Arthritis and Musculoskeletal Alliance
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

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.

“No health without MSK health”. Those were the words of our guest speaker at the ARMA AGM and they clearly struck a chord with members. They were on my mind last week when I attended a consultation meeting held by NHS England about the new ten-year plan for the NHS. At the moment MSK health doesn’t get as much profile as conditions such as mental health, cancer or cardiovascular. Not to downplay the importance of these conditions, but MSK health underpins all aspects of our ability to be independent and lead the active lives we want. We all know the cost to the NHS, to individuals and families, and to the economy is enormous.

The pain and limited mobility of MSK conditions also has a knock-on impact on other aspects of health – difficulty opening medication or food packaging; difficulty getting on the bus to shop for healthy food or attend appointments; difficulty carrying out all the self-care and self-management activities that enable us to manage other health conditions. Arthritis Research UK reports that by age 65 years, almost 5 out of 10 people with heart, lung or mental health problem also have a musculoskeletal condition. If you are struggling at home with your arthritis and you need to go into hospital for any reason, you are likely to need more support to return home as a result.

So why does MSK not get a higher profile? The answer is: at a local level it does. The majority of CCGs have MSK as a priority for service improvement locally. And at a national level NHS England has a plethora of relevant programmes and activity, it’s just they don’t all sit under the banner of a single MSK programme. By contrast, Public Health England has a new MSK programme which will be working on MSK initiatives and ensuring that MSK is embedded in other PHE work.

Wouldn’t it be great to see this all recognised with a profile in the ten-year plan? So as the NHS consults on the plan they will hear one message from ARMA members loud and clear: No health without MSK health.

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.

This final guideline has now been published on the NICE website. You can also find the supporting evidence, as well as all the stakeholder comments that NICE received during consultation and the responses to these comments. The comments were invaluable in helping to develop and refine the guideline. NICE has also produced an equality impact assessment to support the guideline.

The recommendations from this guideline have been included in the NICE Pathway on Rheumatoid arthritis (update), which brings together everything that was said on Rheumatoid arthritis (update) in an interactive flowchart.

NICE would like to thank you for your interest in developing this NICE guideline and any support you can give to promote its use in practice.

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

Guest blog by Ms. Nuzhat Ali, National MSK Lead, Public Health England

Health inequalities are avoidable, unjust differences in people’s health that are persistent and difficult to shift, until and unless we actively focus on them as a society and a whole system.

People living in the most deprived areas in England can expect to spend nearly 20 fewer years in good health compared with those in the least deprived areas. The trajectory and the scale of the inequity worry me for at least three reasons – it is:

  • A societal injustice, one that has serious consequences for us all in many ways
  • A factor in slowing down life expectancy and healthy life expectancy
  • Increasing demand for health care which equates to increasing costs

Health is dependent on so much more than healthcare.  Research from the Canadian Institute of Advanced Research, Health Canada, Population and Public Health Branch found that healthcare contributed no more than 25% to our health, and others like McGiniss et al found from their research that it is a 15% contribution. Our genes, lifestyle behaviours, environment, housing, socioeconomic and working conditions, and much more are all key determinants of our health. Surely this points to the need for us all to focus greater attention to these factors in meaningful ways.

The Determinants of Health (Dahlgren and Whitehead, 1991)

The figure above shows the main determinants of health as layers of influence. At the centre of the model, individuals are endowed with non-modifiable factors that influence health potential, including age, sex and constitutional factors.  

Surrounding the individuals are layers of influence that can be modified. The innermost layer represents the personal behaviour and way of life adopted, such as smoking habits and physical activity, with the potential to promote or damage health. Individuals interact with friends, relatives and the community, and are therefore affected by the social and community influences represented in the next layer. Mutual support within a community can sustain the health of its members in otherwise unfavourable conditions.

The wider influences on a person’s ability to maintain health include their living and working conditions, food supplies, and access to essential goods and services. Overall, there are the economic, cultural and environmental conditions prevalent in society as a whole, represented in the outermost layer.

What do we know about the relationship between musculoskeletal (MSK) health and inequality?

Gender differences:

An estimated 17.8 million people live with a MSK condition in the UK, which is around 28.9% of the total population. Of these, 7.7 million are men and 10 .1 million are women.

Socioeconomic differences:

People who live in the most deprived areas are much more likely to report arthritis or back pain than people in equivalent age groups who live in less deprived areas. 40% of men and 44% of women in the poorest households report chronic pain, compared to 24% of men and 30% of women in the richest households.

