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

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.

The new NHS Workforce Health and Wellbeing Framework is now available. This is the result of two years’ work with NHS organisations, NHS Employers, NHS Improvement, Public Health England and a range of voluntary sector and government partners. The NHSE appreciate the MSK-specific expertise that we have shared with them on behalf of ARMA.

The Framework will support NHS organisations through an easy-to-use diagnostic tool and a comprehensive range of guidance against fourteen core organisational enablers and health interventions proven to improve staff health and wellbeing. This will enable NHS organisations to develop comprehensive health and wellbeing plans and evaluate improvement over time. 

The NHS Workforce Health and Wellbeing Framework is a diagnostic tool to be used in a flexible way to meet the needs of your organisation. You can use these resources in total or in part to start, revise or re-launch a programme. The framework is divided into two sections, organisational enablers and health interventions.

by Dr Steven Boorman CBE, Director of Employee Health, Empactis,
Chair of the Council for Work and Health

As I head towards the milestone later this year of passing my thirtieth year in occupational health, I find myself optimistic mixed with the “glass half empty” of recognising that the same barriers remain in place: barriers to those who want to work with long term conditions. Over my career I have worked regularly with ARMA members and experts, and I have personal experience of working with a MSK condition.

The recent “Improving Lives” consultation and subsequent Government Strategy paper highlighted that since 2013, 400000 more people have become disabled (rising to over 7 million across the UK) and 3.7 million people have a musculoskeletal disorder, yet only 1.7 million of these are employed.

For people of working age without a disability the employment rate is around 80% but for those with disabling conditions the figure is 46%.

Let’s be clear, I do understand that for some people employment is not feasible. However, we do know that, providing it is good work, work does benefit your health. The social, financial and other benefits of work activities can improve many conditions, including many MSK conditions, reducing disability and frequency of recurrence or exacerbation. My profession, occupational health, isn’t about trying to force those that can’t to work, to do so risks harm and isn’t good for employers or employees! On the contrary it is about helping those that want to work to match their health conditions to the work available … which is easy to say, but can be challenging, particularly if a condition such as a MSK disorder has symptoms that vary over time and may be unpredictable in its impacts.

But my reflection here is that whilst we know such conditions are painfully common, we haven’t yet managed to adapt our health, social care and employment practices to adequately help those that want to be in work to be there.

Let’s start with sickness certification. It’s not always easy to see a GP, and whilst conceptually the idea of changing a sick note to now include an option to advise an employer about potential work adjustments is a good one, the reality is that many GPs lack the training or the time to adequately explore options during a short clinical consultation. My time spent working to improve disability assessment also taught me how difficult it is to adequately consider changing function with time and so, in the mistaken belief that it’s the safest option, often it’s easier to say “unfit for work”.

Annually 300,000 people become sick and lose their jobs and come in to the benefits system, many with MSK, often also associated with other conditions. Benefits assessments focus on the information collected on the day and don’t consider the barriers or practical difficulties that prevent work. If things improve to enable a consideration of returning to work, the risk may be loss of benefits and a long wait and further assessments to get them back, and the challenge of finding employers (even given the requirements of Equality legislation) willing to adapt and match work to physical needs can also be hard.

Occupational health advice may help, but “Improving Lives” shows clearly that it is not there for many – many, particularly smaller, employers have limited knowledge or access to OH and to be brutally honest the quality and experience of OH providers to cope with complex fluctuating conditions can be poor. Again, Occupational Health assessments are often undertaken at a point in time and whilst they will include consideration of symptoms and disability changing, flexible working adjustments can be hard to create.

At its simplest, what’s needed are mechanisms to enable a person who wants to work with a long term and changing medical problem to be able to interact with their employer / manager without delay and with the capability to change work to match needs at the time. Again, I recognise that this isn’t always feasible or practicable, but now working for a technology firm, I realise that real-time solutions are achievable, but under-utilised. Given the right and timely information most employers want to support their employees to enable work, but poor communication and understanding often makes this difficult.

