North Wales ARMA Network group report

Guest blog by Stephen Mack-Smith BSc, DC, MRCC. MEAC
Chair, North Wales ARMA

I received a letter about 14 years ago from my professional association looking for volunteers to join an umbrella group of patients and professionals with an interest in MSK problems. Funding for three years came from the English NHS, and fortune had it that owing to lobbying from North West Wales professionals within ARMA, a Pilot ARMA Network Group was formed in March 2007. It was the only one in Wales.

It was initially well attended with consultants, doctors, nurses, managers, patient group representatives, and other associated professionals. Chris Sweetnam, a 63 year old, BackCare organisation member agreed to chair the group which he did until I took over in 2016. Various projects were started but met with limited, and sometimes no success. The Group expanded to cover North Wales in 2010 so as to cover all of the newly formed Betsi Cadwaladr University Health Board (BCU-HB).

More needs to be said about this character, Chris. He has chronic back pain. He usually turned up to meetings with a camp bed in case his pain was so bad that he could no longer sit. Having a video conference call with an empty table and a disembodied voice talking sense is all in a day’s work for an ARMA representative. Such scenarios did highlight the need to help people who have chronic conditions and cannot travel easily.

As Chair, Chris was plugging away, writing to senior management and local politicians, and eventually in November 2016, the BCU-HB agreed to set up the formal Musculoskeletal Services Joint Services Advisory Group (MSK JSAG). A good working relationship had been built with BCU-HB since 2011 and a ‘Signposting Initiative’ was launched in October 2015 by the BCU-HB Chairman.

The MSK JSAG has been involved with a review of the BCU-HB Rheumatology Services, and has provided input into a chronic pain and MSK services consultation. Here we highlighted that there was no rehab pathway, and we hope to include MSK Social Prescribing, which is a new avenue to help keep people active and healthy. We have shown our support for this to the Health Board, and this topic is growing and developing quite nicely.

We have helped set up the infrastructure for a signposting system, that will hopefully refer every MSK patient to a local patient group, where people can get support. We also suggested that if patient groups can provide advice, activities, and moral support to patients, they can hopefully get more out of life, and therefore reduce the pressure on local GPs.

Another pillar of the group is Lorraine Cosgrove. She has set up half a dozen groups of people with chronic pain. These have been a success with people. COVID-19 has slowed this down temporarily, and it’s important for local health professionals to signpost people to the groups, and get other health professionals to give talks to the groups so that the people can get the information to help them get the best out of life.

Another role that JSAG has been delegated to is to provide patient oversight of the transformation of rheumatology services over the coming years.

As a founding member, I suppose I am the third pillar of the group. As a chiropractor, I am MSK-trained, independent from the NHS, and can go to meetings and events. Considering the local health board covers an area of 90 by 50 miles, going to meetings can sometimes be a problem if you have an MSK condition. Virtual meetings during the lockdown have been a great help, but we don’t know what will happen when things return to normal.

As everyone else in the group was either a patient or working for the NHS, I felt I had a professional duty to step up to the plate once Chris had retired from being the Chair of our ARMA group.

I have recently been invited to be on a local ‘Wellness Centre’ committee. This is where people will go to get and stay healthy, so that they don’t need to go to the ‘Health Centre’. This Wellness Centre has the support of the Welsh Government, the local heath board, and the local council, and will hopefully become a pilot project to try out different ways to keep people healthier, and out of the GP surgery. We have plenty of ideas, and will see what the local health professionals and local population think of them.

North Wales mapThe North Wales ARMA Committee has had a long job. It is important that as many MSK support organisations provide a representative to become a member of the North Wales ARMA group, or the BCU-HB JSAG to work in partnership with health professionals to raise issues and discuss ideas and develop initiatives to improve service delivery. Wales Versus Arthritis is already contributing, as is the National Osteoporosis Society, but we need the smaller organisations to provide their specialist knowledge and guidance that our patient groups will need.

We are in a position to help change how some parts of the current health system work, and anyone with an interest is invited to contact us. We need as many different perspectives as possible.

Watch this space!