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.

Arthritis News

The State of Musculoskeletal Health 2018 is a resource for health professionals, policy makers, public health leads and anyone interested in musculoskeletal health. We believe that with the best information you can build awareness, make more informed decisions, feel more confident and ultimately help more people with musculoskeletal conditions. The resource was put together by Arthritis Research UK.

Using the best available data on prevalence, risk factors and comorbidities, the report lays out the key factors affecting musculoskeletal health, the economic benefits of musculoskeletal research, and describes the scale and impact of the problem.

You can read more details on the report from the arthritisresearchuk.org website and download the full set of statistics (PDF 2.9 MB).

Health Education England, together with South, Central and West Commissioning Support Unit, has developed an easy-to-use tool to support clinicians, managers and commissioners in their efforts to forecast and monitor the impacts of MSK self-referral to first contact practitioners (FCP).

It is called the MSK First Point of Contact Model.

The model would be useful for anyone considering:

  •     Writing a business case for a first contact practitioner service
  •     Evaluating the impact of an already established FCP service
  •     Planning a service improvement initiative within a MSK health system

You can find and download the model from ARMA’s Network Resources page.

As part of the Institute of Osteopathy’s partnership with the National Ankylosing Spondylitis Society (NASS), two refresher seminars held for osteopaths and chiropractors at the Norfolk and Norwich University Hospital and the Royal National Hospital for Rheumatic Diseases in Bath.

The iO is supporting NASS’s work to reduce the current 8.5 year delay to diagnosis in axial spondyloarthritis, including ankylosing spondylitis. Over 100 delegates attended the seminars, where Drs Karl Gaffney and Raj Sengupta presented an update on the most recent tools for diagnosis, with an emphasis on the use of MRI and the presence of extra articular manifestations, such as uveitis, inflammatory bowel disease and psoriasis. The NICE Guideline for Spondyloarthritis was also discussed, as well as the newer biologic treatments which have become available in the past decade.

NASS was also thrilled to have presentations from Zoe Clark and Wendy Holden on osteopathy, as well as Mario Lucchetti, Mandy Rush and Peter Dixon giving the chiropractor perspective. There was also a wider discussion around the issues that some face with onward referral; a tool is currently being developed to help with this. NASS also showcased the range of patient information that they have available, including their website and helpline.

The feedback from the events has been excellent, with many stating that they would be changing their practice as a result of the seminar. For further information and resources visit www.nass.co.uk.

The Faculty of Sport and Exercise Medicine has updated its position statement Physical Activity in Adolescence. The statement is a useful reference document for both the Sport and Exercise Medicine community and all health professionals, with evidence-informed recommendations for health-related physical activity.

The statement highlights recent objective studies, which have collected data using accelerometry, indicate that less than 25% of adolescents accumulate an average of 60 min per day of moderate physical activity. The guidelines include information on muscle strength, skeletal health, obesity, mental health and wellbeing with recommendations for the type and length of regular physical activity in this population. Read Physical Activity in Adolescence here.

Guest blog by David Albury, Board Director Innovation Unit

Why have so many innovations in the NHS failed to make the impact they might because they remain in isolated pockets and never spread? Here at the Innovation Unit we decided to look at this question from a more positive angle and ask where innovation has spread and what made that possible?

There is broad agreement that the pressures and challenges currently facing the NHS can only be addressed through developing and scaling innovations that significantly improve outcomes whilst significantly reducing costs. This is as true in musculoskeletal services as in other sectors.

But proven innovations and best practice tend to spread slowly in the NHS. Innovations such as first contact physiotherapist or ESCAPE-pain remained as isolated pockets of good practice long after they had been shown to be effective. ESCAPE-Pain is now rolling out in many areas, thanks to a grant from Sport England, but the first evidence that it worked was as long ago as 2007.

The barriers to spreading innovation have gained a lot of attention. The Innovation Unit, in collaboration with the Health Foundation, wanted to look at the enablers – what will help the spread of good practice. We looked at ten examples of successful spread of innovation in the NHS. Our report identifies common factors that enabled their spread. Whilst none of the case studies were in MSK, the key enablers we identified will apply equally well to MSK innovation.

