As 2013 draws to a close and we prepare to welcome in the new year – after a highly-welcome Christmas break – we can reflect back on what I feel has been a highly successful year for ARMA.
It was this time last year that we first learnt of the creation of the new role of MSK National Clinical Director for England, and nearly 12 months since I was invited to be on the advisory panel for recruitment to this post. Since then we have appointed a Project Manager for our MSK clinical networks project and made great strides in bringing together both evidence of what works in MSK, and leaders in the MSK field. As a community, we have continued to influence and shape the public debate on the big issues, from commissioning to care planning to public health, with some very encouraging results. We have also grown and consolidated our standing as an Alliance, with a number of new member organisations, greater member involvement in discussions and better sharing of information. We have improved our website and our communications, and I encourage you all to continue to use and to regard these as an added resource for you all.
The last few months in particular have been very eventful, the chief highlight of which has been our first-ever, pan-MSK summit on 26 November, followed by our annual ARMA lecture that evening with not one but three NCDs as our keynote speakers. The discussions very useful in informing the next stage of our key project on MSK clinical networks, and the feedback has been of the kind which an organisation with many times our size and resources would have been proud of. In our first-ever member blog, NASS CEO and ARMA trustee Debbie Cook reflects on this event and where we go from here as a community.
We will be sharing more detailed information about this in January, when our Project Manager Ann returns from a well-earned holiday in New Zealand, which is about as far as she could possibly go from here. In the meantime, we have captured the presentations and some useful resources on our dedicated new webpage.
Our clinical networks project will of course continue to be a key priority for ARMA in 2014. Although the Goals and overall Aims of our current 3-year plan are unlikely to change, there are a few things which are likely to represent important new opportunities for MSK in 2014. One of these is the broad public health agenda, where we will continue to build on the Global Burden of Disease data with a likely emphasis on physical activity, which, as Prof Peter Kay has said, is emerging as something of a “rallying cry” for many NCDs in England.
…And on that note, I am delighted to welcome the Faculty of Sports and Exercise Medicine as our newest members.
There are, as ever, also developments which require our collective response, and the recent announcement of changes to the Quality and Outcomes Framework in England, with the removal of two indicators on RA and the amendment of one on osteoporosis, is one of these. We have duly written to the Rt. Hon. Jeremy Hunt, not so much to call for an unlikely rethink on the indicators themselves as to invite the opportunity to have an informed discussion about what outcomes measures the “new NHS” in England needs to have in place to ensure that people with all forms of MSK disorders are in fact getting the best possible care.
At our MSK 2013 summit a few weeks ago, I used the story of the elephant and the blind men as an allegory for the MSK community. We are a very broad and varied community, and we all hold clear and well-founded views on a range of issues from each of our respective positions, but if we are to be successful in our shared objectives we have to be able to see the big picture, and embrace the transformational change that is required of us to do that. That way, we can legitimately aspire to make 2014 the year of MSK.
Musculoskeletal Conference -
The Patient Story
Last week I had the pleasure of speaking at the Arthritis and Musculoskeletal Alliance's MSK2013 conference about the patient experience.
I was honoured to be asked, to be given the opportunity of talking to commissioners, Healthcare professionals and other patient group representatives. I shared the patient journey slot with Jo from Arthritis Care.
I presented the highlights, key messages from our recent patient survey. It was great to have data representing the journey and opinions from 1630 people with a diagnosis of AS. I was able to highlight the often 'invisible' nature of ankylosing spondylitis, the prevalence data (it’s not a rare condition) and talk about the impact on patients' lives and the lives of those around them.
I'd talked about the same issues the night before to a room full of journalists. It's clear from the feedback on both days that this information is really making the listeners stop and think about AS and that they are learning more about the disease.
People also report that I speak with passion about the issues. I'm in the wrong job if I don't.
After the conference ARMA also managed to secure the 3 national Clinical Directors for MSK, Spinal disorders and Major Trauma who all gave a presentation. That was a large undertaking; to get 3 such high profile post-holders together in a room at the same time. It was fantastic to hear them too speak with passion for making improvements. Really heartening.
It's so important that both patients and patient groups get to hear about all this stuff: things that happen to improve the patient experience, but are not always visible to the patient. Working together, we are all aspiring for improvements.
MSK has no National Strategic Clinical Network to advise commissioners.
That puts MSK behind the curve in terms of the new health landscape.
