Arthritis and Musculoskeletal Alliance
This is a category taken from the full feed of Musculoskeletal and Arthritis news provided by ARMA's members.
  • The Arthritis and Musculoskeletal Alliance (ARMA) is the umbrella body for the arthritis and musculoskeletal community in the UK, and our mission is to transform the quality of life of people with musculoskeletal conditions. We have 40 member organisations ranging from specialised support groups for rare diseases to major research charities and national professional bodies.

Author Archive

As this newsletter goes out, the International Symposium on the Ehlers-Danlos syndromes will be under way in Ghent, Belgium. Philip Bull, HMSA Trustee and medical advisor will be there, and is one of the speakers on the patient day; and the HMSA medical advisor, Alan Hakim, will be there too.

Dr Philip Bull has been incredibly busy recently and over the past few weeks has trained over 300 GPs in Kent on the basics of recognising and managing hypermobility syndromes. Of course there are still 1000s of GPs we need to reach across the country, but as the saying goes ‘every little helps’ and we are really pleased that progress is being made.

The HMSA helpline is getting busier after the summer lull. School is back, so questions are coming in about hands, and the strain they’re under from writing. Talk to the teacher or the SEN co-ordinator (SENCO) if you think your child needs extra help.

A report by Public Health England has been published in the World Health Organization’s European journal, Public Health Panorama.

“Developing partnerships and a whole-system approach for the prevention of musculoskeletal conditions in England”

Abstract: This case study reviews the experience of PHE in developing and implementing a public health approach to the prevention of and early intervention in MSK conditions. We reflect on key elements of the approach, and the essential role of galvanizing and supporting partnerships, as well as achievements and lessons learnt so far.

Achievements: Since 2013, through investment in people and partnerships, evidence synthesis, development of support tools and communications, we have built a strong foundation for MSK public health in England. Important relationships have formed and policy direction and commitment established for health improvement, work and health, health intelligence, local planning and delivery, the public health workforce and embedding MSK health in the work of Public Health England.

Lessons learnt and recommendations: Significant progression of the MSK conditions prevention agenda in England has been possible because of strong partnerships based on a clearly articulated common vision and a shared narrative for a public health approach. On this journey, we have adopted dynamic reflection and review as a critical part of our growth as a partnership and network. Ultimately, only a whole-system approach to MSK health can substantially reduce the burden on those affected, their families and carers, public health and care services, the economy and the wider society. Flexible, committed partnerships, when combined with sustained political will and leadership for change, can bring this about.

Click here to open and download the report in PDF.

The BOA is nearing the end of our Centennial year and reflecting on 100 years of developments in orthopaedic surgery. While innovation in surgical techniques has dramatically improved patient care, the changing nature of healthcare delivery systems, rationing and access to care mean that many patients are still struggling with the day-to-day impact of MSK conditions.

During our Congress last week we heard powerful stories from patients on the impact of waiting for surgery. From a patient waiting for carpal tunnel release who was struggling to deal with basic daily tasks such as handling money, preparing food or getting dressed to another describing his wait for knee surgery, in huge amounts of pain with increasingly reduced mobility impacting on overall fitness and the ability to enjoy life.

It is undoubtedly a challenging time for MSK patients in the NHS. There is chronic under supply of resources for NHS services, and huge increases in the numbers of people waiting longer for surgery in many parts of the UK. In April this year we issued a press statement to highlight the situation in England, and shockingly, at the time of the release, there were still some trusts that had not resumed elective operations after the winter moratorium. The number of people who had waited over 18 weeks was at its highest level for many years and the graph below shows that this has been progressively deteriorating for several years (source: Waiting times data).

The number of people waiting over a year has also increased markedly in England, while the situation in Northern Ireland is even more stark, and we are speaking to the Chief Medical Officer there about this next month (see graphs below – source: Waiting times data).