Our eight key enablers

In pursuit of spread:
1. Building demand through existing networks and narratives
2. Using evidence to build demand
3. Balancing fidelity, quality and adaptability
4. Scaling vehicles rather than lone champions

Creating the conditions for spread:
5. Capitalising on national and local system priorities
6. Using policy and financial levers to kick start momentum
7. Commissioning for sustainable spread
8. External funding to support spread

Read Against the Odds for more on the eight key enablers and some provocations for system leaders, funders and innovators. We hope you will find it useful as you face the challenges of how to spread innovation and good practice in MSK across the NHS.

As you read this, ARMA will be at the BSR Conference, launching our new MSK Knowledge Hub.

This will be a resource for everyone working on any aspect of MSK. The Hub will widen the ability of the MSK community to collaborate and share knowledge. Anyone can access the resources – why not take a look and see what’s already been posted? You can also register to post your own materials and to access the discussion forum. If you can’t find the discussion topic you want, let us know and we can create a channel for you. I am excited to see how the Hub will be used to increase collaboration.

ARMA members have just started to discuss our strategy for 2019 – 2021. Something said by the CEO of one of our members struck me as very true: “It feels as though we are at a tipping point.” MSK is rising up the agenda. The DWP, Health and Safety Executive, business, the insurance industry – everyone is beginning to realise the impact the MSK has on every aspect of society. The NHS has increasing numbers of initiatives looking to improve MSK services, and Public Health England’s new strategy for the first time includes a programme on MSK.

Opportunities are everywhere, which means ARMA faces a different challenge: to use them to best advantage. We are no longer knocking at the door, but deciding which doors to walk through to make the maximum difference for people with MSK conditions. Our strategy will be all about choices: How do we make sure nothing is forgotten? There is currently too little focus, for instance, on mental health or pain – two things that are important to everyone with an MSK condition. For which issues can we do more together than any of us could achieve alone? Where is collaboration most needed?

If, like me, you think this is an exciting challenge, then get involved and collaborate. Join the Hub; join our Network; make sure your organisation is a member of ARMA. Things in MSK are tipping. Together we can give the push that will tip them in the right direction.

Throughout April, the Institute of Osteopathy has been promoting their #LoveYourHealth social media campaign, showcasing key health and wellbeing messages with the public. The focus of the campaign was to provide practical advice and tips to help people make informed decisions to improve their health.

#LoveYourHealth, which was centred around International Osteopathic Healthcare Week, showcased new patient-facing resource pages that the iO has recently developed around a number of key themes:

  • Getting active
  • Healthy aging
  • Sleeping better
  • Health at work
  • Understanding persistent pain

The focus of the social media campaign was to promote the positive role that osteopathy plays in supporting the health of our patients.

You can access the resources at www.iosteopathy.org/osteopathy-for-health and support the campaign by using #LoveYourHealth on social media. We would like to thank sincerely the members of ARMA who supported this campaign and shared #LoveYourHealth messages with their followers.

See #LoveYourHealth on Twitter.

The London Choosing Wisely programme is a clinically-led review of evidence for a set of surgical procedures. It looks to ensure they are used consistently across London and their use follows a criteria that ultimately improves the health of patients.

Aim of the review
To make sure people with an equal need, wherever they live in London, have equal access to treatments. A standard approach across London means people will achieve better healthcare and doctors will have better guidance on what should be offered to patients.

Procedures that are being reviewed
Eight procedures will be reviewed by primary and secondary care clinicians, patient representatives, equality and diversity leads and public health experts:

  • Surgical removal of benign skin lesions (abnormal growth or abnormal appearance of skin)
  • Hip arthroplasty (replacement)
  • Knee arthroplasty (replacement)
  • Knee arthroscopy (keyhole surgery)
  • Interventional treatments for back pain
  • Varicose vein procedures
  • Shoulder decompression (removing bone spurs and soft tissue through keyhole surgery)
  • Cataract surgery (replacing a clouded eye lens with an artificial lens)

Read more – and check back for updates – on the www.healthylondon.org website.
Further information will be published in the resources section as the programme develops.

