conference of Acupuncture and Oriental Medicine is to be held on 21st and 22nd September. All are welcome to attend -  go to for more information and to register.

The British Acupuncture Council member presented a poster of statistics on chronic pain and acupuncture at a GP conference recently, and exhibited with the Professional Standards Authority at a Kings Fund event on innovation in the NHS, held at the Royal Society of Medicine.

A recent meeting regarding a proposed review of the advertising sector by the Committee of Advertising Practice/ Advertising Standards Authority (CAP/ASA).  Pleasingly, the BAcC's status with the Professional Standards Authority Assured Voluntary Register has been shown to assist in CAP/ASA seeing BAcC members as suitably medically qualified. An event discussing the nature of high quality research in complementary medicine is to be hosted by the Research Council for Complementary Medicine.

Speakers include Nick Hudson from CAP/ASA at the Royal Society (6-9 Carlton House Terrace London SW1Y 5AG) on 25th September. RCCM and CAMRN members - £80.00 Non-members – £95.00 until 30th August (after £110). To register in advance, e mail

BARC newsletter - August 2013

BARC newsletter - August 2013

Welcome to the Summer edition of the BARC newsletter, from the Birmingham Arthritis Resource Centre. This edition offers three main articles: The first is written by one of BARC’s volunteers, on the subject of arthritis and higher education. The second reviews the chronic condition of Fibromyalgia. The final article announces the world’s first treatment centre for black bone disease.

Naturally, the newsletter includes the usual pieces - words of inspiration, words of gratitude to those who made donations, shopping and donating money to BARC, and a Q&A session with one of BARC’s first volunteers.

View the newsletter by clicking on the image.

BSR bursaries for conference attendees

BSR bursaries for conference attendees

The British Society for Rheumatology has launched a new bursary scheme, sponsored by MSD, for consultant rheumatologists and trainees to attend the American College of Rheumatology Annual Meeting in San Diego this October.

The Deadline for applications is 5th September

Each bursary, one for each of the four UK nations, consists of up to £1,500 to reimburse the cost of travel, registration and accommodation for attendance at the American College of Rheumatology Annual Meeting (25-30 October 2013). Consultants in their first two years post-qualification, and trainees in their final year of specialist training, are invited to apply. For more information, please see this page on the BSR site.

“This is a great opportunity for rheumatology health professionals, who might otherwise not be able to afford to attend an important international conference,” said Chris Deighton, President of the British Society for Rheumatology. “We greatly appreciate the sponsors’ support of the leading rheumatologists of the future.”

For further information, contact Zena Wigram at the British Society for Rheumatology on 020 7842 0900 or

MSD, the scheme’s sponsor, will have no involvement in selecting the bursary winners.

The funding will not influence any of BSR’s officers in any way, including not giving any advantage to MSD in any decision-making. The funding has nothing to do with any prescribing, administering or recommending any MSD product by bursary applicants. For more information about MSD, please see

M-PROM & MSK Calculator Grants

M-PROM & MSK Calculator Grants

Arthritis Research UK announces the award of a special strategic grant to develop a M-PROM (Musculoskeletal Patient Reported Outcome Measure)

Arthritis Research UK is delighted to announce the award to further develop a musculoskeletal patient reported outcome measure (M-PROM) has been made to a collaborative initiative between the Primary Care Sciences Research Centre in Keele, led by Dr Jonathan Hill, and the Oxford University Nuffield Orthopaedic Trust, led by Professor Ray Fitzpatrick. This will be the first time the two research teams have worked together.

Patient reported outcome measures (PROMs) are a way of recording how people rate their own health status. They are of particular value in musculoskeletal conditions where few biomedical measures are available to assess the effect of a disease on a person’s health. For conditions such as these, PROMs can be an effective way of measuring health outcomes.

The research teams will develop a candidate instrument that means patients’ own feedback on progress about meaningful aspects of their health status can be used to monitor and evaluate clinical outcomes in different musculoskeletal care settings. Key stakeholders within the musculoskeletal community, including people living with musculoskeletal conditions and clinicians, researchers, service providers and commissioners, will determine whether the proposed set of questions are acceptable, feasible and applicable across general practice, physiotherapy, rheumatology and orthopaedic settings.

Work will begin on developing the instrument in October 2013, expected to complete phase one in June 2014.


Arthritis Research UK announces a special strategic grant award to develop the MSK calculator

Arthritis Research UK is delighted to announce a research award to Imperial College London, led by Dr Michael Soljak, to develop four population prevalence models for the online musculoskeletal (MSK) calculator.

