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 33 member organisations ranging from specialised support groups for rare diseases to major research charities and national professional bodies.

Collaboration

ARMA joins Public Health England and the Centre for Ageing Better to make England the best place to grow old, because musculoskeletal health is vital to healthy ageing.

ARMA joined over sixty high-profile organisations in the UK’s health, housing, employment, research and voluntary sectors to launch a landmark shared vision on healthy ageing.

There are five key principles: prioritising prevention and public health; creating opportunities for people to contribute to society as they age; fostering accessible and inclusive homes and neighbourhoods so everyone can live where they want; narrowing inequalities in healthy ageing; and challenging ageist language, culture and practices.

This initiative is led by Public Health England (PHE) and the Centre for Ageing Better. We will work together with these and others because musculoskeletal health is vital to a good later life.

Find out more from the Ageing Better website.

CEO update by Sue Brown

One of the things I love about my job is the variety of things I get involved in. The wide scope of what is covered by musculoskeletal health and the variety of ARMA members, partners and stakeholders means no two days are ever the same.  August has been a month to prepare for the exciting variety of activity we have planned including our annual lecture, a roundtable on pain, an event on physical activity and more webinars.

Physical activity has been quite a theme this month, with the launch of the We Are Undefeatable campaign. I love the positive but realistic messaging which is so relevant to MSK conditions. This will help reinforce the messages from clinicians using Moving Medicine or the RCGP Active Practice Charter. My concern is that when people turn up at their chosen activity, be it a local leisure centre, gym or walking group, staff/volunteers won’t understand MSK and will be concerned about them taking part. This is the reason ARMA supports the parkrun Facebook group for people with MSK conditions, as it gives peer support and encouragement for people to be active in a way that works for them.

ARMA is planning an event for providers of mainstream activities to help them understand how to support people with MSK conditions to be active, and to include them in their activities. The emphasis of We Are Undefeatable is on self-management and being more active without medical supervision or special programmes, just like the parkrun initiative. I hope that we can help those motivated by the campaign to get a positive response wherever they choose to go.

The other big theme of my August has been pain. ARMA collaborated on some qualitative research around chronic pain which I presented at a Chronic Pain Policy Coalition event. It is clear that chronic pain is extremely common. It’s not all MSK related, but at lot of it is. The lack of services for chronic pain leaves patients and healthcare professionals alike struggling to know what to do for the best. That’s why we are promoting IAPT-MSK pain in a webinar later this month. It’s why we are holding a roundtable in October to look at how the situation can be improved. Look out for more from us in the coming months on this.

One thing that pain and physical activity have in common is complexity. There are a whole variety of barriers to people with MSK conditions being active and effective multidisciplinary pain services need to be available at every level from community peer support to specialist services. No one can solve either of these issues alone. Work together – then we might stand a chance.

by Michael Ly, Health Intelligence Manager, Versus Arthritis

In January 2019, NHS England published the NHS Long Term Plan, outlining its vision to improve the health and wellbeing of people over the next 10 years. Central to this vision is a commitment to designing and delivering services that are more joined-up, tailored and community-based to meet the needs of local people, including those who face health inequalities.

To do this effectively, the Long Term Plan recognises that local health and care systems will need to work in partnership with communities and charities to understand the health and care needs of their local population.

To support this, members of the Health and Wellbeing Alliance, together with Healthwatch and Versus Arthritis, have produced Health and Wellbeing Resources Packs for local health and care systems in England.

The Resources Pack brings together a range of information and data to build a shared understanding about the local population and the communities in which they live, the wider local context affecting health and wellbeing, and specific aspects related to the delivery of local health and care services. This includes existing information from national sources, along with other data about the voluntary sector, local people’s views, and wider social factors affecting health and wellbeing that is perhaps less well known.

It is intended for all those working in and with local health and care systems in England, including those working for the NHS or other public sector services, charities, social enterprises, or special interest and community groups.

Resources Packs have been produced for the 42 STPs and ICSs in England in July 2019.

Read more from the Age UK website.

 

Two things happened in July which will be significant for MSK services: the publication of the Prevention Green Paper Advancing Our Health, and the creation of over 1,200 Primary Care Networks (PCNs) across England. ARMA will be supporting members to engage with the Green Paper and to ensure PCNs deliver what is needed for MSK. We hope all our newsletter readers will get involved too.

I was pleased to see that Advancing Our Health gives plenty of profile to MSK. We’d like to see more focus on action and we’ll all be pushing for this in our responses. See the analysis of the content from an MSK perspective by our members in this month’s newsletter. It is a consultation document and anyone can respond online. I would encourage everyone to respond and encourage others to do the same. Government needs to hear that there is support for bold action to prioritise prevention and that the MSK sector is ready to collaborate to make a real difference.

Primary Care Networks were the subject of a presentation at our AGM this year. The Medical Director for Primary Care and Digital Transformation for London explained that GP practices will work collaboratively with each other and health, social care and voluntary partners to deliver services that can’t be delivered on a smaller scale. This animation explains how they are intended to work. PCNs will be important in providing MSK services, First Contact Practitioners and social prescribing. As with any collaboration, they will take time to establish and will take different forms in different areas. We heard worrying reports from members that PCNs weren’t giving it as much focus as is needed. Worrying given the profile for MSK in the Prevention Green Paper and in most CCGs priorities. We all need to work together to change that as the PCNs get established.