Arthritis Research UK’s vision is to develop and cultivate a UK-wide community of multi-disciplinary learners, leaders and influencers of change in musculoskeletal health services, with the ultimate aim of improving the quality of lives for people affected by musculoskeletal conditions.

Together with Ashridge Executive Education, we have created a bespoke leadership initiative, which individuals through a unique development programme to become Champions of musculoskeletal care. The programme will be tailored to meet individual leadership development needs and ensure that Champions are supported and coached to drive tangible improvements in MSK services within their local health systems. If your application to this programme is successful, you will be supported and coached to drive improvements in musculoskeletal care within your local health system.

We are looking for individuals who are involved in the design, commissioning and/or delivery of musculoskeletal care, including front line clinicians, public health practitioners, commissioners and service managers.

We are committed to representing the communities within the system that we aim to affect, and so the cohorts of champions will be multidisciplinary and diverse and instead of hierarchical position, we will focus on the potential to lead, adapt to change and deliver impact.

The Programme:
Duration of 18-20 months and involves:

  • 5 x residential learning modules at Ashridge Executive Education.
  • Development and delivery of a work-based MSK service improvement project.
  • 4 x Action Learning Sets.
  • Access to Virtual Ashridge – an online learning tool to complement your learning.
  • Ongoing support and connection with Arthritis Research UK and your fellow Champions.
  • Support from a network of mentors; eminent leaders within the MSK sector.
  • Support from a panel of patient insight partners.

The Champions:
Throughout the consultation stage we were struck by the need to ensure the cohorts are fully representative of the breadth and diversity of the MSK workforce. As such, we are looking for individuals who are involved in the design, commissioning and/or delivery of MSK care, including front line clinicians, public health practitioners, commissioners and service managers. To ensure cohorts are multidisciplinary and diverse we will focus less on hierarchical position and take into consideration the potential to lead, adapt to change and deliver impact.

Key dates:
Programme open for applications – 9 April 2018
Deadline for applications – 17 June 2018
Interviews – w/c 16th and 23 July 2018
Programme starts – w/c 22 October 2018

If you would like to find out more about this amazing opportunity and how to apply, please visit the application page.

Are you passionate about leading changes in musculoskeletal care?

Arthritis Research UK are delighted to announce the launch of the MSK Champions programme; a prestigious leadership development opportunity.

Together with Ashridge Executive Education, we have created a bespoke leadership initiative, which will support you through a unique development programme to become a Champion of musculoskeletal care.  If your application to this programme is successful, you will be supported and coached to drive improvements in musculoskeletal care within your local health system.

We are looking for individuals who are involved in the design, commissioning and/or delivery of musculoskeletal care, including front line clinicians, public health practitioners, commissioners and service managers.

We are committed to representing the communities within the system that we aim to affect, and so the cohorts of champions will be multidisciplinary and diverse and instead of hierarchical position, we will focus on the potential to lead, adapt to change and deliver impact.

 

The programme will be tailored to you, ensuring we fully meet your leadership development needs, and crucially support you to make the changes needed in your local area.

It will last for 18-20 months and involve:

  • 5 x residential learning modules at Ashridge Executive Education.
  • Development and delivery of a work-based MSK service improvement project.
  • 4 x Action Learning Sets.
  • Access to Virtual Ashridge – an online learning tool to complement your learning.
  • Ongoing support and connection with Arthritis Research UK and your fellow Champions.
  • Support from a network of mentors; eminent leaders within the MSK sector.
  • Support from a panel of patient insight partners.

 

If you would like to find out more about this amazing opportunity and how to apply, please contact us at champions@arthritisresearchuk.org

There is so much going on in the world of MSK it is sometimes hard to know where to start. I am constantly reminded of the vast range of good practice that exists out there. In the last few weeks I have heard about all kinds of activity, from trialling health trainers for joint pain in community settings, to the development of a toolkit for good MSK health for mobile workers.

But how do people working locally to improve services know what they might be able to achieve? And more importantly, how do they know what to do to implement good practice? ARMA is all about joining people up – patients with professionals, statutory and voluntary sectors, research and practice. We are also about sharing knowledge across the whole MSK sector.