It's not good enough and we need to push hard for a better deal for MSK.
Believe me. We are.
But we’re not waiting for an SCN to fall into our lap, nor would it prove a ready-made answer to the issues we’re all grappling with. We – and who better than us? - have got to come up with those answers ourselves, by working together, and that’s why we’re getting on with the job of building MSK clinical networks in England from the ground up.
Peter Kay, the National Clinical Director for Musculoskeletal Disorders puts it very well when he says something like "MSK healthcare is not usually about saving lives but good MSK healthcare makes life worth living".
Take care all,
Clinical Commissioning Guidance
Last month, the British Orthopaedic Association published five Clinical Commissioning Guidance documents which were jointly developed with the Royal College of Surgeons and other stakeholder groups using a defined process, accredited by NICE.
The documents cover a wide range of conditions, and were officially launched at an NHS England/Right Care event. The documents have been well received and there is currently a second series of documents in development.
The published documents are available on the BOA website.
NICE Recruiting to Commissioning Group
NICE are currently recruiting new members for our Clinical Commissioning Group Outcomes indicator Set (CCGOIS) Advisory Committee. The recruitment advert is now available on the NICE website and can be accessed via the link below. The deadline for applications is Friday 27th December 2013 at 17:00.
Member: CCG OIS Advisory Committee
Please forward this email to anybody who you think may be interested in applying for a position on the CCGOIS Advisory Committee.
In addition, ARMA would like to notify you of the following consultation. Could you please inform us if you would like us to support a comment on your organisation's behalf:
Quality Standards for Public Health - Consultation on potential future public health quality standard topics. Deadline: 20th December 2013
Hip and Knee Replacements:
Combating Patient Lotteries
Report from The Medical Technology Group
Summary: Shortly before Christmas may be the best time of year to need hip or knee joint replacement surgery – with just after Christmas the worst time. Like the postcode lottery, this time of year lottery means patient outcomes are radically different depending on the financial calendar.
Clinical Commissioning Groups should stop the practice of imposing restrictive conditions before referring patients; patients should not be stopped from having surgery due to age, weight or other characteristics; Trusts should ensure greater equity of access throughout the year; all trusts should have strategies in place improve patient outcomes; the Best Practice Tariff for hip and knee should be extended to include the length of wait between referral and treatment as a qualifying criterion.
To read the full press release, selected stats and findings, click here, or go straight to the full 28-page PDF report on the mtg.org site.
BOA Comment on Dr Foster Report
The British Orthopaedic Association welcomes the Dr Foster Hospital Guide 2013 publication and its focus on hip and knee replacement data.
Committed to clinical leadership and our patients, we are already working closely with NHS England, Hospital Trusts and Clinical Commissioning Groups to ensure high quality orthopaedic clinical care for all.
We are therefore concerned that the report highlights a reduction in the number of hip and knee replacements performed in some areas.
Those patients who are not receiving joint replacements at the time they most need them are being denied the significant benefits that this surgery can bring.
There is strong evidence that these are highly effective operations with a wider economic and social impact because they restore mobility and reduce disability.
They are also very cost-effective for the NHS, and if they are being reduced for financial reasons as the report suggests, we consider this to be both counter-productive and detrimental to patient care.
BBC News coverage can be viewed here.
Health Minister visits award-winning Rheumatoid Arthritis Centre at Guy’s Hospital
The Minister for Care and Support, Norman Lamb MP, visited the Rheumatoid Arthritis Centre at Guy’s Hospital in December. During the visit he met patients, clinicians and representatives of the leading patient and healthcare professional bodies to discuss the importance of early diagnosis and public awareness in the successful treatment of the chronic autoimmune disease, rheumatoid arthritis.
Raising public awareness of the disease is vital, as there is a known ‘window of opportunity’. If a person is diagnosed and started on appropriate treatment within 12 weeks of symptom onset, they are more likely to achieve remission or minimise the severity of the disease, meaning they can have a much better quality of life and avoid much irreversible joint damage. However, a National Audit Office report showed that half of rheumatoid arthritis patients don’t even visit their GP within this time frame.
The visit was an opportunity for the Minister to listen firsthand to concerns from patients about delays, and at the same time recognise the efforts of Guy’s and St Thomas’, the British Society for Rheumatology (BSR), and the National Rheumatoid Arthritis Society NRAS, who are striving to deliver the highest standards of care for patients. NRAS and Guy’s and St Thomas’s were winners in this year’s prestigious BSR Rheumatology Best Practice Awards and were presented with their certificates by the Minister.