Among people aged 45–64, the prevalence of arthritis is more than double in the most deprived areas (21.5%) compared to the least deprived areas (10.6%). Further, people of working age (45–64 years) are almost twice as likely to report back pain (17.7%) as those from least deprived areas (9.1%).

Physical inactivity, obesity and comorbidity are all strongly associated with deprivation. People in the most deprived areas develop multi-morbidity 10–15 years earlier compared to those in the least deprived.

My top three humble suggestions on how we might tackle this wicked system problem:

  • Balance the medical model of health with the social model of upstream efforts on wider determinants of health. This means working in partnership and collaboratively across sectors and with our community’s
  • Focussed secondary prevention in primary care is the best way to get quick wins in narrowing health inequalities (King’s Fund)
  • Provide targeted support to help people find and remain in good work

Public Health England (PHE)’s mission is to protect and improve the nation’s health and wellbeing, and reduce health inequalities. PHE have published a range of tools and resources to support professionals to tackle inequalities. PHE’s guidance – Reducing health inequalities: system, scale and sustainability – set out a revision of the DHSC’s Health Inequalities National Support.

For further information, you can visit PHE’s return on investment tool for MSK conditions, Health Matters and the recently published review on muscle and bone strength and balance.

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 www.skillsforhealth.org.uk for more information, or register to download the framework here.

Introduction

Across a range of MSK conditions there is evidence of significant delays to diagnosis which result in avoidable morbidity and mortality. GPs have a critical role to play in reducing time to diagnosis. This article looks at the delays, their impact, and the resources available to GPs to support their referral decisions. Our simple message is #ThinkRheum.

Delay to diagnosis

Significant delay from symptom onset to diagnosis has been seen across a range of MSK conditions: an average of 6.4 yeas in Lupus [1], 8.5 years in axial spondyloarthrtis (axial SpA) [2] and an estimated 10 years in Ehlers-Danos syndromes (EDS).

Although some of the delay can be attributed to patients not reporting symptoms to their GP, the largest delays occur within the healthcare system. These include GPs not referring patients to rheumatology, referral letters to GPs from osteopaths and chiropractors not being actioned, and a lack of understanding among radiologists and other specialties. In a recent study, patients presenting with acute anterior uveitis (AAU) were evaluated clinically and with MRI in order to estimate the prevalence of axial SpA; the study found that one quarter of axial SpA patients were previously undiagnosed.[3]

Impact of the delay

As with all conditions, rapid diagnosis is key to effective medical care and treatment. A delayed diagnosis can mean having to live with prolonged pain, with the untreated disease progressively worsening.

In Lupus, delay in accessing effective treatment also increases the risk of permanent organ damage and disability, and even death [4]. Studies have shown that SLE patients who are diagnosed early, on average, have lower rates of mild, moderate and severe flares, and lower rates of hospitalisation [5]. Early diagnosis can be especially important in cases of lupus nephritis with research demonstrating that a delay between the onset of nephritis and a renal biopsy constitutes an important risk factor of end-stage renal disease (ESRD).[6]

Nadia, who lives with lupus said:

“I developed what I thought were my first symptoms of lupus (joint pain, muscle aches and fatigue) when I was 18 years old. I initially attributed these symptoms to the stress of an unrelated spinal surgery but as I developed more symptoms I started to suspect something else was going on. I was continually dismissed as overly anxious and made to feel like I was a hypochondriac. After developing severe heart-related symptoms and being admitted to A&E three times I started to look for answers myself. I read about lupus and identified with a lot of the common symptoms. I requested blood tests from my GPs which revealed positive results, but the significance of these results were not fully understood.

Finally, last year, at the age of 24 I paid for a private consultation where I was diagnosed with lupus within half an hour and prescribed treatment. The consultant believes that I may even have had symptoms of lupus (interstitial cystitis and anaemia) when I was 15. My diagnosis means that I have had to make significant changes to the way I live my life and I will always need treatment, but I now have answers and I won’t give up the fight. I visit my doctor a lot less now that I have a diagnosis! I was visiting the doctor weekly prior to diagnosis. I would say I go once a month now perhaps? If things are worse maybe every few weeks but overall my visits have decreased.”

In ax SpA, studies have consistently shown that the delay in diagnosis results in significantly worse disease activity index, functional index, spinal mobility and/or radiographic damage [7] as well as poorer treatment response.