As the Chief Medical Officer has recognised, MSK health conditions are a data poor area. There is not good data available about the numbers of people with MSK conditions such as osteoarthritis for use in local planning of health services. This means that arthritis sometimes gets ‘left off the table’ when health planners are considering long term conditions.

To address this ‘data gap’, Arthritis Research UK is developing a MSK calculator to provide local estimates of the numbers of people with musculoskeletal conditions for use in local Joint Strategic Needs Assessments (JSNA), which are developed through the forum of the Health and Wellbeing Boards. The first wave of data in the MSK calculator will look at four of the more common MSK conditions in England: osteoarthritis, rheumatoid arthritis, back pain and the high fracture risk model (owing to the underlying condition of osteoporosis). These will encompass prevalence, incidence, and condition specific risk factors.

Work has commenced on developing the prevalence model for osteoarthritis, and the team hope to have the online tool available by Summer 2014.

Arthritis Research UK PsA Booklet

Arthritis Research UK PsA Booklet

PSALV and others were given the opportunity to review the Arthritis Research UK PsA Booklet which is used extensively in clinics across Scotland and the UK. We were able to show that 1 in 5 people with minimal skin psoriasis develop a varying degree of psoriatic arthritis (according to SIGN NHS QIS Clinical guideline 121) this figure had previously been stated as 1 in 14.

As a person with psoriatic arthritis, for 39 years, I was delighted to assist our expert Rheumatology advisers which included Dr H Wilson.

Report by Janice Johnson


PSALV will be attending the following events in the coming month:

On 4th September we will attend the ALLIANCE Scotland /ABPI Seminar with the shadow Health Minister.

The next ARMA Scotland meeting will take place on 9th September – for more information please contact the ARMA office.

The next Psoriatic Arthritis /Psoriasis Cross Party group takes place on 25th September at Holyrood, Edinburgh, this is open to all. This is a hugely important campaigning body for us in Scotland as health is devolved.


Osteoarthritis, Cartilage and Acupuncture

The British Acupuncture Council would like to highlight this article from the University of York on acupuncture for osteoarthritis of the knee, in which researchers compare physical therapies against each other in an innovative network meta-analysis. Acupuncture is associated with the most high quality studies, but also outperforms most other therapies

An abstract of the article is below, and the full (open access) article can be found here on the Science Direct site. (Note: to view this website your browser’s cookies must be enabled.)

Osteoarthritis Cartilage. 2013 Sep;21(9):1290-8. doi: 10.1016/j.joca.2013.05.007.

Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis.

Authors: Corbett MS, Rice SJ, Madurasinghe V, Slack R, Fayter DA, Harden M, Sutton AJ, MacPherson H, Woolacott NF.

Source: University of York, UK.
Electronic address:


To compare the effectiveness of acupuncture with other relevant physical treatments for alleviating pain due to knee osteoarthritis.


Systematic review with network meta-analysis, to allow comparison of treatments within a coherent framework. Comprehensive searches were undertaken up to January 2013 to identify randomised controlled trials in patients with osteoarthritis of the knee, which reported pain.


Of 156 eligible studies, 114 trials (covering 22 treatments and 9,709 patients) provided data suitable for analysis. Most trials studied short-term effects and many were classed as being of poor quality with high risk of bias, commonly associated with lack of blinding (which was sometimes impossible to achieve). End of treatment results showed that eight interventions: interferential therapy, acupuncture, TENS, pulsed electrical stimulation, balneotherapy, aerobic exercise, sham acupuncture, and muscle-strengthening exercise produced a statistically significant reduction in pain when compared with standard care. In a sensitivity analysis of satisfactory and good quality studies, most studies were of acupuncture (11 trials) or muscle-strengthening exercise (9 trials); both interventions were statistically significantly better than standard care, with acupuncture being statistically significantly better than muscle-strengthening exercise (standardised mean difference: 0.49, 95% credible interval 0.00-0.98).


As a summary of the current available research, the network meta-analysis results indicate that acupuncture can be considered as one of the more effective physical treatments for alleviating osteoarthritis knee pain in the short-term. However, much of the evidence in this area of research is of poor quality, meaning there is uncertainty about the efficacy of many physical treatments.


