This is a category taken from the full feed of Musculoskeletal and Arthritis news provided by ARMA's members.


The challenge of the next decade: are hip fracture services ready?

The National hip Fracture Database (NHFD) has recently released its latest annual report focussing on the six NHFD key performance indicators used to monitor and drive up standards across the country. 2020 will no doubt prove to be one of the most challenging years in the history of the NHS. This report also presents the first data about the effect of COVID-19 on trauma units around the country and on outcome for patients with hip fracture who have COVID-19 when admitted to hospital or develop it after their operation.

We would like to thank Captain Sir Tom Moore for his support for the NHFD and its aims to drive up the standards of care for hip fracture sufferers like himself.

He is a shining example of what can be achieved after breaking a hip and is in many ways a symbol of the inspirational resilience of multidisciplinary teams across the country at this challenging time. As he says himself: ‘We have to keep on going.’ At the time of writing, Captain Sir Tom Moore is being treated for COVID-19 and our thoughts are with him and his family.

How can the NHFD data be used?

  • NHS leaders should use the NHFD data on COVID-19 to understand the course of the pandemic and the impacts on frail older people
  • Local hip fracture teams should review the NHFD KPIs for their unit and target below average KPI’s with local QI projects
  • Ward teams should reflect on the additional challenge of social distancing for frail older people and ensure they are offering patient information leaflets and carer support information
  • Hospital managers should use the NHFD run charts for their hospital to understand the impact of the pandemic
  • NHFD clinical leads should use the new NHFD casemix adjusted mortality run charts to check the quality of their data

Should you have any queries about the latest report findings, please contact or NHFD Senior lead clinician:

The report is available to read here alongside a recording of a webinar in which NHFD clinical leads Dominic Inman and Antony Johansen discussed the report findings, the first data on Covid-19 and answered attendees’ questions. The webinar also includes a presentation from the Programme’s Patient and Carer Panel, Julia Ellis, introducing a new and much-needed resource for family carers whose loved one is in hospital after a hip fracture.

report coverThe report emergent from Baroness Cumberlege and the Independent Medicines and Medical Devices Safety review was published in early July and has been welcomed by the British Orthopaedic Association. This comprehensive review has demonstrated the impact on the physical and mental health of patients when implants fail. The review shows that there is a clear need for detailed surveillance of implants, and we welcome the recommendation for the establishment of more National Implant Registries.

Read the BOA’s full position on this issue.

The BOA also continues to update their website with information for both patients and health professionals regarding COVID and its impact on trauma and orthopaedics. This information specifically for patients can be found on the FAQs for Patients page, and wider information is available via the Information for BOA Members page.

The Society is currently revisiting its strategy and short and long term plans for its course provision.

The ‘Theory and Practice of Injection Therapy’ and ‘Advancing Clinical Practice in Musculoskeletal Medicine’ modules, stand-alone or optional modules within the Society’s MSc Musculoskeletal Medicine, are being reviewed within the context of the four pillars of advanced practice, as presented in the NHS ‘Multi-professional framework for advanced clinical practice in England’ (Clinical Practice, Leadership & Management, Education and Research) and NHS Education for Scotland’s ‘AHP Advanced Practice Education and Development Framework (Musculoskeletal)’ (Clinical Practice, Facilitating Learning, Leadership, Research).


New online infographic posters summarising the National Institute of Health and Care Excellence (NICE) guidance relevant to allied health professionals are now available online. Produced by the Institute of Osteopathy and endorsed by NICE, these easy to use resources provide a quick reference guide to current NICE guidance which can be printed and displayed in a clinical setting and support CPD.

There are currently three topics available; osteoarthritis, osteoporosis and spondyloarthritis, with plans to develop others in the near future.

The posters translate the NICE guidance into an easy to follow visual format to aid health professionals in primary care to identify and assess for the conditions and provide recommended pathways for care and management.

Matthew Rogers, Professional Development Manager at the Institute of Osteopathy and fellow of NICE, has been leading the project: “As a clinician I am acutely aware of the demands on health professionals to keep up to date with current guidance. As part of my fellowship with NICE I was keen to develop resources that would assist clinicians more easily embed the guidance into practice.”

The infographics are available to download for free from

ARMA policy teams and CEOs collaborated to agree a Policy Position Paper on Supported Self-Management for People with Arthritis and Musculoskeletal Conditions. The Policy Position Paper sets out recommendations for change.

The evidence identifies the importance of patients as partners in their own care. While people with musculoskeletal conditions can play a pivotal role in their condition, most are simply unaware of the difference they can make. That’s why the Alliance believes people should be supported to take a proactive role in their health, to live well, feeling confident and in control of their condition with supported self-management. Currently, supported self-management sits at the side-lines yet it works – it improves quality of life and clinical outcomes. In the paper, recommendations include a whole system, integrated approach across the care pathway, joining up public health messaging and clinical care.