The Rheumatology Best Practice Awards recognise ground-breaking and innovative practice in rheumatology and musculoskeletal services. The work commended in the awards has improved patient experience, health care value, and outcomes and offers examples of ways in which rheumatology services can be improved.
During the site visit, the Minister toured the Rheumatoid Arthritis Centre during a regular arthritis clinic with patients and observed the use of cutting edge ultrasound technology to examine patients for signs of inflammation caused by the disease.
Care Minister Norman Lamb MP said: "It was great to meet the patients who are benefiting from the pioneering treatment at Guy's Rheumatoid Arthritis Centre and to meet the staff behind this award-winning centre.
"We know patients with rheumatic diseases need fast and effective treatment and Guy's Hospital is making sure that happens. We also know that early diagnosis is really important which is why the Department of Health is giving NHS trusts financial incentives to get patients with suspected inflammatory arthritis seen by a specialist within three weeks and treated within six weeks."
Article continues online.
Nurse Specialist Needed
Support BSR’s national clinical audit of rheumatoid and early inflammatory arthritis
BSR is looking for a nurse specialist to volunteer to help shape future improvements in rheumatology services across the UK. They will join the British Society for Rheumatology’s audit programme and contribute to the development and reporting of the national clinical audit. Funded by the Department of Health, the audit will find results which will help clinicians improve the quality of care for patients and control their joint inflammation.
The volunteer will take part in project meetings and help to develop the project by contributing their own perspective as a specialist rheumatology nurse. They would need to attend monthly meetings during the set-up of the audit (January and February 2014) and then quarterly meetings once the audit is in place from February 2014 onwards. They will also be asked to reply to some emails and comment on documents – this will be once or twice a month.
Travel expenses will be reimbursed. Please apply by submitting a copy of your CV together with a short outline (max 300 words) of your experience with clinical audit to date to Paula Beare, Project Director for the national clinical audit, on firstname.lastname@example.org. The closing date for applications is 31 December 2014, with the first meeting for the role taking place on Friday 17 January 2014.
& Direct Referral Project
PIP is the new benefit that is replacing DLA. All DLA claimants aged 16 – 64 will eventually be re-assessed to see if they qualify for PIP. Under the new rules, if a claimant can walk more than just 20 meters they will no longer qualify for the higher rate of the mobility component of PIP. This would mean they would no longer qualify for a vehicle under the Motability scheme.
There are also big concerns about how people are assessed. For example, a claimant could be ‘clinically’ assessed by someone who doesn't have a detailed understanding of their condition.
We are inviting supporters to fill in this online survey, created by the Disability Benefits Consortium, to capture people’s experiences of claiming PIP: surveymonkey.com/DBC_PIP_survey
The survey will run into next year, and the responses can be broken down by specific condition, so it will provide individual members with valuable policy and campaigning material. We would encourage other ARMA members to take part also.
Direct Referral Project
Steve McBride, Arthritis Care's Policy Adviser for Scotland and Northern Ireland, has been nominated to the Physiotherapy Direct Referral Project Board in Northern Ireland. The Board, run under the auspices of the Public Health Agency in Northern Ireland, has responsibility for introducing a system in which people will be able to go directly to physiotherapists without first being referred by a GP. Speaking after the first meeting of the Board Steve said 'we know that this is something that people really want, and I hope I will be able to contribute to creating a project which delivers real results for patients’.
Steve has also been taking part in the EULAR/PARE autumn conference in Reykjavik, Iceland, as a representative of ARMA (the Arthritis and Musculoskeletal Alliance).
Rheumatoid Arthritis Summit
The National Rheumatoid Arthritis Society held its second annual RA Summit in Parliament on 11 December. This year’s event focused on the impact of poor public awareness on rheumatoid arthritis patients and the NHS. The event was chaired by Baroness Brinton, the new Liberal Democrat Health Spokesperson in the House of Lords, and featured presentations from individuals including the National Clinical Director for Musculoskeletal Conditions, Professor Peter Kay, and Professor Karim Raza, a leading expert on public awareness issues relating to rheumatoid arthritis at Birmingham University.
