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.

Health Policy

The final scope and equality impact assessment for this NICE guideline have now been published, along with all the stakeholder comments that were received during consultation and the NICE responses to these comments.

The ARMA organisation was identified as a key stakeholder for this topic; NICE would like to thank the ARMA members for our continued involvement and interest in this guideline. The comments received during the consultation period helped to develop and refine the scope.

NICE will contact ARMA again when the draft guideline is released for consultation, and they ask that we prioritise sending them our comments.

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

On 20 March 2018, Arthritis Research UK hosted its first parliamentary event of the year, sponsored by Andrew Bowie MP. The drop-in event attracted almost 50 MPs, alongside MP researchers, who came to find out how they can support constituents affected by arthritis.

Thank you to everyone who took our e-action in advance of the event, and asked their MP to attend. It certainly made a difference, with some MPs saying they only knew about the event because their constituent had raised it with them. If you’d like to support our work in this way, you can join our campaigner network.

MPs from across the UK spoke to people living with arthritis, learned about the services we offer, talked with our research team about our current projects and success stories, and discovered how many people in their constituency are affected by arthritis. Attendees also had the opportunity to try on our arthritis gloves which simulate the mobility restrictions arthritis can cause in hands.

Read the full article here.

 

The Faculty of Sport and Exercise Medicine UK has responded to this Public Health England consultation with a focus on MSK services in the NHS.

The Faculty’s response emphasises that specialist clinicians are needed who understand the cause of MSK problems and are able to provide focused treatments as well as lifestyle interventions to manage and prevent MSK disorders. If the NHS could create MSK medicine consultants to lead services together with physiotherapy practitioners and GPs with a special interest, it would do a great service to the millions of patients that suffer from MSK disorders.

NHS trusts should invest in those services, not to take away from orthopaedic surgeons or rheumatologist, but to allow both MSK physicians, surgeons and rheumatologist to see the patients they have been trained to help.

A new guide has been published to showcase the extensive range of programmes being delivered by the AHSN Network to improve clinical services in the areas of musculoskeletal (MSK), falls, fractures and frailty, all key priorities for the NHS.

Collectively, MSK, falls, fractures and frailty have a major detrimental impact on patients, families and carers, and are a major cost to the NHS.

With a growing and ageing population, health and social care services need to be proactive in their response to this challenge. Whilst many different clinical pathways and services are provided to manage these four problems, there are clear links between them.

Across the 15 Academic Health Science Networks (AHSNs) there is a wealth of experience and practical skills in working with NHS organisations to improve clinical services in these clinical pathways, with service evaluation projects that have been shown to improve patient outcomes and deliver more efficient use of resources.

Compiled by Alison Gowdy, Clinical Innovation Adoption Manager at Oxford AHSN, with input from all 15 AHSNs, this new guide provides a useful overview of these projects.

It is hoped the guide will help shape discussions with Sustainability and Transformation Partnerships (STPs), commissioners and providers regarding future work to improve services and patient outcomes in these areas, while enabling others to share in learning to help implement and / or build on an existing, proven concept.

Download the guide here.

Happiness in elder rehab facility. Retired successful people

 

The webinar will outline the development of the JSNA chapter and why this is important for improving the musculoskeletal health of a local population. Ian Bernstein and Rutuja Kulkarni-Johnston will outline the process of developing an MSK JSNA chapter. Kevin Fenton will explore the benefits of this and how it might be used.

The London Borough of Ealing and NHS Ealing CCG published the Joint Strategic Needs Assessment (JSNA) chapter on Musculoskeletal Health in December 2017. The JSNA is a statutory document that describes the health and social care needs of the population, identifies gaps and unmet needs, and makes evidence-based recommendations to health and social care commissioners.

Two versions have been published: a visually appealing ‘Focus on’ Musculoskeletal Health chapter provides a compact, easy-to-navigate review. The full version adopts the life course approach proposed by Arthritis Research UK (ARUK), and includes both national data from the Global Burden of Disease, and local data from the ARUK Musculoskeletal Calculator.

See our post on the update to the Ealing MSK JSNA Chapter.

Who should attend:

Directors of Public Health, senior policy makers, health and social care commissioners, Health and Well-being Boards, providers tendering for services, patient groups.

Presenters

Ian Bernstein, Clinical Lead for Musculoskeletal Transformation, NHS Ealing CCG and NW London STP
Rutuja Kulkarni-Johnston, Consultant in Public Health, London Borough of Ealing
Professor Kevin Fenton MD PhD FFPH, Director of Health and Wellbeing, Southwark Council

Register in advance for this webinar.

