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Research

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By Steve Boorman, Chair, Council for Work and Health

Work and Health Unit commissioned resource to support GPs in identifying work modifications.

You may be aware from previous contacts and, or consultations, that the Work and Health Unit (WHU), as part of its “Improving Lives” strategic programme, has identified a need to provide additional support resources to Doctors, to help them in supporting patients to identify work adjustments to improve workability and improve recovery.

The Council for Work and Health was commissioned to research and develop this work and a dedicated researcher was used to review published literature, collate existing available resources and to develop content. Council members and other contacts have been actively consulted during this development process and much work has been done to date.

You will also be aware from recent consultation that work has been underway to revisit the “Work as a Clinical Outcome” consensus statement due for relaunch shortly. The “Work as a Clinical Outcome” consensus statement reminds all healthcare workers that such conversations are an important part of clinical practice.  This resource is primarily aimed at GPs to help support their medical consultations and consideration of “Fit note” options, and whilst this resource seeks to be used in a medical context we have tried to balance some clear advice that most work adjustments are simple and practical arrangements.

I would be grateful if you would share the link with your colleagues and invite them to contribute to user testing this resource as part of its continued development – we are keen to understand views regarding its content, accessibility and usefulness. Accessing the link will trigger a short feedback survey which will be in place over the next month’s testing period. We will then take stock and evaluate the feedback in consultation with the Work and Health Unit in order to finalise a resource, which is planned to be freely accessible via the Council for Work and Health website from April 2019.

The resource is deliberately written in a style and manner aimed at doctors – we absolutely recognise that the key in all this is people having good conversations with employers and this is being looked at elsewhere in the WHU programme – this piece of work is to encourage GPs to consider work adjustments in their consultations with patients.

This resource will not sit in isolation and many other converging programmes are also in development to support other health care practitioners, employees and employers to enable positive conversations on work options. We also recognise that different GPs will use resources in different ways, and that levels of knowledge and capability may be variable.

It is also recognised that good quality occupational health advice may help support and work is being undertaken on how best to provide such.
This resource has been developed for use by doctors during their clinical consultations with patients, it is illustrated with some simple case studies and there may be opportunity to add to these later.
This is still work in progress, and the following link will give free access to the current version, which we are keen to now seek further feedback and evaluation upon. 

https://www.councilforworkandhealth.org.uk/work-modifications/

If you follow the link it will take you to the Council for Work and Health’s website and the relevant resource page. The resource can be read from start to finish if preferred, but we anticipate users will jump to relevant sections, links or case studies and that in time we can provide more relevant linked content applicable to wider stakeholders. The evaluation resource will generate a simple survey on closing and we hope that you will feel able to share the link as widely as possible and encourage stakeholders to give feedback during the next month. After this period we will consider any necessary revisions and more formally plan to launch the web resource in March 19.

I know some stakeholders will feel that this resource risks medicalising the work and health conversation, once again the context, we are testing here, is for use in General Practice and to support patients in starting conversations where appropriate.

 

BSRM are interested in understanding the variability between UK clinicians in the use of single dose local anaesthetics in intra-articular injections. Clinicians are invited to complete this 2-3 min survey at:

www.surveymonkey.co.uk/r/KXRFQWN

3rd BSRM National MSK Medicine and Rehabilitation course

The programme for physicians taking place in Leeds, 11-13 Feb, is available here in PDF.
Booking is via the BSRM website.

This 3-day course is aimed at physicians managing non-inflammatory musculoskeletal conditions and will appeal to those in rehabilitation medicine, sport and exercise medicine, rheumatology, pain medicine, radiology, orthopaedics and general practice.

The comprehensive course aims to cover both basics and advanced skills in musculoskeletal medicine and rehabilitation for those in training and established specialists in the area. Physicians who manage secondary musculoskeletal complications in their non-MSK practice are also likely to find the course useful.

ARMA wants to find out what is happening across England’s MSK services so we can learn how best target to our support for improvements.

This MSK Services survey gathers information on the quality of local services, programmes and improvements related to primary care, orthopaedics, rheumatology, pain management, community MSK, and public health. This is part of our Clinical Networks Project, a partnership between ARMA and NHS England.

Our report will be anonymised; no names of individuals, CCGs or STPs will be released.

Please find the survey here. It only takes a short time to complete.

A new paper published [24 October 2018] in the Lancet highlights regional imbalances in health and reveals the huge burden of disability linked to long-term conditions such as low back and neck pain, anxiety and depression, highlighting the need for health services to adapt to managing these conditions. 

The study uses GBD 2016 data on mortality, causes of death, and disability to analyse the burden of disease in the countries of the UK and within local authorities in England by deprivation quintile.

