This is a category taken from the full feed of Musculoskeletal and Arthritis news provided by ARMA's members.

Tag: Prevention

Whatever anyone may claim, the NHS has been, and still is, completely overwhelmed by the impact of Covid-19. Across the board MSK services are struggling. Meeting the targets of 90% elective procedures and 100% of outpatient appointments by October is not easy. Lots of things will be required – efficient pathways, appropriate use of digital, increases in support for self-management. Three things I feel must be included are lived experience, a focus on equality and prevention.

I’ve been privileged to be part of the Lived Experience Group which informs all aspects of NHS England work on MSK services post-Covid. Please read Power to the People, the fantastic blog about their work, and join our tweet chat at 7pm on 21 September, #MSKCoPro.

Like many organisations, ARMA has been discussing our work in relation to equalities. There are many ways in which this is relevant to MSK. We can’t think about what good pain services look like unless we acknowledge that there are geographical as well as educational differences in the incidence of chronic pain. I’m pleased that our conference on 30 November will hear from Dr Asim Suleman, a GP in Bradford on BAME communities and Equity of Pain Care. Our next webinar looks at the different ways Axial Spondyloarthritis manifests in women and the implications for diagnosis and management.

Finally, the best way to reduce pressure on services is prevention. Much of the pain of MSK is preventable. The announcements about the future of Public Health England (PHE) last month focused on the response to Covid-19 and future epidemics/pandemics. There was little about the rest of the very important functions of PHE, including MSK. The framework for MSK prevention published by PHE last year is of vital importance. Whatever the final future shape of public health in England, it is vital that this focus on MSK is not lost. 

ARMA understands the enormous challenge faced by MSK services trying to clear the record waiting lists. We also understand the experience of people waiting in pain. Lives have been put on hold – lives which also need restarting. So we will continue to support improvements in MSK services, but we are also here to challenge where systems are not giving the pain of MSK conditions the priority it deserves, and where they are not putting enough focus on lived experience, equalities and prevention.

Versus Arthritis have made available their responses to recent consultations and governmental health proposals.

In particular, you can read November’s response to the HM Government consultation ‘Advancing our health: prevention in the 2020s’, and the joint submission document, sent alongside other charities and health organisations, to highlight the urgent need for increased, sustainable public health funding.

Visit the Versus Arthritis Consultation Responses page.

ARMA and its members have responded to the Government’s Green Paper: Advancing our health: Prevention in the 2020s.

ARMA welcomed the high profile of musculoskeletal conditions in the green paper which is important given that it is a fundamental building block of health and important for pain-free mobility.

Action is required by all parts of the NHS and local authorities as well as community groups, businesses and employers, to create the environment that will enable good lifetime MSK health.

ARMA responded with a consensus view of MSK patient and professional organisations. 
Read the response [pdf]

Last October, Moving Medicine was launched by the Honourable Matt Hancock, Secretary of State for Health and Social Care. The free, evidence-based resources, available at movingmedicine.ac.uk support high quality conversations on physical activity across a broad range of chronic diseases including musculoskeletal pain, inflammatory rheumatic conditions and primary prevention, to mention a few.

The resources are all developed with experts, healthcare professionals and patients, and are endorsed by professional bodies and charities, including ARMA. Whether you have 1 minute, 5 minutes, or more minutes to speak with patients about physical activity, Moving Medicine will help support this. 

For further information visit movingmedicine.ac.uk, contact us contactus@movingmedicine.ac.uk, or follow us on social: @movingmedicine on twitter, facebook.com/movingmed or @movingmedicineuk on Instagram.

Following initial policy direction in the Advancing our health: prevention in the 2020s green paper in July, on Friday 16 August the Health and Social Care Secretary Matt Hancock announced an evidence-based review into the NHS Health Check service. Alongside suggestions that checks are personalised in future, the review will consider ‘increasing the range of advice the checks can offer – for example, prevention of musculoskeletal problems’. This is a brilliant opportunity to make sure that people are routinely asked about the health of their muscles, bones and joints at 40 years of age, and are provided with advice to support their musculoskeletal health.