One axial SpA patient told us:

“It took me 8 years to get a diagnosis from the onset of my symptoms, and I don’t think I would have been diagnosed now if I had not realised that I had AS from Googling it on the internet. I then went to my GP with a tick list of AS symptoms which I had and basically dared her not to refer me.

I was diagnosed within 6 weeks of that appointment and my family were devastated but I was strangely elated, as I felt like I had an explanation for my pain that could enable others to understand. In the years prior to diagnosis, I wasted hundreds of pounds on acupuncture, chiropractors and osteopaths and was fobbed off by numerous doctors, nurses and physiotherapists. If I had been diagnosed sooner, I feel that I wouldn’t have been viewed as ‘putting it on’”.

Gout is the most common form of inflammatory arthritis worldwide, currently affecting one in 40 people in the UK. It causes sudden and extremely painful inflammatory attacks in the joints (usually developing in the night or early hours of the morning) – most commonly the big toe, ankles and knees but any other joint too. Gout is eminently treatable yet fewer than one in five gout patients are prescribed urate lowering therapy within six months of their diagnosis, and only around one in four is on this treatment a year after diagnosis. Gout is a chronic and progressive disease and is often associated with many other serious health conditions including kidney disease, diabetes, heart attack and stroke. There is also a growing body of evidence demonstrating it leads to an increased risk of death. [8]

Security guard Fred Bloggs had his first attack of gout in 2010 but it wasn’t diagnosed until two years later. Fred feels his recent life has been completely blighted by his condition. He has spent lengthy periods in hospital and, on occasions, has been confined to a wheelchair.

He reckons he has lost thousands of pounds in income due to long periods signed off work (approximately ten weeks on statutory sick pay) and it has badly affected his employment record.  “I started a new job this year and I had a bad attack soon afterwards, resulting in two weeks off work. It’s embarrassing, but what can I do? I’m afraid that I will soon become unemployable because of all my time off work.” Fred spent days trawling the internet for advice about his condition. He tried all the dietary recommendations such as cutting out high purine foods and increasing intake of fluids. “Nothing seemed to work.” He says he doesn’t drink alcohol.  He is now permanently under the care of a specialist and long-term treatment. 

Most types of EDS left untreated result in deconditioning as targeted exercise is key to keeping joints strong and preventing pain and dislocations. Undetected vascular EDS is potentially life-threatening due to aneurysms and organ ruptures. Unrecognised gut symptoms can lead to gastroporesis and the need for tube-feeding in extreme cases. Significant anxiety and depression can result from a delayed diagnosis; people with EDS have often been labelled with a mental health problem at some point in their search for a diagnosis.

Scleroderma affects just under 20,000 people in the UK based on new research published in 2018. Due to the lack of data relating to this rare condition, we cannot give an accurate time to diagnosis. For us this is one of the key challenges as without reliable data we are unable to lobby for change. Based on a survey conducted in 2017 45% of respondents said they waited 3 or more years to receive a diagnosis of scleroderma after presenting with their first symptom. [9]

Scleroderma is a rare and complex condition that presents in many ways, meaning the condition affects different people differently.

Grace, aged 57, has had symptoms of scleroderma since the age of 33, when she was diagnosed with Raynaud’s. It was another ten years before she was diagnosed with scleroderma.

“It was after quite a traumatic birth with my son that I started to notice symptoms, my skin was getting tighter, I had severe reflux and I began to struggle with everyday tasks. After continued visits to my GP, I was diagnosed with Rheumatoid Arthritis and put on various painkillers, which obviously didn’t work.

My breathing was getting worse and I was having repeat visits to A&E, thankfully on around my eight trip to A&E, I met a young doctor who noticed scarring on my lung x-rays. I was given an immediate referral to a lung specialist where I was diagnosed with scleroderma. On diagnosis, I started the maximum course of the chemotherapy, to stabilise the aggressive nature of the disease.

Due to late diagnosis the extent of my disability is huge, as my lungs, skin, heart, kidneys and oesophagus are all affected. I am on oxygen due to my severe lung disease but I still feel constantly breathless.”

 

Across a range of less common MSK conditions, delays to diagnosis result in avoidable costs to the NHS (multiple unnecessary referrals with no outcome; cost of multiple investigations with no useful outcome; inappropriate use of A&E services as no other service can meet immediate need, etc.) and costs to the economy through lost productivity.

