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


by Mark Brandreth, NOA Lead CEO and
CEO of the Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation

As the new lead CEO for the National Orthopaedic Alliance (NOA), I am proud to be part of a group of organisations and people who are working to drive improvements in orthopaedic care nationwide. I’m pleased to have been given the opportunity to contribute a guest blog to ARMA’s newsletter to share an update on our work with you. At Robert Jones and Agnes Hunt Orthopaedic Hospital (RJAH), our work with the NOA, and its vanguard work in particular, is vital to our future – and to the future of orthopaedic care received by patients across the country.

Ultimately, the NOA wants to improve the services that its members provide and through the vanguard project, create a framework (or pathway) others can follow leading to consistent high quality care for patients across the country. The objectives of the vanguard are:

  1. Agree what good looks like in orthopaedics and set a formal quality standard for this
  2. Recruit, assess and support members
  3. Grow membership across the country to spread provision of consistent high quality care
  4. Support the development of Quality Standards by members
  5. Support the development of a quality assured system for orthopaedic care

Progress with the vanguard to date has been centred on mobilising and recruiting members to help build our orthopaedic quality standards. Development of these standards is well underway and once launched will help ensure that patients, no matter where they are treated receive the same quality of care and are looked after using the same evidence-based, reliable and safe processes.

The success of the NOA so far has been driven by input from members and we are ever grateful for their support. Just recently, members contributed to producing The NOA Short Guide to Clinical Coding for Clinicians – a useful guide to help address an area needing attention across many NOA member organisations. More detailed guidance, including the full NOA suite of standards will be available to members once the vanguard launches its quality standards.

I for one am proud to be part of this movement. If you want to find out more about the NOA vanguard work, I encourage you to read the latest newsletter here. You can also follow @NOA_Vanguard on Twitter.

The RCN Rheumatology Forum would like to report that in September 2017 the 4th edition of the RCN Biologics guidance document for Rheumatology Practitioners went live: “Assessing, managing and monitoring Biologic therapies for Inflammatory Arthritis

It is available online now as a downloadable PDF via our link:

Strategy Day

On the 17th Nov 2017 the RCN Rheumatology Forum are planning to meet for a (self-funded) Strategy Day where future projects and final details of the forthcoming RCN Rheumatology Nursing Workshop will be discussed.

The RCN Rheumatology Nursing Workshop 2018

This best-practice event is to be held at the RCN HQ on the 12th January 2018, starting at 11am and finishing around 3pm.

Topics include:

  • patient fatigue
  • pain
  • leadership and resilience training
  • psychological impact of chronic disease
  • Biosimilars update and how they impact on practice
  • Rheumatology Specialist Nursing Competency frameworks.

This workshop has been developed and based on the results of a forum survey which asked you to identify issues relating to the management of rheumatological disease, interventions, treatment and support.

The aim of the workshop is to address these issue as well as developing the unmet need of clinical leadership skills and personal and professional resilience. This event will enable specialist nurses to continue to deliver excellent care, follow best practice and inspire colleagues despite continued NHS barriers and difficulties.

The British Orthopaedic Association (BOA) is pleased to announce the recent publication of four revised commissioning guides with the Royal College of Surgeons of England. These NICE-accredited guides set out best practice care pathways to assist CCGs in designing optimal care for their populations. We are extremely grateful to all those involved in the rigorous development and accreditation processes. The guides, which can be found here, are:

  • Pain Arising from the Hip in Adults
  • Painful Deformed Great Toe in Adults
  • Painful Osteoarthritis of the Knee
  • Treatment of Carpal Tunnel Syndrome

Following the recent BOA and ARMA position statements on the rationing of elective orthopaedic services, we are urging stakeholders to consider these guides and to promote their adoption wherever appropriate with local CCGs. The use of these guides will assist CCGs to deliver high quality care in each of these pathways.

If you have any further questions, please contact

Arthritis and musculoskeletal conditions affect the bones, joints and muscles, and burdens the lives of so many people.

Musculoskeletal conditions are now the UK’s the biggest cause of pain and disability, accounting for an astounding one-in-five of all visits to the GP. Furthermore, trends indicate that more people than ever will be affected by MSK disorders in the coming years, which is why preventing them has never been more important. For this reason, the Arthritis and Musculoskeletal Alliance (ARMA), an alliance of prominent health charities, professional and research bodies, has produced a Policy Position Paper on Prevention of Musculoskeletal conditions.

The position paper highlights that a transformation is needed so that the care and public health systems go beyond merely tackling musculoskeletal conditions when they arise, to promoting good, lifelong musculoskeletal health. At every age people should be supported to maintain and improve the health of their joints, bones and muscles.