Youth Task Force Survey from EULAR

Youth Task Force Survey from EULAR

EULAR PARE survey - What are the challenges of young people living with rheumatic and musculoskeletal diseases in Europe today? Help us gather information by promoting a short survey. This survey is developed by and for young people between 18-35 from all over Europe. It will only cost the respective respondent about 10 minutes to answer our questions.

By disseminating this survey to young people with MSDs you help us to get a better understanding of what young people experience and how we can improve our information and support!

Survey will be open until 20 September 2013

Your help is very important and much appreciated! For any questions you have or further information, please contact us at anytime!

EULAR launches the Edgar Stene Prize 2014

EULAR launches the Edgar Stene Prize 2014

Each year EULAR PARE runs an essay writing competition and this year the essay title is:

“Vision 2043 – my ideal world for people with a rheumatic or musculoskeletal disease.”

The Stene Prize is EUR 2'000 and includes travel to the Annual EULAR Congress of that year with hotel accommodation for up to four nights as well as an invitation to attend the Opening Plenary Session and the Congress Dinner at the EULAR congress.

This is a very exciting competition and although the UK has not won in recent years we have made it into the published brochure. The deadline for submissions to the ARMA office is 31st December 2013 and winner will be announced by EULAR on 15th March 2014. The competition entry rules can be found here and more information is available here.

If you require any further information then please don’t hesitate to get in touch with the ARMA office. We look forward to receiving many inspiring and encouraging essays at

Policy Items

NHS Hospital Data Consultation

NHS Hospital Data Consultation

An opportunity to encourage data collection about musculoskeletal conditions in HES

Arthritis Research UK is keen to encourage responses from ARMA organisations and their professional members to the recent consultation from NHS England and the Health and Social Care Information Centre. The consultation seeks views on the future of hospital data collection to inform the development of the Hospital Episode Statistics (HES) system.

This is an excellent opportunity for the community to call for improved data collection about musculoskeletal conditions in outpatient departments.

Arthritis Research UK have provided an overview and suggested response, which you can read here in PDF format. The closing date of the consultation is 16 September 2013.

You can also read about the consultation on the NHS England website.

ARMA adds RA Endorsement

ARMA adds RA Endorsement

ARMA has endorsed the NICE Quality Standards for Rheumatoid Arthritis - QS33, issued: June 2013.

Thank you to all our members who fed in their views during the process.

NICE quality standards describe high-priority areas for quality improvement in a defined care or service area. Each standard consists of a prioritised set of specific, concise and measurable statements.

The quality standard QS33 covers the diagnosis and management of rheumatoid arthritis in adults (16 years and older).

Consultations open for Review

Consultations open for Review

ARMA would like to notify you of the following consultations. Could you please take note of the following, along with their respective dates, and inform us if you would like us to add our support to a comment on your organisation's behalf.


If anyone would like to feed in their views then please send their comments to by the date stated.

Progressive conditions dossier

Progressive conditions dossier

NRAS has worked alongside Parkinson’s UK, MS Society and Cystic Fibrosis Trust to produce a ‘progressive conditions dossier’ to be presented to Dr Paul Litchfield as part of the ‘Fourth Independent Review of the Work Capability Assessment (WCA)’.

The dossier illustrates the main problems people with these types of long term conditions face when applying for Employment and Support Allowance, with perhaps the most distressing of all being that almost half of the people with these progressive conditions are being told they will recover enough to look for work in the future.

The consultation for the review closed on 27th August and the department of Work and Pensions are now analysing the feedback submitted. 

Spotlight On...

Physical Activity Guidelines from the CMO

Physical Activity Guidelines from the CMO

With the growing emphasis on public health and healthy living, there is an increasing recognition of the importance of physical activity for preventing and reducing the impact of long-term conditions such as MSK disorders. These guidelines on physical exercise from the Cheif Medical Officer are not new but are still useful resources in this area in a very broad sense.

ARMA Calendar

Public Health England Annual Conference                     10th-11th September
IMID Summit: Let's Talk Health!                                        12th-13th September
Policy Leads and Stakeholder meeting                              19th September
RCGP Annual Conference                                                      3rd-5th October
BSR Autumn Conference, Edinburgh ICC                        3rd-4th October
Future of Health Conference, London                                3rd-4th October
ARMA CEO Meeting                                                                 10th October
CSP Conference                                                                         11th-12th October
ARMA Board Meeting                                                             17th October
ARMA Annual General Meeting                                          17th October
World Osteoporosis Day                                                          20th October
PCRS Conference                                                                       21-22 November
NHS Alliance                                                                             27-28 November

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