NHS England is consulting on proposals that will stop routine prescribing in primary care of over the counter treatments for a number of conditions, including the maintenance use of vitamin D. Receiving adequate vitamin D intake is crucial for current and future bone health and NICE Public Health Guideline 562 (PH56) states that a licensed dose of vitamin D, for prevention of vitamin D deficiency, should be widely available to at-risk groups.

The consultation recognises that vitamin D should continue to be prescribed for patients who are deficient and that it can be prescribed in combination with calcium for osteoporosis. However, vitamin D for maintenance is subject to restrictions and there is a risk that at-risk patients, may not purchasing it themselves (due to cost, accessibility or lifestyle reasons) or purchase a product which is inappropriate for their needs (due to ingredients or dosing levels). If you are going to respond to this consultation, consider raising the issue of availability of a licenced dose of vitamin D on prescription among at-risk patients. Let us know if you are responding.

Together for Mental Health in North Wales is an all-ages plan for mental health services in North
Wales covering the period up to 2021.

It has been put together by NHS Wales with partner organisations and with people who have lived experience of mental health issues. The project is supported by Caniad, an organisation created to involve people with lived experience in the design, delivery and evaluation of our mental health services.

The strategy outlines NHS Wales’s ambition to offer a comprehensive range of services that:

  • Promote health and wellbeing for everyone, focussing on prevention of mental ill health, and
    early intervention when required;
  • Treat common mental health conditions in the community as early as possible;
  • Are community-based wherever possible, reducing our reliance on inpatient care;
    Identify and treat serious mental illness as early as possible;
  • Manage acute and serious episodes of mental illness safely, compassionately, and
    effectively;
  • Support people to recovery, to regain and learn the skills they need after mental illness; and
  • Assess and treat the full range of mental health problems, working alongside services for
    people with physical health needs

Open the Together for Mental Health in North Wales strategy update document [PDF]
Law yn Llaw at Iechyd Meddwl yng Ngogledd Cymru – Chwefror 2018 [PDF]

 

Musculoskeletal conditions, disability and employment

Dame Carol Black is the outstanding expert advisor on health and work and principal of Newnham College Cambridge. Her lecture, delivered in London as part of the ARMA Annual Lecture series, was on progress to date by government, health professionals and employers on musculoskeletal conditions and their impact on employment and a person’s wellbeing.

The lecture and reception was well attended with an interesting Q&A session and lively twitter dialog using #MSKatWork.

You can watch the lecture on this page, where you can also find the accompanying slides for the presentation and photos from the event, or see the video directly via our YouTube channel.

Presented in 2018 with the generous support of Arthritis Action.

The final scope for the NICE Chronic pain: assessment and management guideline has now been published, along with all the stakeholder comments that were received during consultation and responses to these comments.

NICE would like to thank you for your continued involvement and interest in this guideline. The comments received during the consultation period helped us to develop and refine the scope. ARMA has been identified as a key stakeholder for this topic and will be contacted again when the draft guideline is released for consultation.

If you have any further queries, please contact PersistentPain@nice.org.uk

On 28 November 2017, the UK Gout Society joined forces with Welsh Assembly Members, doctors and other charities to help raise awareness of gout in Wales.

Speaking at the Welsh Assembly, Rhun ap Iorwerth AM, the Plaid Cymru Health Spokesperson who hosted the event, said: “The impact of musculoskeletal conditions in Wales is huge and we have a big job to limit that impact. Working together to raise awareness of gout must play a part. We know that gout is often seriously undertreated and greatly misunderstood.”

Arthritis Care Wales and the UK Gout Society called for the British Society for Rheumatology’s recent guidelines for managing gout to be fully implemented in Wales.

High profile parliamentary attendees included the Chair of the Health, Social Care and Sport Committee; the Minister for Social Care; and the Leader of Opposition and Welsh Conservatives.

Two leading gout experts also spoke about the burden of gout and diagnosis and treatment: Professor Ernest Choy, Head of Rheumatology and Translational Research, Cardiff University; and Dr Martin Bevan, Lead Clinician, Consultant Rheumatologist, Abertawe Bro Morgannwg UHB. Two people living with gout also talked about how gout affects their everyday lives and the importance of seeking help and support from a health professional.

#shoutaboutgout

UK Gout Society’s Friends newsletter

Logo-for-UK-Gout-Society

Take a moment to see the January 2018 edition of the UK Gout Society’s ‘Friends’ newsletter, which includes articles on:

  • New Year Charity Symphony Orchestra raises gout awareness on BBC South Today TV
  • Gout and Diet – how certain foods containing quercetin can reduce your uric acid levels
  • Meon Valley Orchestra – 10 March 2018, Fundraising concert in Portsmouth

Click here for the newsletter in PDF.