The figures overall are stark:

  • The number of people in England waiting over a year for T&O surgery reached a high of 978 in June 2018, which compared to 375 a year earlier (a 260% increase).
  • The number of people waiting more than 18 weeks reached a peak of 81,663 in April 2018; the highest level since reporting began November 2010.
  • A BOA survey of hospitals in England received 84 replies from BOA Link people and 31 % of these had experienced winter closures of 3 months or more.

These delays have also had a major impact on orthopaedic trainees, who are losing opportunities to learn. This impacts the future workforce and is a situation we are continuing to monitor closely.

At our Congress we discussed access to Elective Care in further detail. The HSJ recently reported our concerns about Sussex CCGs policies that patients for hip surgery meet the requirement of: “uncontrolled, intense, persistent pain resulting in a substantial impact on quality of life … which have failed a reasonable period of conservative treatment of at least 6 months.” (HSJ article) We highlighted the BMJ coverage of growing numbers of Individual Funding Requests for hip and knee replacement as a result of more restrictive CCG policies. (BMJ article).

During the year we’ve done as much as we could to get our messages out to the media and speak out on behalf of our patients about the restrictions on access to care. Besides the articles above, have received coverage in the Telegraph, Times, and Daily Mail among others. We are making plans to develop relationships with key decision makers, both through ARMA, but also directly. We also continue to promote and highlight the joint position statement from ARMA.

Most recently we have been working with four specialist societies (BESS, BSSH, BASS and BASK*) to respond to the latest attempt to limit seven orthopaedic operations through the Evidence Based Interventions consultation. We as a profession agree that there are some operations where this is appropriate, but for others we have raised issues about the proposals, the consultation and the data it is based on. Our full response was posted online last week, here in our News section.

The BOA is very aware that our concerns are shared right across the ARMA community and are pleased to be part of this alliance, working together to shine a light on these important issues as part of our continued commitment to be “Caring for Patients, Supporting Surgeons”.

(*British Elbow and Shoulder Society – BESS, British Society for Surgery of the Hand – BSSH, British Association of Spine Surgeons – BASS and British Association for Surgery of the Knee – BASK.)

Versus Arthritis is currently promoting their new report, “Working It Out” on the Access to Work programme at the political party conferences. At the time of writing the team have attended Liberal Democrat and Labour, and are preparing for Conservative and SNP conferences. 

The report is based on a survey of almost 1,600 people with arthritis and related conditions across the UK, which asked how their working life has been affected by their health condition, and their awareness of Access to Work and employer support. It will be publicly released later in October and the team will share it with ARMA members once it’s available.

At the conferences, Versus Arthritis have been highlighting their findings and recommendations to party members, local Councillors and MPs. They are calling for the Government to take action to promote the Access to Work scheme and to make it clear to employers what reasonable adjustments they should provide for people with arthritis.

So far, a number of MPs – including the Shadow Secretary of State for Health, Jon Ashworth – signed up to be Arthritis Champions, pledging to work with us to prevent and cure arthritis, and transform the services available to people with musculoskeletal conditions.

There will be a roundup of this activity on the charity’s new website in mid-October on the news page and you can follow us on Twitter for live updates from conference @VersusArthritis.

Launch Event at Horizon Leeds, 3rd Floor, 2 Brewery Wharf, Leeds, LS10 1JR

23 October 2018, 9.30am – 4.30pm

The Northern Musculoskeletal Collaborative Programme (#MSKnorth) is a regional approach to transformation in elective MSK care.

  • Do you want to improve musculoskeletal services?
  • Do you know what the priorities and opportunities are to improve musculoskeletal care?

The programme launch will be opened by Professor Peter Kay, National Clinical Director for MSK and will feature frontline clinicians who are leading change and transforming MSK services.

To learn more about the size of the MSK challenge and to hear about the potential solutions, reserve your free place via the event page on NHS England website.

 

The ARMA annual lecture will be on 21 November on the theme of physical activity. Three speakers will discuss three different perspectives on how to get more people, more active, more often. The event will discuss the roles of statutory, voluntary, private sectors and communities in addressing this important challenge.

