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  • 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

Last Friday, March 31st, NHS England published a significant document about the future of the NHS: Next Steps on the NHS Five Year Forward View. The original NHS five year forward view set out why and how the NHS should change to address three issues: the health gap, the quality gap and the financial sustainability gap. The next steps updates on progress and sets out future plans.

Musculoskeletal conditions account for a major part of the workload of the NHS, 40% of which is due to potentially preventable risk factors. The NHS spends £5 billion a year treating them. Yet they get surprisingly little focus in Next Steps, at least directly. Musculoskeletal includes everything related to bones, joints and muscles, from back pain to rheumatoid arthritis. The associated pain and mobility problems have a significant impact on people’s ability to work (and pay tax), and to contribute to family and community life. This impact is set to rise as we all live longer and healthcare demands will increase with us needing to remain mobile and independent.

The most significant reference to MSK is to hip and knee replacements, including recognising that waiting times for these operations may go up. Whilst Next Steps talks about the huge increase in hip replacements in the last 15 years, a recent report from the Kings Fund found that in the last year there are signs that the number of hip replacements is going down. Given the high level of evidence of the effectiveness of this operation and the needs of the population, this is travel in the wrong direction.

Whilst there are few other explicit mentions of MSK in the rest of the document, it is clear to me that MSK services have a big role to play in these plans for the future of the NHS. Priorities include integration of services, better access to primary care and prevention. There are many links between these and good musculoskeletal services.

ARMA, working in partnership with NHS England, recently organised a series of regional events, bringing together professionals from primary and secondary care with patients, to talk about local plans to improve musculoskeletal services. The discussions would have felt very familiar to the authors of Next Steps. Integration, partnerships, moving care into the community, how physiotherapists in GP surgeries can reduce pressure on GPs and so save money. One frustrated physiotherapist said “we’ve shown it works for patients and saves money. Why is this not being rolled out everywhere?” Yet the chapter on primary care talks about a wider range of staff without mentioning physiotherapy.

Ultimately what this document is about is financial sustainability – saving money. All the evidence is that there is wide scope for more effective use of resources in musculoskeletal services to deliver what patients want and need. As our events showed, the will is there in the MSK community – both patient groups and professionals. What is needed is for the NHS, both locally and the national improvement programmes, to embrace this and make sure it happens everywhere.

Selected duties:

  • Maintaining a sustainable level of campaigning activity to raise political awareness of the needs of those with rheumatoid arthritis and juvenile idiopathic arthritis working from the excellent reputation built and base of campaigning activities delivered to date
  • Organising one on one meetings with parliamentarians, ministers, civil servants, key opinion leaders, and key NHS figures to ensure that RA and JIA are prioritised amongst long term conditions
  • Monitoring the political environment and disseminating relevant information to the CEO, other colleagues and volunteers in the campaign networks as appropriate

Location: 4 The Switchback, Gardner Road, Maidenhead, Berks SL6 7RJ

For a full list of responsibilities, required qualifications and skills, and salary details click here.

Pictured: Jim Shannon MP and Emeritus Professor George Nuki

Gout: No Laughing Matter

The UK Gout Society held a parliamentary reception at the House of Commons on 28th March 2017 to launch #shoutaboutgout – a social media campaign to raise awareness about gout, a musculoskeletal disorder which now affects one in 40 people in the UK.  Nearly 60 MPs, peers and other stakeholders in the MSK space, including many ARMA members, attended the event.

Jim Shannon, MP for Strangford (Northern Ireland) and DUP Spokesperson for Health, who sponsored the event, stated: “It’s time we put the facts on the table and told people the truth about gout.”

The George Nuki, Emeritus Professor of Rheumatology, Edinburgh, and trustee of the UK Gout Society explained that gout is the most common form of inflammatory arthritis worldwide and eminently treatable and potentially curable. “Despite having known how to treat gout effectively for at least fifty years, it has increased in frequency and is more common now than rheumatoid arthritis.  This has enormous consequences for the NHS.”  He went on to explain the importance of treating gout to a target urate level. “However, in general practice, we know that less than ten percent of patients are having their uric acid levels monitored.” 

Paul Webber, a patient, who discovered he had gout at just age 25, talked about the ‘the deep thudding pain of gout’ and how it affects his everyday activities, like travelling to and from work.

The charity called for people to ’come out’ about their gout and share their experiences on social media, as well as become a Friend of the charity to help fund vital educational activities:


Pictured: Jim Shannon MP and Emeritus Professor George Nuki.   

It’s been a very busy month for the HMSA with the release of new EDS nosology. We’ve prepared some material for people unsettled by these developments in classification: a letter which can be printed and given to medical professionals explaining what the changes mean, and an update for clinicians that contains a simplification of the changes for people working in the MSK field. Both can be found on our website sidebar, appended to an interview with our HSD Ambassador, Hannah Ensor, here:

Our major fundraising campaign this summer is in the hands of Keith Diaper, who is completing 52 middle distance triathlons for us between April and September. We’ve successfully launched livechats on our social media during March and look forward to introducing more in the coming months as we work with related organisations to best represent our patient membership.