For more information about preventing musculoskeletal conditions, and to get involved in ARMA’s work, please get in touch via and Twitter @WeAreARMA.


In early August, ARMA has published a Policy Position Paper titled:

‘Rationing’ Access to Joint Replacement Surgery and Impact on People with Arthritis and Musculoskeletal Conditions [document opens in pdf]

It deals with the damaging nature of thresholds and scoring tools, the problems of waiting times and restricted access to surgery, and how patients with musculoskeletal conditions are affected.

The Alliance is drawing attention to worrying trends in treatment access and the paper makes clear the key outcomes we are seeking from CCGs and the NHS.

In July LUPUS UK released the newest edition in their range of publications, ‘LUPUS: Bone Health & Osteoporosis’.

The factsheet was kindly written by Dr David Armstrong (Consultant Rheumatologist, Altnagelvin Hospital, Londonderry).

This factsheet can be downloaded from the LUPUS UK website at and physical copies are available from the National Office in Romford.

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.

Rheumatoid Arthritis supplement

To help raise the awareness of Arthritis Week last week, BSR and NRAS have come together to produce a supplement focusing on Rheumatoid Arthritis (RA). The supplement was featured in The Guardian, bringing attention to the public about the impacts and implications that RA can have on people’s everyday lives.

Inside there’s articles from Laura Guest, Chief Executive Officer of BSR, Alisa Bosworth MBE, Chief Executive of NRAS, Dr Peter Lanyon, BSR President, Dr Jill Firth, BHPR President and much more! View the online supplement of Rheumatoid Arthritis online.

RCN Consultation Response to the Prime Minister

Last week a coalition of over 20 healthcare bodies, which included BHPR, and coordinated by the Royal College of Nursing, wrote an open letter to the Prime Minister calling on the Government to halt its plans to reform student funding for nursing, midwifery and allied health professionals (AHPs). The letter warned that these proposals, which include the introduction of student loans for student nurses, risk reducing the supply of future nurses, midwives and AHPs at a time when they are needed more than ever – and the letter asked him to fully consider the impact on patient care in England.

BSR is coordinating its own response to the consultation on the proposals, if you’re interested, please email Anna Lewis.
Members can also view the letter to the Prime Minister online.

New Guideline published

BSR and BHPR guideline for the treatment of systemic sclerosis was published last week in Rheumatology. Scleroderma is a complex, multi-organ disease and this new comprehensive multidisciplinary guideline will help MDTs tackle it more effectively. Head to the Guideline section on the BSR website to view the executive summary and the full guideline.

Rheumatoid Arthritis – Guideline update

NICE has published the draft scope of the update rheumatoid arthritis guideline. You can view the draft scope online. BSR would be delighted if its members contributed to the BSR’s response, by emailing your comments on the draft guidance to Anna Lewis, by 04 July 2016. NICE are also recruiting members of the rheumatoid arthritis guideline committee. They’re recruiting three rheumatologists, two general practitioners (1 with a special interest in rheumatology), a specialist nurse, a pharmacist with a special interest in rheumatoid arthritis, an allied health professional and a radiologist (as a topic specific expert, co-opted to the committee). Visit the NICE website for further details on the roles and application process.

BSR Regional Chair vacancy

A vacancy has become available for a individual to join as the West Midlands Regional Chair. The position will be responsible for supporting BSR members within the West Midlands regions while working closely with BHPR and co-opted Regional Lead Representatives. Full details and how to apply can be found on the BSR website.

Autumn Conference 2016

Bath Assembly Rooms | 13-16 October Thank you to everyone who submitted a case study for this year’s conference. We received a high calibre covering the four topics:

  • Raynaud’s disease – Convened by Prof Ariane Herrick
  • Spondyloarthropthies – Convened by Prof Walter Maksymowych
  • Vasculitis – Convened by Dr David Jayne
  • Infection and arthritis – Convened by Prof Robert Moots

Remember you can save on your conference ticket by booking online before 03 July 2016.

Calling for donations!

BSR’s Heberden Library has a historical record of medico-historical books on rheumatism, gout and other allied conditions. It is important to us that this record is kept up to date to help enable us to have a complete history of Rheumatology. To help ensure we have a wide range we invite you to donate any relevant books to the Heberden Library. This may be something you no longer use or something you have multiple copies of. We would love to hear about anything you would consider donating. Please email BSR with the title and author of the book so we can check it against our current list. For more information visit the Heberden Library online.

National clinical audit launch

On 25 July 2016 BSR will be launching the second phase of the National clinical audit report at the King’s Fund in London. The report will cover key findings, share best practice and discuss the future of the project. Limited places are available, to confirm yours please email Rose David by 07 July 2016.