The AGM was also a chance to hear ARMA members views of what we should be doing. This year we have been working on some key priorities such as mental health, physical activity and what the NHS Long Term Plan means for MSK services. Members felt these are broadly the right priorities but that we should consider what we might be able to do about pain and about children and young people with MSK conditions.

Our webinar programme has taken a bit of break across the summer, but I’m pleased to say that we have two new webinars planned in September and available to book now. We also have plans for some exciting topics in October and November, so look out for those in future newsletters. Our webinars are a great way to learn from good practice and all the recordings are available to watch if you missed the live delivery.

We always like to hear from the commissioners, health care professionals, policy makers and others who make use of our information and materials. So if you love the newsletter, value our webinars or have thoughts on what we could do next to make a difference, do let us know by email or on twitter. The Green Paper and the PCNs give us opportunities which we must all engage with, because none of us can make the changes we need by ourselves.

NASS was delighted to launch the NASS Allies referral template, in conjunction with the Institute of Osteopathy and Royal College of Chiropractors, at the Primary Care and Public Health Conference on 15 and 16 May. The template was developed to help chiropractors and osteopaths in recommending referral for patients with suspected inflammatory back pain to rheumatology.

The template has been endorsed by the Royal College of GPs and Chartered Society for Physiotherapy. NASS is grateful to both the Institute of Osteopathy and Royal College of Chiropractors for their continued collaboration and wonderfully patient-centred approach.

Save Our Pools

NASS is working with a number of organisations, including several ARMA members, on developing a campaign to sustain and in some cases, save, hydrotherapy pools around the country. If you are interested in being involved, please email jill@nass.co.uk. Please also sign and share the petition to save the pool at Bedford Hospital.

 

In April 2019, ARMA, supported by UK charity Arthritis Action, released a new report looking at the impact of mental health on people with arthritis and other musculoskeletal (MSK) conditions. The report followed a roundtable event, organised by ARMA in March, which, for the first time, brought together leaders from Mind, NHS England, Arthritis Action, and other health charities to look at ways to improve access to effective psychological support for MSK patients. ARMA published the report during Mental Health Awareness Week.

roundtable-document

Sue Brown, CEO of ARMA, says:

“It’s not surprising that mental health is so common amongst people with conditions which cause long term pain. What is surprising is how little support with their psychological well-being is offered to people who live with daily pain. This roundtable report should be an important first step in changing this. There are interventions that have been shown to work, but they aren’t available in most areas. ARMA believes that everyone who could benefit from them should be offered them.”

MSK conditions comprise over 100 different diseases and syndromes that interfere with a person’s ability to carry out their normal daily activities. MSK conditions are thebiggest cause of disability in the country, with around 17.8 million people in the UK affected by them.[i]

Around one in five people with osteoarthritis, the most common form of arthritis, report depression and anxiety.[ii] In terms of receiving mental health support, one in five patients with rheumatoid arthritis report being asked about emotional issues by a rheumatology professional, even though almost half of the population would like the opportunity.[iii]

Key themes highlighted in the report are:

  • Treating emotional and mental health conditions should be a fundamental part of managing arthritis from point of diagnosis. A recent survey found that two in five people with arthritis had never been asked by a healthcare professional about their emotional wellbeing [iv].
  • Mental health support is needed at every diagnosis/transition point in a person’s journey.
  • People with MSK conditions often feel that they are the only ones experiencing them. Contact with patient support organisations, either through helplines or support groups, can help people understand their experiences are common.
  • Keeping people in work is as important as getting them into work.
  • Training/supporting employers in managing staff with long-term conditions is key.

Recommendations:

  • Integrated physical and mental health support should be available from basic educational materials to integration in pain clinics and rheumatology.
  • Every healthcare professional with an MSK patient should ask about their emotional/psychological wellbeing at every appointment.
  • Healthcare professionals should ensure that patients are aware of patient support groups and organisations available, both nationally and locally.
  • MSK professionals should receive training and CPD to help them better understand and assess mental health. Training should include risk assessment and knowledge of referral pathways.

Leigh Walmsley, arthritis patient and London 2012 Paralympic Archer, says:

“I developed osteoarthritis after a serious cycling accident aged 11, but noticed the first signs of inflammatory arthritis in my 20s. The impact arthritis had on my life was very significant. I couldn’t run in PE with my classmates, walk too far, stand for too long and as my inflammatory arthritis began to rear its head; there were times I almost couldn’t walk home after work. The fatigue of chronic pain is debilitating and causes depression.

“Arthritis Action appeared in my life when I was at a low point. It was a huge comfort to know there were other people like me, that have the same ideals as me and most importantly, they allow me to help other people with arthritis. I was so inspired, I decided to start a support group for the Charity in the North West. Groups are a great way of bringing people together, helping them feel less isolated or alone, which is really beneficial for our mental health.”

Read the Mental Health Roundtable Report.

[i] Versus Arthritis: State of Musculoskeletal Health Report 2018
[ii] Versus Arthritis: State of Musculoskeletal Health Report 2018
[iii] National Rheumatoid Arthritis Society (NRAS): Emotional Health & Well-being Matters Survey 2018
[iv] National Rheumatoid Arthritis Society (NRAS): Emotional Health & Well-being Matters Survey 2018