My name is Keith Diaper and I am 40 year old husband and father from Hedge End in Southampton. I’m an electrician and a keen triathlete.

Starting on Saturday 1st April 2017 I will be doing one middle distance triathlon every Saturday and Sunday for six months – so I will be covering 3655.6 miles in total, over 52 events. That’s about the same distance as travelling from Southampton to New York.

A Middle Distance Triathlon is a 1.2 mile swim, 56 mile cycle and then a 13.1 mile run.

The reason for taking on such a challenge is to help raise awareness and funds for the charity Hypermobility Syndromes Association (HMSA). My wife, Pippa, has Ehlers Danlos Syndrome, one of the long-term conditions covered by the charity. This condition means there is a defect in her collagen which causes her joints to dislocate on a regular basis. She is in daily pain and suffers with fatigue. There is currently no cure for EDS and there is a possibility that she will one day be in a wheelchair.

Pippa was misdiagnosed for many years. The health professionals carried out many tests but thought Pippa had Fibromyalgia, due to a few similar symptoms. After many more visits to specialists over an almost 3 year period, she was finally diagnosed with EDS. Following this we came across the HMSA’s website, everything my wife was going through was listed along with lots of resources to help her cope.

By teaming up with the HMSA my mission is to bring wider awareness of their work and the conditions suffered by so many. I know we currently can’t cure this condition but we can educate people. If my challenge helps people who are in the situation my wife found herself in, then it would be worth it. Any funds we raise along the way will help the HMSA with their work, which covers research, support and education.

For more information contact
Phone: 07791 893638
Address: 5 Stirling Crescent, Hedge End, Southampton, Hampshire, SO30 2SA

March has been a busy month for ARMA. I have enjoyed meeting so many ARMA members, finding out more about what you do and how ARMA fits with your current priorities. I really welcome the level of support you have offered me in my new role as I begin to get an understanding of the priorities of the MSK community.

The highlight of the month must be the three joint ARMA/NHS England regional events. These have been a huge success. All three events were over-subscribed, showing the high level of interest in improving musculoskeletal services locally. A range of speakers, including ARMA members, outlined key issues and good practice examples. This was followed by roundtable discussions in STP footprints about what needs doing in each local area. Participants completed forms to pledge what action they will take as a result. Looking through these, it is clear that the events will make a real difference with people promising to look at implementing good practice they had heard about, meet commissioners, set up collaborative groups, review all MSK services and focus on prevention, amongst other things. We will be following up these pledges to encourage progress and see what support we can provide. Look out for further events in Manchester on 16 May and in the south. I’m really looking forward to seeing what changes happen as a result.

The other news to highlight is the inclusion in the NHS Mandate of a commitment to “identify opportunities for regular collection of data about incidence, prevalence, clinical activity and outcomes of musculoskeletal patients and services in England.” (Para 7.3) We will be looking at what the MSK community can do to make sure this commitment becomes a reality.

What this activity shows is how important it is for us to work together on issues of common concern. No individual organisation could have the impact that we all have together. Nationally we can’t deliver change without working in partnership with those who deliver services locally. With that in mind, I am looking forward to seeing what April brings.

Guest blog by Dr Brian Hammond D.O.D.C Ph.D. FCC (Orth) PG Cert, Chair of BackCare

There are very many back and neck pain sufferers in the UK.  The cost to the Exchequer and industry is staggering.  In this country, about 2.5 million people experience back pain every day of the year.  Although statistics vary, treatment for back pain and disability payments as a result of back problems costs the tax payer billions of pounds a year.  As a consequence, millions of working days are lost.  Relatively recent figures indicate that every year nearly 10 million working days are missed because people are experiencing back pain and that this costs the British economy the enormous figure of over £1 billion.

Back Pain is one of the leading causes of disability, affecting around 1 in 10 people.  It is more common as people increase in age.  Chronic back pain is made worse due to our increasingly sedentary lifestyles.  Sitting in the same position for long periods of time puts tension on the lower back.   Back pain also arises from poor posture, over exertion, and incorrect lifting, pulling or pushing of items.

BackCare (, the national Back Pain charity, provides authoritative advice and information to people who want to avoid or manage back pain.  It advocates taking responsibility for your body through improving your posture; watching your diet and eating the right foods; lifting correctly; drinking lots of water; exercising; medication; and use of back protection devices, and heat and ice packs.