Changes in health in the countries of the UK and 150 English Local Authority areas 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Read more and download this paper from Lancet website.

Arthritis Action has released the findings from a nation-wide questionnaire-based study looking into the life impacts of arthritis on people of working age in Great Britain. The research, carried out by YouGov, surveyed 2074 people to reveal the effects that the condition can have on personal well-being, life satisfaction, and mental health.

It highlights the true impact of arthritis on the millions of people living with it every day, affecting all aspects of their lives, from their mental health to their family life, work, social activities, and physical health.

Read the report here (pdf).

Public Health England has commissioned the National Guideline Centre (NGC) to produce an evidence review of the literature on dependence, short term discontinuation and longer term withdrawal symptom from prescribed medicines, and their prevention and treatment.

The NGC is inviting stakeholders to submit research data or reports on two key areas to inform the review:

A) Collations of patients’ experi ences of the harms caused by prescribed medicines and ability to access and engage in treatment specifically relating to dependence, short term discontinuation or longer term withdrawal symptoms from the following prescribed medicines: opioids for chronic pain (excluding end of life /palliative care/cancer pain), benzodiazepines, Z-drugs, gabapentin and pregabalin (excluding epilepsy treatment), and antidepressants. (In England only).

B) Effectiveness and cost effectiveness of current examples of health/social service delivery models that prevent or treat dependence and the short term discontinuation or longer term withdrawal symptoms (opioids for chronic pain (excluding end of life /palliative care/cancer pain), benzodiazepines, Z-drugs, gabapentin and pregabalin (excluding epilepsy treatment), and antidepressants). (In England, as well as health service delivery models in other countries that might inform provision in England).

See details below of the requested information and the formats that will be accepted.

We would like:

  • Information published between 2008 and 2018.
  • Unpublished information related to research carried out between 2008 and 2018, including any ongoing research.
  • Reports which summarise / collate patient experiences e.g. organisational reports or internal evaluations of projects or services (the views, experiences and opinions of individual professionals, researchers, commentators or patients will not be able to be included, however).

 

We are especially interested in the following outcomes for part b:

  • Reduction/cessation in prescribed drug use
  • Successful withdrawal
  • Cost effectiveness
  • Use of healthcare resources
  • Health related quality of life
  • Patient / staff satisfaction
  • Social outcomes e.g.  employment, relationships, parenting
  • Reduction in disability

 

Sending information

For published information, send only the details (to include author/s, title, date, journal or publication details, including volume and issue number, and page numbers). Do not send a pdf/Word document or paper copy.

For unpublished information, send:

  • a link to any relevant trials registered with the Cochrane Central Register of Controlled Trials, or with the US National Institutes of Health trials registry
  • paper or electronic copies of other relevant unpublished information.

Highlight any confidential sections (unpublished research or commercially sensitive information) in unpublished information.

Email prescribedmed@rcplondon.ac.uk these forms with any relevant information by midnight on Tuesday 23 October 2018.

The NGC looks forward to receiving information and thanks you in advance for your help.

The Q Improvement Lab brings together organisations and individuals from across the UK to pool what is known about a topic, uncover new insights and develop and test ideas. The Q Lab and Mind have just started a 12-month project focusing on improving care for people with a long-term physical and mental health problem, specifically looking at the experiences of people living with both mental health problems and persistent back and neck pain.

Further details about the project can be found here.


The project is currently in the research and discovery phase where Q Lab is trying to get a better understanding of the topic and unearth the challenges and opportunities within this space.

The Insight Manager for this project, Hannah Patel, is seeking any research or materials linked to the topic of mental health problems and persistent back and neck pain which could support Q Lab in this phase of work. They are trying to gain as broad an understanding of this topic as possible, seeking multiple perspectives on the issue. Please contact hannah.patel@health.org.uk if you can help.

Help us guide future research about problematic knee replacements

The British Association for Surgery of the Knee (BASK) is running a Priority Setting Partnership (PSP) in partnership with the James Lind Alliance (JLA). The aim of this process is to bring patients and carers together with a range of healthcare professionals. We want all groups to highlight uncertainties relating to the assessment, management and rehabilitation of ‘patients with a problematic knee replacement’. We will thereby identify future research questions and ultimately publish a list of ‘top 10 research priorities’. This will guide funders for future research.

What can you do to help?

If you have experience of problematic knee replacements as a patient, carer or professional: Tell us the top 3 questions you would like to see answered by future research at www.jlarevisionknee.com. The survey goes live on Monday 10 September 2018 and we are hoping to get as many responses within the first month as possible.

For any queries or please email jlarevisionknee@gmail.com