During the event, Professor Peter Kay said he regarded poor public awareness of RA as now the number one challenge to improving clinical outcomes for RA. Professor Kay also pledged to hold an event to bring together the key players to discuss the way forward for an awareness campaign on inflammatory arthritis and he joined in a public call for the National Audit Office to review the implementation of its 2009 report recommendations on rheumatoid arthritis services.
SIGN recommends acupuncture
for chronic pain
Scottish Intercollegiate Guidelines Network
SIGN 136 Management of Chronic Pain
Across Europe approximately 18% of the population is currently affected by moderate to severe chronic pain, particularly for musculoskeletal issues. It has a considerable impact on quality of life, resulting in significant suffering and disability. Within Scotland there is evidence of wide variation in clinical practice, service and resource provision, with a general lack of knowledge about chronic pain and the management options that are available.
It is hoped that this evidence based guideline will provide the information needed to improve clinical outcomes and quality of life for patients with chronic pain. The guideline states that Acupuncture should be considered for short term relief of pain for patients with chronic low back pain or osteoarthritis.
Members' News and
ARMA Scotland News
National physiotherapy lead Senga Cree gave the ARMA Scotland committee an update on the MSK Programme at its meeting in Edinburgh on November 27th.
The programme is soon to be extended to take in Dundee, with Lanark, Lothian and Argyll and Bute already functioning, and having initially been focused on point of entry triage it was increasingly looking at the whole range of patient pathways. Senga stressed that the programme board wanted to work with the voluntary sector and draw on its knowledge.
MSK Cross Party Group
The Cross Party Group on MSK in the Scottish Parliament met in Holyrood on November 27th, with transitions for young people the main theme. The group heard presentations from the medical teams at Lanark and Yorkhill, but the highlight of the evening was undoubtedly the presentation by Arthritis Care’s Family and Youth Officer, Gillian Means, supported by youth volunteer Laura, speaking on AC's work with young people with arthritis. Arthritis Care's work with young people focuses on the physco-social dimension and helps to give young people the confidence to deal with their conditions through sharing experiences at activity weekends and other events. Gillian's presentation was very well received.
The Cross Party MSK group at Holyrood met in the sad aftermath of the passing of the group's long time Chair, Helen Eadie MSP, who died after a short illness. Tributes were paid to Helen's work and consistent support for people with MSK and other conditions.
Arthritis Care Scotland announces first professional lecture
Arthritis Care Scotland's first professional lecture will be held on February 5th 2014 in the Scottish Parliament building at Holyrood. Key speakers will be Duncan Porter on recent developments in rheumatology, Martin Perry on the ScotsPHN Needs Assessment on RA, and Professor Martijn Steultjens on “Turning back the tide of MSK pain”. AC Scotland director Angela Donaldson will provide a patient perspective. For further information contact Arthritis Care Scotland.
Beating Back Pain Service evaluation
This service, which includes acupuncture, has just been published in the BMC Complementary & Alternative Medicine journal. The purpose of the service evaluation was to report patient outcomes and experiences of the Beating Back Pain Service (BBPS), a pilot service based in a primary and community care setting, delivering acupuncture, self-management and information to patients with chronic low back pain.
Visit biomedcentral for the open access article, where you can read the background, methods and results of the research.
Acupuncture and self-care service survey
Patient outcomes and experiences of an acupuncture and self-care service for persistent low back pain in the NHS: a mixed methods approach
There were statistically significant improvements over time for pain (p <0.0001), quality of life (p = 0.006), understanding of pain (p <0.001), physical activity (p = 0.047) and relaxation (p = 0.012).
Post-hoc analysis revealed that scores improved between baseline and post-treatment, these improvements were maintained at 3-month follow-up. Patients receiving a combination of acupuncture and self-management sessions produced the most positive results.
Click here to see the abstract of the Beating Back Pain Service evaluation from the BMC website.
PMRGCAuk in November
Mid-November saw the second International Symposium on polymyalgia rheumatica and giant cell arteritis, this time in Southend. Seventy researching clinicians came together to share their latest projects and four patient representatives took part on (almost!) equal terms. It was so interesting to see how the science is confirming that PMR is a form of vasculitis, and beginning to solve the mystery of the overlap between PMR and GCA.
Meanwhile, PMRGCAuk is delighted that a sight research charity is funding two small research projects into sight loss caused by late diagnosis of GCA. The pilot fast track project supported by Lord Howe at the DoH has now reported and it shows that it saves money as well as sight. Our next challenge is to get the fast track embedded into commissioning. PMRGCAuk is hoping to appoint a professional Development Director next month to take this and our other projects forward. With professional support PMRGCAuk hopes to be able to take a more proactive part in the ARMA community. Until then, we wish everybody a happy and pain-free festive season.