Resources for GPs

The good news is that numerous resources are available to help GPs identify patients who may have one of these conditions and who need referral to rheumatology. These include:

GPs are critical to reducing delays to diagnosis in MSK conditions. Educational resources include:

 

Delays to diagnosis are severe, have significant impact on patients and their families and are costly to the NHS and the economy. GPs are critical to reducing delay by earlier referral to secondary care and have access to a range of resources to support clinical decision-making and ensure timely referral.

#ThinkRheum

 

References:

[1] Morgan C, Bland A, Maker C, Dunnage J, Bruce I et al., (2018) ‘Individuals living with lupus: findings from the LUPUS UK Members Survey 2014’, Lupus (27): 681-687

[2] Sykes M, Doll H, Sengupta R & Gaffney K (2015), ‘Delay to diagnosis in axial spondyloarthritis: are we improving in the UK?’, Rheumatology, July

[3] Sykes MP, Hamilton L, Jones C, et al. (2018) ‘Prevalence of axial spondyloarthritis in patients with acute anterior uveitis: a cross-sectional study utilising MRI’. RMD Open;4:e000553. doi:10.1136/ rmdopen-2017-000553

[4] British Society of Rheumatology (2016) A collaborative approach to improving outcomes in rare rheumatic and musculoskeletal diseases: report from a national workshop

[5] Oglesby A, Korves C. Laliberte F, Dennis G et al. (2014) ‘Impact of early versus late systemic lupus erythematosus diagnosis on clinical and economic outcomes’, Appl Health Econ Health Policy April 12(2): 179-190

[6] Faurschou M, Starklint H, Halberg P & Jacobsen S (2006) Journal of Rheumatology, Aug; 33(8): 1563-9

[7] Soe M, Baeek H et al., (2015) ‘Delayed diagnosis is linked to worse outcomes and unfavourable treatment responses in patients with axial spondyloarthritis’ Clinical Rheumatology, 34(8): 1397-405

[8] http://rheumnow.com/content/mortality-gout-increased

[9] RAIRDA patient survey 2017 – extrapolated scleroderma data

The HMSA has been out and about quite a bit this month, last week attending the “Optimising Patient Relevant Outcome Measures for sustainable healthcare systems and strong economies” meeting at the European Parliament.

On Wednesday 20 June, Hannah Ensor (HMSA trustee) and Lisa Renaut (HMSA volunteer) visited the European Parliament for this important meeting of the Brain Mind Pain interest group (thanks to Pain Alliance Europe for funding travel expenses.) The talks were both informative and interesting.

Cathalijne van Doorne, from Euro Ataxia, spoke about the practical importance of clinical research and interventions focusing on what would most benefit the patient – which is a big shift from what the clinical priorities might be. The example she gave was of focusing treatments on improving distance walked when the main problem for the individual is actually the ability to talk and communicate. I could really relate to this – being able to prepare food was a far higher priority for me than walking, but clinicians always seemed to focus on getting me to walk! So it was great to see this highlighted at such a high-profile event that helps inform policy.

Laure Delbecque, from Pharmerit International, expanded on this need to move from just ‘patient-centred outcomes’ to actual ‘patient-prioritised outcomes’. This was something that Christopher Bidad (Pfizer) also picked up on, and by the end of the day, he had changed his references of ‘patient-centred outcomes’ to ‘patient-prioritised outcomes’.

Research is now under way to create validated measures for the treatment outcomes that patients consider a high priority. It’s a huge piece of research but will in the long term make getting appropriate treatment much easier for hypermobile people. It’s a long way down the line still, but it’s exciting to see that the process is under way.

Another newly completed piece of research, undertaken by Pain Alliance Europe, was on the effect of pain. Many of the results won’t be a surprise, but a validated, European-wide research survey will actually really help the HMSA to decide how best to help address the issues we all face.

Some preliminary results:

  • 51% patients had to leave work
  • 44% had a drop in income
  • 66% got no help to stay in work on get back in to work

This data is very useful to have: research-based evidence, not just ‘we know it because we’ve lived it’ testimony.

Hannah Ensor commented: “Although it was hard work and used up a lot of brain power, this event was well worth the effort: raising the profile of the HMSA and hypermobility syndromes; building useful links with other organisations; and learning things that will help the HMSA improve.”

