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

Collaboration

At 7pm on 21 September 2020, people living with musculoskeletal conditions and healthcare professionals and policy influencers congregated in anticipation of a tweet chat on Twitter – ‘Power to the People.’

The tweet chat encompassed co-production of a new NHS MSK strategy – patients and healthcare professionals improving care together. The discussion for that hour involved 51 people, 279 posts, 1197 engagements. The #MSKCoPro was seen over half a million times by over 100,000 users.

If you missed it, there were too many tweets to publish them all, but here are some of the themes that emerged in response to questions about:

Please feel free to continue the chat using #MSKCoPro.

What gets in the way

A number of practical issues were identified such as people thinking it takes too long and lots of meetings but no action. Some very interesting discussions about power and about professionals’ vulnerability.

What helps

Lots of themes came up including giving patients control of the agenda, showing the difference their input will make, listening to patients, raising awareness and demystifying coproduction, the importance of taking time to build relationships. A lot about the fact this requires culture change.

Practical examples of coproduction in action

Last month’s newsletter included a blog about how NHS England/Improvement is working in partnership with people with lived experience of MSK conditions to “co-produce” work on MSK services. In September, over fifty people joined our tweet chat on co-production. In the course of an hour, professionals and people with MSK conditions engaged in lively discussion and debate about what helps coproduction, what gets in the way and good examples in practice. A summary of the discussion has now been published.

Coproduction means that all involved feel engaged in a collaborative healthcare approach with a shared commitment to quality, where everyone is treated with respect and dignity and everyone feels that their needs matter. To attain this, it is essential that patients and members of the public are engaged in all aspects of MSK healthcare through a co-productive approach to planning, delivering and improving services.

It’s not always easy to do, but it is important if we are to deliver services which work for the people they are intended to support. To assist in understanding patients’ experience of services during the pandemic, the MSK Lived Experience Group has produced a report of key themes to help inform decisions about MSK services. We encourage you to use this if you are discussing restart of MSK services or how to manage in the event of a second wave.

All these resources can be found on the ARMA website.

The NHS Change Challenge used crowdsourcing to identify almost 200 initiatives introduced during lockdown which proved beneficial. The project is now working to write these up in more detail so that we can publish them back onto the site for further comments and discussion. Due to the overwhelming responses received, the focus initially is on writing up the highest-scoring ideas based on impact and feasibility within each challenge area. 

The first two ideas have been published on the site. Keep checking for further ideas which will be published over the next few weeks.

by Greta McLachlan, Fellow at the Strategic planning and development cell, NHS England and Improvement, part of the Change Challenge Collaborative.

The change challenge collaborative is a group of professionals who have come together to work across the MSK, orthopaedic and rheumatology specialties to try and capture beneficial changes that have occurred within the NHS during COVID- 19. The aim being to try and capture these changes and ideas to ensure that these innovations are not lost when the NHS comes out of its pandemic measures.

Healthcare provision and delivery has changed greatly during COVID-19. Some changes have been detrimental to patients but not all. In fact there has been a whole host of innovations and different ways of delivering care across the NHS that have occurred in several weeks rather than the usual NHS pace of years.

We asked the communities of MSK, rheumatology and orthopaedics to tell us about the changes they had seen or instigated on a platform called Crowdicity.

Crowdicity is an online platform that allows collaboration of ideas and engagement through comments and discussion around each post. It was the ideal platform for us as it had been previously been used by NHS Horizons, but allowed our project to reach far further than a few emails for feedback might do.

In total over the four weeks that the platform was open for submissions, we had over 180 change ideas posted to the website, over 400 users registered, over 800 comments and some 10,000 plus page views. Our hashtag #nhschangechallenge got over 3 million impressions on twitter.