Eric Topol, the American Cardiologist and technology pioneer, criticised the medical profession for being too slow to change and adapt. I find myself today reflecting that, whilst the “Improving Lives” work rightly highlights the needs to make changes in the way we operate our health and social care systems to improve the chances for people who can to work, to make this feasible we have to make it easy – easy for employers to know what’s needed and how to meet those needs; easy for the employee to understand and communicate those needs; and easy for the care systems to support needs as they change.

I hope it doesn’t take another thirty years for this to happen, and as I learn more about what changing technology can do, I am optimistic that it won’t!

The Association of Directors of Public Health has just published a series of statements examining good health across the life course, which are available to view here.

The policies set out a life-course approach to public health, exploring health and wellbeing, working well, healthy ageing, and health inequality.

See #adph18 on twitter.

All of the ADPH position statements (including those published previously) are can be seen online at the policy statements page on adph.org.uk website.

The UK Government’s Industrial Strategy represents a once-in-a-decade investment in new technologies and research in the UK, with our ageing society forming one of its flagship ‘Grand Challenges’. This £300m+ investment will focus on everything from earlier diagnosis of disease to developing new innovative products and technologies that help people maintain their independence as they age.

Arthritis Research UK has been keeping the Government aware of the importance and impact of tackling musculoskeletal conditions, and we have been working hard in meetings with civil servants and attending at ministerial roundtables to ensure the Government achieves its ambitions around ‘healthy ageing’.

If your organisation has been working on the Industrial Strategy, or would like to find out more, please contact Dr James O’Malley, Policy Manager, Arthritis Research UK – j.omalley@arthritisresearchuk.org.

The State of Musculoskeletal Health 2018 is a resource for health professionals, policy makers, public health leads and anyone interested in musculoskeletal health. We believe that with the best information you can build awareness, make more informed decisions, feel more confident and ultimately help more people with musculoskeletal conditions. The resource was put together by Arthritis Research UK.

Using the best available data on prevalence, risk factors and comorbidities, the report lays out the key factors affecting musculoskeletal health, the economic benefits of musculoskeletal research, and describes the scale and impact of the problem.

You can read more details on the report from the arthritisresearchuk.org website and download the full set of statistics (PDF 2.9 MB).

Health Education England, together with South, Central and West Commissioning Support Unit, has developed an easy-to-use tool to support clinicians, managers and commissioners in their efforts to forecast and monitor the impacts of MSK self-referral to first contact practitioners (FCP).

It is called the MSK First Point of Contact Model.

The model would be useful for anyone considering:

  •     Writing a business case for a first contact practitioner service
  •     Evaluating the impact of an already established FCP service
  •     Planning a service improvement initiative within a MSK health system

You can find and download the model from ARMA’s Network Resources page.

As you read this, ARMA will be at the BSR Conference, launching our new MSK Knowledge Hub.

This will be a resource for everyone working on any aspect of MSK. The Hub will widen the ability of the MSK community to collaborate and share knowledge. Anyone can access the resources – why not take a look and see what’s already been posted? You can also register to post your own materials and to access the discussion forum. If you can’t find the discussion topic you want, let us know and we can create a channel for you. I am excited to see how the Hub will be used to increase collaboration.

ARMA members have just started to discuss our strategy for 2019 – 2021. Something said by the CEO of one of our members struck me as very true: “It feels as though we are at a tipping point.” MSK is rising up the agenda. The DWP, Health and Safety Executive, business, the insurance industry – everyone is beginning to realise the impact the MSK has on every aspect of society. The NHS has increasing numbers of initiatives looking to improve MSK services, and Public Health England’s new strategy for the first time includes a programme on MSK.

Opportunities are everywhere, which means ARMA faces a different challenge: to use them to best advantage. We are no longer knocking at the door, but deciding which doors to walk through to make the maximum difference for people with MSK conditions. Our strategy will be all about choices: How do we make sure nothing is forgotten? There is currently too little focus, for instance, on mental health or pain – two things that are important to everyone with an MSK condition. For which issues can we do more together than any of us could achieve alone? Where is collaboration most needed?

If, like me, you think this is an exciting challenge, then get involved and collaborate. Join the Hub; join our Network; make sure your organisation is a member of ARMA. Things in MSK are tipping. Together we can give the push that will tip them in the right direction.

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.