HMSA news for November
HMSA Trustee to Pain UK
Donna Wicks, trustee for Hypermobility Syndromes Association, has been appointed to trustee for Pain UK an umbrella group for smaller organisations who want a voice in pain services and policy at all levels.
Donna feels that this role will in fact complement her current role with the HMSA, as people with hypermobility syndromes suffer from chronic pain which is not recognised as an issue in its own right. Donna is looking forward to representing Pain UK at future events.
HMSA - Working in the North.
The HMSA had a very busy week at the end of October.
The charity ran a volunteers training day in Hull and successfully recruited two additional skilled and experienced group leaders to complement the other northern groups. A new social media volunteer was also added to the social media team and an existing volunteer expanded her role to take on supporting the HMSA Volunteers Management Programme.
This was followed by a wonderful Dinner and Dance hosted by Melanie Howram. It was a fabulous night!
Unfortunately, staff had to get up early and drive to Wakefield to run the HMSA Family Programme and Big Bash. The Family Programme event is covered by the Information Standard (accredited by Capita on behalf of NHS England) and was very successfully received by the separate children and parent groups. The Family Programme goes from strength to strength.
The HMSA would like to thank Professor Howard Bird for attending and giving his support to the charity. For further information on the HMSA Family Programme please contact email@example.com.
The HMSA would like to congratulate the new (BSR) trustees for ARMA, which includes Chief Medical Advisor to the HMSA, Dr Alan Hakim.
Love Your Bones 2014 conference
Wednesday 25th June 2014 – The Mountbatten Centre, Portsmouth.
ARMA Portmouth, Portsmouth Hospitals and the National Osteoporosis Society would like to invite you to have a free exhibition stand/ table to promote the work of your organisation/ charity.
For the exhibition, stand holders will be provided with:
- Table and 2 chairs
- Refreshments and lunch
- Free Parking
Set up time will be from 08:00-09:00 with the doors opening to the public at 9 am
Stand holders are encouraged to attend any of the lectures being held. If you would like to register for a stand, please send your details and any special requirements to Valerie Robins
We look forward to hearing from you and hope that you will join us for this our eighth year.
Download the Love-your-bones-flier-2014-3 for the event.
The 2013 “Love Your Bones Day” event was held on 26th June at the same venue. It attracted no less than 460 visitors from all over Hampshire and W. Sussex, including Fizz Thompson (NOS Operations Director) and colleagues from the Winchester Support Group. There were stalls from various community, local authority and hospital organisations, who provided information about exercise, diet, carers, artificial hips and other aspects of well-being.
NRAS Patients in Focus Awards 2014
The National Rheumatoid Arthritis Society is pleased to announce the launch of its twelfth Patients in Focus Awards to recognise best practice in the education, treatment and care of people with rheumatoid arthritis.
Have you developed a new idea to improve the services, education or information for your rheumatoid arthritis patients? Each entry must show a patient focused initiative and include evaluation of outcomes and evidence of patient benefit. Entries must be able to identify sustainability of the project and best use of available resources and shared care.
Applications are invited from those working in rheumatology either in a hospital unit or in the community. Completed entries should be sent to NRAS and must be received by Friday, 7th February 2014.
The winning entry will also be invited to present their initiative at the British Society for Rheumatology (BSR) conference in Liverpool in April 2014.
Visit the NRAS website to access further guidance and an application form.
BARC "Joint Effort" newsletter
Click here for the latest "Joint Effort" newsletter from the Birmingham Arthritis Resource Centre.
It contains articles on:
- the Health and Wellbeing Day,
- Young People and fundraising,
- BARC in the community,
- and Systemic Lupus Erythematosus.
FMA UK appoint new trustee
FMA UK would like to announce the appointment of a new trustee Glen McGregor who is to take on the role of treasurer.
His previous experience in the charity sector is bound to be beneficial to us.
Click here to see a list of FMA UK trustee contacts.
Shop for NRAS this Christmas!
Shop online with 'Give As You Live' this Christmas and when you make a purchase at any of the thousands of stores which participate a percentage of every £1 you spend will be donated to NRAS at no extra cost to you.