  • the CEO of parkrun
  • the physical activity programme manager from Public Health England
  • a musculoskeletal specialist physiotherapist.

Look out for booking details coming soon.

12-20 October 2018

12-20 October is a time of important collective campaign activity for ARMA members, with Bone and Joint Week. The theme of campaign is: “Musculoskeletal conditions: The elephant in the room?

It’s highlighting that musculoskeletal conditions of the bones, joints and muscles are a big problem in the UK; with over 17 million people living with a musculoskeletal condition, more people suffer with disability from musculoskeletal conditions than anything else.

The aim of the campaign is to encourage policy and decision makers to shift mindset and take action to champion good musculoskeletal health of the bones, joints and muscles throughout life.

For Bone and Joint Week, we’re releasing a series of infographics with key messages throughout the period that the ARMA policy and communications professionals crafted. Please retweet them from our account on @WeAreARMA. Lookout for Vlogs from during the event too. NHS England and Public Health England are supporting the event as well.

Alliance members are using #BoneJointWeek during the period and we encourage you to tweet with it!

During this annually occurring event there are dedicated days to highlight major rheumatic and musculoskeletal conditions.

12-20 October – Bone and Joint Week:

    • 12 October: World Arthritis Day
    • 16 October: World Spine Day
    • 19 October: World Paediatric Bone & Joint Day
    • 20 October: World Osteoporosis Day

Bone and Joint Week 2018 is part of an international campaign to improve musculoskeletal health.

I have just returned from the British Orthopaedic Association centenary congress, where ARMA had a session on integrated pathways for orthopaedics. One thing that struck me about the event was the recognition of the importance of multi-disciplinary working. There were significant numbers of delegates who were not orthopaedic surgeons, particularly physiotherapists. A session I attended on hip fracture covered the crucial role of physios in rehabilitation.

It is easy to understand how any professional can become focused on their part of the pathway, delivering the surgery or the rehab to a high standard. But that’s not how patients experience the system. In Greater Manchester, by ensuring a co-ordinated approach across the MSK pathway, they have improved the patient experience. For instance, for knee surgery the number of hospital visits has been reduced from 8 to 3 and the time in the pathway from 12 months to 3 months. You might be surprised by the range of professionals involved, for instance: the fire service assessing fall risks when visiting homes to advise on fire safety.

ARMA is all about collaboration, seeing the value of working together, the power of combining the perspectives of patients alongside a range of professionals. We hope that the NHS ten-year plan will also recognise both MSK, and the importance of a multidisciplinary pathway approach to supporting people with MSK conditions. If you are interested in finding out more about MSK pathways and how to set them up, our forthcoming webinar: Everything you wanted to know about setting up a Musculoskeletal Service but were afraid to ask! Is for you. Register free.

As always, ARMA members will be collaborating this month to increase awareness of MSK during Bone and Joint Week 2018. I’ve had a preview of the infographics for this year and they look great. With a lot of our members using social media during the week this is a great opportunity for us to support each other. Last year we demonstrated just how much we can amplify our key messages when we all work together. See the article in this newsletter for details of how you can take part this year and make an even bigger impact.

Finally, I’d like to welcome a “new” member to the ARMA community. Arthritis Research UK and Arthritis Care, both long-standing ARMA members, have merged to form a new charity: Versus Arthritis. We look forward to their continued involvement and the value we can bring to each other. 

As Peter Kay, NHSE National Clinical Director for MSK, said at our recent event: for many people with MSK conditions, the pathway is their whole life. That’s a complex challenge, and not one anyone can solve alone; together we can make a real difference.

The Primary Care Rheumatology Society’s annual conference is due to be held 22-24 November 2018 at the Park Inn Hotel in York.

They have put together a poster summarizing the event. Open it here.

Applications are now open and the Programme and Application Form are available via their event page.