Our next webinar on Friday 6 April, takes things back to fundamentals: how to understand the need out there in your local population and use that to plan services and to think about prevention. Sign up if you haven’t already. It’s going to be a practical and interesting session. This one will have broad relevance for health, social care and public health sectors.

In a discussion about improving primary care pathways last week I heard someone say: “Initially we went about it the wrong way.” This is what people need to know – not just what to do, but also how (and how not) to do it. That’s one of the things ARMA is planning to do with our webinars over the next year. We’re going to commission a How to…. series, where people who have delivered initiatives that work explain how they went about creating the change, including the lessons they learned along the way. Let us know if you are aware of a service that would make a good example.

If you are working to improve MSK services, you may also like to join our MSK Network Project. By joining you will be linked in to others working in your local area, informed of new initiatives, evidence and good practice that may be useful to you. Every local system is different and serves a different population. But they all share some things in common, one of which will be high, and increasing, levels of musculoskeletal conditions. We are all living longer, working longer, so it’s in all our interests to make sure we maintain good MSK health and can access the prevention and treatment services we need, when we need them. Collaboration is the way to make this easier. Collaboration is what ARMA is all about.

Guest blog by Satjit Singh, Chief Executive, Society for Promoting Chiropractic Education

It is great that most of us will live to an age that our parents could never imagine. Better living standards, improved public health and an NHS accessible to all, have all helped.

This is excellent, but living longer means that we are likely to be working longer. It also means that for us to enjoy that longevity, we need to live active, fulfilling lives. Too many of the population are afflicted by ‘aches and pains’, mainly back and neck, i.e. musculoskeletal. This not only has physical implications, but like so many chronic problems, has effects on mental health too.

Musculoskeletal problems are responsible for 30% of visits to a GP 1 and have an enormous impact on the quality of life of millions of people in the UK; 10.8 million working days are lost as a consequence of musculoskeletal conditions1. Our healthcare sector, already under so much strain, has to cope with the burden of an increasing number of people presenting with MSK issues; our economy certainly cannot afford to lose so many man-days.

Not only are we faced with an increasing MSK burden, we also lack the healthcare resources to deal with it. NICE recommends manipulation as part of the package of care to deal with this; however, regulated manipulative therapists, comprising mainly chiropractors, osteopaths and some physiotherapists, are nowhere near what the country needs. We only have 3,000 chiropractors, 5,000 osteopaths and some 1,100 physiotherapists who are members of the MACP 2, trained to undertake manipulation. We need more, many more. Not only do we have an ageing population, our health workforce is ageing too. We have seen the consequences of that amongst GPs; other professions are also not immune! The ability to access a ready pool of healthcare professionals from Europe, will reduce significantly, post-Brexit.

Looking around at the chiropractic profession, I saw that there were only three universities in the UK offering chiropractic degrees. Many schools in the country were not even aware of the profession, to make it available as a choice to their A-level students. Given the current rates of growth in the UK profession, it would take over a century to achieve current rates of chiropractor access in Canada or Denmark.

That is why The Society for Promoting Chiropractic Education was established last year. Launched by George Freeman MP, former Life Sciences Minister and Chairman of the Prime Minister’s Policy Board, it aims to encourage school leavers to consider a career in chiropractic; whilst simultaneously working with universities to offer chiropractic degree programmes.

London South Bank University has launched a new four-year masters course in chiropractic and students will start their course in Autumn 2018. What is especially important, is that students will learn in multi-professional settings alongside others studying physiotherapy, nursing and occupational health. This will ensure that future graduates understand how they fit into the wider health landscape. Other programmes are planned in poorly served geographical locations.

Our aim is to work towards a situation where healthcare professionals practising manipulation become part of direct access arrangements within GP practices. For that to happen, we need more of them.

References

  1. https://www.england.nhs.uk/ourwork/ltc-op-eolc/ltc-eolc/our-work-on-long-term-conditions/si-areas/musculoskeletal/
  2. https://macpweb.org/home/index.php?p=366