Stores such as Boots, Tesco, HMV, iTunes, Marks & Spencer and John Lewis are included. Click here to find out more and sign up. It’s a great opportunity to buy presents this year that will keep on giving!
For the first time NRAS has guaranteed places in the 2014 Brighton Marathon, the second largest marathon in the UK. If you weren’t lucky enough to get a place in the London Marathon take on Brighton and run for NRAS. For more information contact firstname.lastname@example.org or call on 01628 501547 or visit our website at www.nras.org.uk/events.
NRAS HAS MOVED!
We have outgrown our previous office space and moved to larger premises in Maidenhead. This will not affect anything we do but it has given us the space to continue to grow over the coming years to meet the demand on our services we anticipate.
Our new address is:
4 Switchback Office Park
Chronic Diseases and Health Care Delivery 2020 Conference
Conference held at EU Parliament & Thon Hotel EU, Brussels, 17th October 2013
Eumusc.net is a project initiated by EULAR and undertaken with the support of the European Commission. For the first time, thanks to the methods and tools developed with this initiative, it will be possible to assess, monitor and benchmark the burden of Rheumatic musculoskeletal diseases (RMDs) as well as the quality of care that people with RMDs receive in EU countries. This information will allow countries to set goals for improvements in the provision of health care as well as to measure progress towards equity of care, write Prof Anthony Woolf and EULAR President Prof Maurizio Cutolo in the foreword for the conference.
The conference brought together representatives from:
- EU institutions
- Member state institutions
- Research organisations
- Medical and health professional associations
- Patient organisations
- Research funding bodies
- Social service providers
The initial part of the day took place in the EU Parliament, involving speakers from EULAR, the EU commission, Ministry of Health in Lithuania, Association of People with RMDs in Crete, the WHO representative to the EU and eumusc.net; who each spoke about the need for standards of care for people with rheumatic conditions in the EU.
Anthony Woolf, the eumusc.net Scientific Coordinator, explained that one of the many outcomes of the project was a report on standards of care for two musculoskeletal conditions: Osteoarthritis, the most common joint disorder which accounts for more disability among the elderly than any other disease; and Rheumatoid Arthritis, the most common inflammatory disease of the joints.
The report covers all aspects of musculoskeletal conditions (MSC) although it was hard to find anything on connective tissue diseases. You can read the Standards of Care from the eumusc.net website, and do also explore the items listed under the Publications tab.
In the conference’s afternoon session delegates joined break-out workshops at the Thon Hotel, a short walk from the EU parliament.
The purpose of the workshops was discuss the barriers to successful implementation of each SOC. Such barriers will of course differ between member states but our group’s statement for discussion was: “People with Rheumatoid Arthritis should be assessed regularly to ensure disease control.” The main barrier might surprise you: it was the lack of Rheumatologists who understand RA and would understand the importance of regular assessment.
We were also trying to explore ways around the barriers as due to the lack of monetary funds within the EU. We decided that just demanding more Rheumatologists was not really an option, so we explored other ways, which included specialist nurses and other health practitioners who would assist the consultants in their already busy clinics.
In the final part of the day, Dr Isabel de la Mata, Principal Advisor for Public Health and Risk Assessment for the European Commission, suggested that we look at other areas regarding funding (rather than just concentrate on the Health Commission) such as the commission in charge of social security, for example.
Global Burden of Disease in EU and EFTA countries
Of non-communicable diseases in the EU and EFTA countries, musculoskeletal disorders now show the largest increase on the health of people, and account for almost 30% of all disability.
This is according to the EU and EFTA Regional Results (released November 13th 2013) from the Global Burden of Disease 2010 study. It shows that there has been an increase in NCDs for the EU and EFTA countries from 83.31% in 1990 to 86.14% in 2010, measured by DALYs.
Read the full EU and EFTA GBD Press Release, Nov 2013.
Read more about the UK data from the Global Burden of Disease study.
Quality Standards for Public Health Consultation Closes 20th December 2013
NICE CCGOIS Applications Deadline 27th December 2013
ARMA CEO Meeting 22nd January 2014
ARMA Board Meeting 30th January 2014
Policy Leads meeting 4th February 2014
NRAS Patients in Focus Awards close to entries 7th February 2014
NHS Innovation Expo 3rd March 2014
National Voices AGM 26th March 2014
BSR Conference 29th April 2014
To see previous editions of the newsletter, click here.
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