The National Institute for Health and Care Excellence (NICE) produces guidance on the most effective ways to prevent, diagnose and treat disease and ill health, and provide social care support. NICE guidance is based on research evidence and takes into account the views of people working in or using relevant services, and other stakeholder groups.

NICE are currently looking for people who have used technology to change their behaviour and improve their health and wellbeing, as well as their carers and those who advocate on their behalf (usually referred to as ‘lay members’ at NICE). We would like them to join the committee developing our guideline on technology-based ways of changing people’s behaviour to improve their health and wellbeing. 

The guidance will cover everyone, including children and young people aged under 16 (as well as their families and carers). The guideline will focus on technology based ways to change the following behaviours people have in order to improve their health and wellbeing:

  • smoking
  • harmful drinking
  • poor eating patterns
  • a lack of physical activity
  • unsafe sexual behaviour
  • managing weight

The guideline will also look at technology-based ways to improve mental wellbeing. For example, ways to build resilience: this is about our capacity to adapt in the face of challenging circumstances, whilst maintaining a stable mental wellbeing, as well as looking at how well people sleep and reducing feelings of loneliness or isolation.

The guideline will also specifically consider the needs of those with the following chronic or long-term conditions:

  • affecting the heart or blood vessels (including high blood pressure, stroke and coronary heart disease)
  • lung disease (asthma and COPD)
  • diabetes
  • affecting the muscles, joints and skeleton
  • mental health (including anxiety, depression and dementia)
  • cancers for which managing lifestyle behaviours would help (for example, lung cancer and quitting smoking)

Recruitment is open until 5pm on Tuesday, 24 July 2018.

Visit this link on the NICE website to apply.

The Welsh Government has published its draft ‘Living with persistent pain in Wales guidance’ for consultation and is seeking views on the draft guidance which will replace the Service Development and Commissioning Directive for Chronic Non-Malignant Pain 2008.

The consultation is on the proposed direction of the draft guidance, which includes: living with pain, supported self-management and health service provision.

More information on the consultation, together with the draft guidance, can be downloaded from the gov.wales website.

The consultation ends 14 September 2018.

To help inform the Arthritis Care / Arthritis Research UK input, Hywel Evans, Policy and Engagement Manager Wales, would be grateful to receive copies of responses to this consultation from ARMA member organisations.

Please send your feedback to hywele@arthritiscare.org.uk .

NASS welcomes the publication by NICE of a set of Quality Standards for Spondyloarthritis. Now we need to ensure that they are implemented effectively across the country so that every AS patient, every time, gets early diagnosis and high quality care.

The NICE Quality Standard for Spondyloarthritis covers four areas:

  • Adults with suspected axial or peripheral spondyloarthritis are referred to a rheumatologist.
  • Adults with suspected axial spondyloarthritis and an X-ray that does not show sacroiliitis have an MRI using an inflammatory back pain protocol.
  • Adults with axial spondyloarthritis are referred to a specialist physiotherapist for a structured exercise programme.
  • Adults with spondyloarthritis are given information about their condition, which healthcare professionals will be involved with their care, and how and when to get in touch with them.

Read more from the NASS website.

Time is running out to become a Champion of Musculoskeletal Care. The deadline for this unique opportunity is 17 June 2018.

Arthritis Research UK, together with Ashridge Executive Education, have created a bespoke leadership initiative with the aim of driving forward tangible improvements in MSK services within the local health systems of each Champion.

We are looking for individuals who are involved in the design, commissioning and/or delivery of musculoskeletal care, including front-line clinicians, public health practitioners, commissioners and service managers.

The Programme:
Duration of 18-20 months and involves:

  • 5 x residential learning modules at Ashridge Executive Education.
  • Development and delivery of a work-based MSK service improvement project.
  • 4 x Action Learning Sets.
  • Access to Virtual Ashridge – an online learning tool to complement your learning.
  • Ongoing support and connection with Arthritis Research UK and your fellow Champions.
  • Support from a network of mentors; eminent leaders within the MSK sector.
  • Support from a panel of patient insight partners.

Arthritis Research UK are committed to representing the communities within the system that we aim to affect, and so the cohorts of champions will be multidisciplinary and diverse and instead of hierarchical position, we will focus on the potential to lead, adapt to change and deliver impact.

The deadline for applications is 17 June 2018. The interviews will take place between 16 – 23 July, and the programme starts in October 2018.

To find out more, please visit the MSK Champion page.