The charity is holding a Back Pain Show at St Andrews Stadium, Birmingham on 19 and 20 May. This iconic show is free for back pain sufferers and their carers, as well as professional practitioners.  There will be access to presentations by leading experts on the latest developments in managing back pain and opportunities to meet a wide range of companies and professional individuals focused on providing treatment services, support and products for back pain sufferers.  Both public and professionals can register for the event and book any of the talks and lectures – at


The Government’s Mandate to NHS England for 2017-18 has been published. This sets out annual deliverables against the seven objectives to 2020. All of these objectives are relevant to musculoskeletal services, but one has been added which makes specific reference to MSK data. This is in relation to the Government’s goal to reduce the disability employment gap and says the NHS should:

“Work with Government to identify opportunities for regular collection of data about incidence, prevalence, clinical activity and outcomes of musculoskeletal patients and services in England.”

ARMA will be looking at how the MSK community can support the implementation of this objective.

The Royal College of Nursing Congress runs from 13th – 17th May in Liverpool Arena & Convention Centre.

The RCN Rheumatology Forum will be facilitating a fringe meeting on the 16th May 2017 at 1pm, at which Rheumatology Nursing will be showcased to a wide range of nurses, working in a wide variety of health care settings. All those interested are welcome to attend.


Updated Biologic therapies practitioner

The fourth edition of this guidance document will soon be published online.


RCNRF Facebook page

In 2016, the RCNRF developed a Facebook page that has been received extremely well by a wide range of nurses working in various health care settings, those who are either directly or indirectly involved in the speciality.

The response/uptake/networking that has occurred since it has gone live has been very encouraging, educational and invaluable, especially for those new in post or where services are being developed or changed.

Strategy Day

The RCNRF Strategy Day will be held soon at RCN HQ on 28th March 2017, where ongoing and future RCNRF development action plans will be discussed and planned.

In the past month LUPUS UK has published updated versions of three of our information leaflets/booklets. These publications were updated to ensure that they meet the requirements of the Information Standard and reflected the most up-to-date evidence.

Physical copies are available to order free of charge from LUPUS UK National Office, or you can read/download them on our website by following the hyperlinks:


Contribution to the Scottish Medicines Consortium’s (SMC) consultation of the use of Benlysta (belimumab) in SLE

Benlysta (belimumab) is due to be discussed by the SMC and a decision made for its use by certain SLE patients in Scotland. LUPUS UK has recently produced a report which it has submitted as evidence to the SMC as a Patient Group Partner. The SMC committee will meet on 4th April 2017 to discuss Benlysta and the decision will be made publicly available approximately five weeks later.

The latest guidance is out for the prescription and monitoring of non-biologic disease-modifying anti-rheumatic drugs (DMARDs). It’s aimed at primary and secondary care practitioners managing patients with rheumatic disease in the UK.

Significant updates include:

(1) Harmonisation of monitoring schedules, recommending that all DMARDs that require laboratory monitoring follow the same frequency of testing

(2) More nuanced discussion of the use of methotrexate in lung disease is provided, drawing from the two large meta-analyses recently published.

(3) Significant change is made regarding the evaluation of retinal toxicity for hydroxychloroquine users:

Lead author Dr James Galloway, Senior Clinical Lecturer at King’s College London says:
“These updates have two major focuses: firstly, streamlining monitoring schedules wherever possible, given the myriad of different regimens across drugs, and most of the schedule variations were somewhat arbitrary in their origins; second, to review and incorporate the evidence base available, acknowledging several key publications that have emerged since the first guidance. The update provides an accessible and useful tool for primary and secondary care prescribers of anti-rheumatic therapies.”

View the full guideline online.

New strategy

On behalf of the Board of Trustees, we are delighted to share our new vision for how the society will operate. As a membership organisation, our primary duty is to put our members first in everything that we do.

With a focus on communication, transparency and collaboration, this strategy will enhance our ability to provide a wide and valuable range of resources to you over the next three years and beyond.

View the strategy online.

5 New scientific outputs from the Rheumatoid Arthritis register

The Biologics Registers have started 2017 with a surge of scientific outputs that’ll be of interest to Multi-Disciplinary Teams and their patients. After only three months there are already five outputs – four papers and one letter. They came out in a variety of journals and cover a broad range of the evidence needed for decision making, the risk of lymphoma, the relationship between exposure to anti-TNFs and the incidence and severity of MI, drug specific risk and characteristics of lupus and vasculitis-like events and the use and effectiveness of tocilizumab. The Letter was on pregnancy outcomes in women.

View the full references to of these publications online.

Rheumatology 2017 Conference

There are just a few weeks remaining until the UK’s leading rheumatology event returns to Birmingham, 25-27 April.

Registrations close 12 April 23.45 GMT – don’t miss out!

Register here.

Budget 2017

Arthritis Care’s response to the Budget welcomed the announcement of £2 billion of additional funding for social care in England as a step in the right direction, but argued that it falls far short of what is needed. We also blogged about what we wanted from the Budget here, calling for long-term solutions to the health and care crisis in England and an end to benefit cuts.


Judi Rhys appointed as Non-Executive Director of Public Health Wales

Judi Rhys, Chief Executive of Arthritis Care, has been appointed as the Third Sector Member (Non-Executive Director) at Public Health Wales. This complements her role as Arthritis Care’s Chief Executive. More information is available here.