ARMA works in partnership with our members and other stakeholders. Please get in touch if you would like to work with us to promote this paper, would like us to write a blog or article for your publication or are interested in other collaboration.

The MSK physio-themed review is now live.

Moving Forward – Physiotherapy for Musculoskeletal Health and Wellbeing  highlights evidence from the National Institute for Health Research and others on why research in this area matters, assessment and matching patients to treatment, restoring musculoskeletal health and maintaining musculoskeletal wellbeing.


It features:

  • 37 published studies
  • 25 ongoing research projects
  • Questions to ask your physiotherapy musculoskeletal services


You can download this review from the National Institute for Health Research website.

Rapid access to the right care and supporting patients to be fully involved in their care is at the heart of a new capabilities framework launched today (31/07/2018) by NHS England, Health Education England, Public Health England, Skills for Health and the Arthritis and Musculoskeletal Alliance (ARMA). The Musculoskeletal Core Capabilities Framework, aimed at practitioners who will be the first point of contact for people with musculoskeletal conditions, sets out to support improved access to care and ensure quality outcomes for patients.

Musculoskeletal conditions, such as neck and back pain, arthritis and rheumatic conditions, are the biggest cause of disability in the UK, accounting for one in five visits to the GP. They have enormous impact on quality of life for millions of people, with much of the disability avoidable.

This new framework sets out the knowledge, skills and behaviours needed to deliver first contact practitioner expertise consistently and effectively in a range of healthcare settings. It helps to ensure that patients get improved access to person-centred musculoskeletal care and support early on, with musculoskeletal expertise part of the frontline general practice and primary care team. This approach could transform patient experiences, enabling people to stay at work or return to work more quickly, require less treatment at a later stage and have a much better overall quality of life.

John Rogers, Chief Executive of Skills for Health said: “We are delighted to have worked with our partners in HEE, NHS England, Public Health England, ARMA and alongside service users in producing this framework. Musculoskeletal conditions can have devastating consequences for some people. The first contact practitioner framework aims to support the workforce and to support the public to have confidence in a range of professions working within the primary care setting.”

Beverley Harden, Allied Health Professionals Lead, Health Education England said: “Musculoskeletal conditions such as neck and back pain, arthritis and rheumatic conditions effect around 9.6 million adults in the UK and can have a significant impact on their quality of life. It is vital that those suffering from these conditions have timely access to the care they need to enable them to stay physically active, in work, education and socially engaged.

This framework will establish the standards for clinical staff working as first point of contact musculoskeletal practitioners in primary care and direct access services.”

Dr Victoria Tzortziou Brown FRCGP, MFSEM, PhD, MSc., Royal College of General Practitioners Joint Honorary Secretary said: “The musculoskeletal framework will serve as a useful tool that sets out the core capabilities for first point of contact practitioners to ensure expert diagnosis, prevention, supported self-management advice, shared decision making and early treatment of musculoskeletal conditions. It can assist practitioners to review their learning needs as part of an ongoing process of continuing professional development and can support a more integrated approach to musculoskeletal management aiming to deliver better outcomes for patients.”

Professor Peter Kay, National Clinical Director for Musculoskeletal Services, NHS England said: “The musculoskeletal framework makes clear the benefits of early management in supporting people to stay active and independent. A person-centred approach to care will not only deliver improved outcomes for people living with MSK conditions, but also improved outcomes for the health and care system.

“The framework emphasises a commitment to collaborative and integrated services. Through multi-professional team working, across services, we can ensure a partnership approach to treatment, care and support that is tailored to meet people’s individual needs.”

Professor Anthony Woolf, Chairman of ARMA said: “The framework has been developed by the whole musculoskeletal sector collaborating on an issue that we all agree is important. We believe it will make a real difference to outcomes for people with musculoskeletal problems.”

Nuzhat Ali, National Lead for Musculoskeletal Health and Wellbeing at Public Health England said: “The Musculoskeletal Core Capabilities Framework covers the entire musculoskeletal pathway from prevention to rehabilitation. It highlights how health professionals, such as GPs, nurses and therapists, can support their patients by providing them with essential advice so they can better manage their condition.”

Visit for more information, or register to download the framework here.

ultrasound diagram

The European League Against Rheumatism, EULAR, has published a set of recommendations, which look at the use of imaging modalities in primary large vessel vasculitis, including giant cell arteritis and Takayasu arteritis.

The recommendations are intended to advise physicians on the use of imaging modalities (including ultrasound, magnetic resonance imaging, MRI, computed tomography, CT, and positron emission tomography, PET) when making a clinical diagnosis of large vessel vasculitis (LVV), and when to apply imaging for monitoring of disease activity and damage.

See the press release, Recommendations for the use of imaging in large vessel vasculitis in clinical practise [pdf] for detail and explanation. Accompanying the text is a diagram [credit to Christian Dejaco] showing example utrasound images of patients with large vessel vasculitis. Click here to see it in full size.