Once all submissions were closed, each change idea was discussed for its impact and feasibility and was assigned ‘themes’ so that we could see what commonalities there were between change ideas. The discussion that took place around each change idea took a co-productive, collaborative approach. For example, the group that discussed the rheumatology change ideas was made up of two consultant rheumatologists, one consultant physiotherapist, a patient with lived experience of MSK, a chair and secretary. The impact and feasibility were based on the premise that whilst some change ideas might be great during a pandemic and for a short period of time, they may not be feasible on a national scale or with the long term picture in mind. The same for impact. We wanted to be able to identify changes that would have greatest impact across the NHS, not just changes that have helped a small niche of patients or clinicians.

Now comes the hard part of this journey. Taking these change ideas forward and trying to work out how to champion them to the wider communities. ARMA has been a great supporter of this work, and helped us get to this point and I know will help us continue to make this project such a unique one as we look to next stage of this collaborative process. ​

Alongside the pain and misery of the Covid-19 pandemic there have also been some beneficial side effects – quiet streets and skies, birdsong, less pollution. This is also true in the world of MSK. ARMA has been a champion for the NHS Change Challenge, a project to identify the new and innovative ways of working that have been rapidly developed across the NHS and to ensure beneficial changes are captured and locked in. I think it is no accident that NHS Improvement chose to pilot this in MSK. The way in which the MSK sector has come together to collaborate and lead the changes needed to respond to the crisis has been outstanding.

The Challenge now has over 100 initiatives posted in just two weeks. Everything from online pain management classes to improved data collection, from virtual MDT meetings to different ways to deliver medication and avoid the need for hospital visits. It’s fantastic to be championing this project, encouraging the widest range of professionals to submit ideas and ensuring patient views inform the decisions about how to take this forward.

We are beginning to see the lockdown ease and services planning how to restart some of what has been put on hold. It’s clear this is going to be a long, slow process. ARMA’s involvement in a lot of different pieces of work will continue. We’re pushing for better support for people shielding, including advice on return to school for children shielding. We’re enabling collaboration to support private MSK practitioners to make the right decisions about when and how to return to work. Many people with MSK conditions choose to see a private healthcare practitioner and their contribution will help ease the pressure faced by the NHS. We’re continuing to raise the many issues coming through to patient organisation helplines and to contribute to NHS MSK services response to the crisis.

We are also beginning to think about restarting some of our business as usual. Tickets for our conference, Working Together to change the face of MSK, are now on sale. I’m looking forward to discussions with some of the most innovative and forward thinking people in the world of MSK. So if you want to join us, book now while early bird rates apply. Whether we deliver it as planned, as a conventional conference, or online, it will be a fantastic day, no doubt informed by the NHS Change Challenge as well as some brilliant work that was happening before Covid-19.

We also continue to deliver our webinars during lockdown, with one in April and one this week, both with a paediatric theme. Thanks to those presenters who have given their time to enable this.

Like everyone else we will continue to balance responding to the crisis with delivering our existing plans. 2020 will not turn out quite as I expected. Thanks to the NHS Change Challenge, and some extraordinary collaboration, it will be a year of progress for MSK.

New information on preventing musculoskeletal #bone, joint and muscle pain, and supporting mental well-being, has been compiled by NHS England, The Chartered Society of Physiotherapy, Versus Arthritis, Public Health England and ARMA.

See the Managing your physical and mental health and wellbeing page on the CSP website.

Suggestions are rolling in for which changes the NHS has made during the pandemic that people think we should keep.

You can see the other suggestions and add or vote by visiting the NHS Change Challenge website.

Following a successful start for the first cohort, applications are now open for the Aspiring to Excellence programme in 2020. The programme is designed to encourage and recognise service improvement in axial SpA (AS) care and is a strategic partnership between NASS, BRITSpA and sponsoring companies AbbVie, Biogen, Novartis and UCB.

Whilst COVID19 is impacting on us all, NASS is keen to keep driving forward as much as possible and being practical with Aspiring to Excellence, and we welcome applications. The deadline for rheumatology teams to apply is 24 July 2020 and all the application details can be found on the NASS website.

For further information please contact annamcgilvray@nass.co.uk.