Guest blog by Liz Lingard, NHS RightCare Delivery Partner

Over the past 3 months I have joined the ‘Whole System MSK events’ that ARMA and NHS England have organised as the RightCare speaker. This was an opportunity to clarify the RightCare approach to everyone working across the system and how they can apply this in their local health economies. The core aim of RightCare aligns to what each of the ARMA partners aspires to achieve: ensure the right person is able to access the right care in the right place at the right time, making the best use of available resources to help deliver a sustainable NHS. Identifying unwarranted variation and a greater focus on population health is now central to many of the national programmes. It is only when you review population data across a whole pathway of care that you are able to begin to understand variation of risk factors, prevalence of conditions, healthcare utilisation and outcomes of care. Identifying where there are the greatest potential opportunities for improvement is just the first step and further investigation is required to triangulate high level RightCare data (indicative data) with other national provider and local data sources alongside qualitative information from patients and providers (evidential data).

Before working as a RightCare Delivery partner, I was a Public Health epidemiologist who believed that ‘data was beautiful’ and using measurement for improvement was the key to success. Nick Milton wrote that ‘social connection and discussion is 14 times more effective than written word, best practice guidance, databases and toolkits’. So while I continue to work with the RightCare Intelligence Team to provide a better narrative around the data we produce, I am increasingly convinced that the face-to-face narrative we have at a local level between providers, commissioners and patients is the real key for making transformational change that is sustainable happen.

As a RightCare Delivery Partner working with CCGs, I know the enormous pressures they are under to make financial savings and how healthcare providers across all sectors are concerned about what this will mean for their services and patient care. I also know that in some local health economies there has been some really innovative transformational work. There was strong clinical leadership with engagement from all provider organisations working alongside CCGs and local authorities to optimally design pathways of care and ensure that these pathways were implemented in year.

Al Mulley recently reminded me of the story of the Fosbury Flop. At the 1968 Summer Olympics, after years of high jumpers making incremental improvements to their jumps, Dick Fosbury dramatically increased the heights that could be reached. He used a different technique that then became the dominant style and is still used today. No one had tried it because it sounded so wrong; it turned out to be the right thing to do. We are at a Fosbury Flop moment for MSK care where we can no longer make incremental improvements. So I encourage everyone to connect with the MSK work happening in their local networks and be part of the discussion to transform pathways of care that will reach new heights.

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