The PCRS hope you decide to join them on the day and they look forward to hearing from you.

Public Health England has commissioned the National Guideline Centre (NGC) to produce an evidence review of the literature on dependence, short term discontinuation and longer term withdrawal symptom from prescribed medicines, and their prevention and treatment.

The NGC is inviting stakeholders to submit research data or reports on two key areas to inform the review:

A) Collations of patients’ experi ences of the harms caused by prescribed medicines and ability to access and engage in treatment specifically relating to dependence, short term discontinuation or longer term withdrawal symptoms from the following prescribed medicines: opioids for chronic pain (excluding end of life /palliative care/cancer pain), benzodiazepines, Z-drugs, gabapentin and pregabalin (excluding epilepsy treatment), and antidepressants. (In England only).

B) Effectiveness and cost effectiveness of current examples of health/social service delivery models that prevent or treat dependence and the short term discontinuation or longer term withdrawal symptoms (opioids for chronic pain (excluding end of life /palliative care/cancer pain), benzodiazepines, Z-drugs, gabapentin and pregabalin (excluding epilepsy treatment), and antidepressants). (In England, as well as health service delivery models in other countries that might inform provision in England).

See details below of the requested information and the formats that will be accepted.

We would like:

  • Information published between 2008 and 2018.
  • Unpublished information related to research carried out between 2008 and 2018, including any ongoing research.
  • Reports which summarise / collate patient experiences e.g. organisational reports or internal evaluations of projects or services (the views, experiences and opinions of individual professionals, researchers, commentators or patients will not be able to be included, however).

 

We are especially interested in the following outcomes for part b:

  • Reduction/cessation in prescribed drug use
  • Successful withdrawal
  • Cost effectiveness
  • Use of healthcare resources
  • Health related quality of life
  • Patient / staff satisfaction
  • Social outcomes e.g.  employment, relationships, parenting
  • Reduction in disability

 

Sending information

For published information, send only the details (to include author/s, title, date, journal or publication details, including volume and issue number, and page numbers). Do not send a pdf/Word document or paper copy.

For unpublished information, send:

  • a link to any relevant trials registered with the Cochrane Central Register of Controlled Trials, or with the US National Institutes of Health trials registry
  • paper or electronic copies of other relevant unpublished information.

Highlight any confidential sections (unpublished research or commercially sensitive information) in unpublished information.

Email prescribedmed@rcplondon.ac.uk these forms with any relevant information by midnight on Tuesday 23 October 2018.

The NGC looks forward to receiving information and thanks you in advance for your help.

The Q Improvement Lab brings together organisations and individuals from across the UK to pool what is known about a topic, uncover new insights and develop and test ideas. The Q Lab and Mind have just started a 12-month project focusing on improving care for people with a long-term physical and mental health problem, specifically looking at the experiences of people living with both mental health problems and persistent back and neck pain.

Further details about the project can be found here.


The project is currently in the research and discovery phase where Q Lab is trying to get a better understanding of the topic and unearth the challenges and opportunities within this space.

The Insight Manager for this project, Hannah Patel, is seeking any research or materials linked to the topic of mental health problems and persistent back and neck pain which could support Q Lab in this phase of work. They are trying to gain as broad an understanding of this topic as possible, seeking multiple perspectives on the issue. Please contact hannah.patel@health.org.uk if you can help.

The Global Alliance for Musculoskeletal Health wishes to bring to your attention a series of papers published in a supplement of the European Spine Journal this month. They have been written by the Global Spine Care Initiative (GSCI), a sub group of World Spine Care, which in turn is a project of GMUSC.

This was a 4-year initiative, involving numerous individuals forming a GSCI Secretariat as well as a large delphi group that contributed to different papers in this 16 paper series. It is hoped that this series of papers will help to raise awareness of the burden of spine conditions and in particular, the challenges faced for people living in low-and middle-income communities and the providers/systems that support spine services in these settings.

The papers can be downloaded from the publications section of the GMUSC website.