Policy colleagues at Versus Arthritis will be working to develop the case for including musculoskeletal conditions in the NHS health check. If ARMA members have evidence to contribute, or would like to know more please contact policy@versusarthritis.org.

NASS logoby Jill Hamilton, Professional Engagement Manager, National Ankylosing Spondylitis Society

On 22 July 2019, the government quietly published their green paper Advancing our health: prevention in the 2020s. There has been a lot of commentary in the media, although it has been hugely overshadowed by activity in Westminster and the appointment of a new Prime Minister.

What is a green paper?

A green paper is a consultation document. This means that this isn’t the final version and so people both inside and outside parliament are able to comment on policies being proposed.

Relevance axial SpA (AS)

Many people may read the title of the paper and think to themselves ‘this has nothing to do with AS, you can’t prevent it from happening’, and they would be right about axial SpA (AS) not being preventable, but not that this paper has nothing to do with people living with the condition.

Musculoskeletal (MSK) conditions are problems with bones, joints and muscles, and axial SpA falls into this broad category. MSK conditions are mentioned a significant amount in the paper, particularly when it comes to the amount of disability caused by MSK conditions. Axial SpA (AS) is not specifically mentioned.

There are many areas of the paper which can be directly applied to axial SpA (AS), including a very heavy emphasis on physical activity, mental health, access to work and social prescribing.

The paper is also asking for evidence on musculoskeletal conditions including:

  • raising awareness of MSK conditions among the public
  • the role of physical activity
  • population-level behaviour change programmes
  • action to support staff in the workplace
  • links between mental and MSK health
  • What data should be routinely collected on MSK conditions

 

Is it slightly disappointing that awareness of MSK conditions amongst health professionals is not a focus, as is the lack of recognition of the role of the voluntary sector, which NASS will include in their response. You can read the open letter from National Voices members, including NASS, which was published in The Guardian a few weeks ago in anticipation of this paper being published.

NASS plan of action

The consultation is running from now until 22 October. During this time, NASS will put together a comprehensive response to the paper, ensuring that people with axial SpA (AS) and the Medical Advisory Board are consulted on their views before the submission of a final version. The response from NASS will be very specific to the AS community. NASS will also work with the Arthritis and Musculoskeletal Alliance (ARMA) on a joint response from the whole MSK community which will be more general.

APPG for Axial SpA

The All-Party Parliamentary Group for Axial Spondyloarthritis will also be working to prepare a response to the consultation, led by NASS and will look to ask parliamentary questions on the paper when parliament reconvenes in the autumn.

Two things happened in July which will be significant for MSK services: the publication of the Prevention Green Paper Advancing Our Health, and the creation of over 1,200 Primary Care Networks (PCNs) across England. ARMA will be supporting members to engage with the Green Paper and to ensure PCNs deliver what is needed for MSK. We hope all our newsletter readers will get involved too.

I was pleased to see that Advancing Our Health gives plenty of profile to MSK. We’d like to see more focus on action and we’ll all be pushing for this in our responses. See the analysis of the content from an MSK perspective by our members in this month’s newsletter. It is a consultation document and anyone can respond online. I would encourage everyone to respond and encourage others to do the same. Government needs to hear that there is support for bold action to prioritise prevention and that the MSK sector is ready to collaborate to make a real difference.

Primary Care Networks were the subject of a presentation at our AGM this year. The Medical Director for Primary Care and Digital Transformation for London explained that GP practices will work collaboratively with each other and health, social care and voluntary partners to deliver services that can’t be delivered on a smaller scale. This animation explains how they are intended to work. PCNs will be important in providing MSK services, First Contact Practitioners and social prescribing. As with any collaboration, they will take time to establish and will take different forms in different areas. We heard worrying reports from members that PCNs weren’t giving it as much focus as is needed. Worrying given the profile for MSK in the Prevention Green Paper and in most CCGs priorities. We all need to work together to change that as the PCNs get established.

The AGM was also a chance to hear ARMA members views of what we should be doing. This year we have been working on some key priorities such as mental health, physical activity and what the NHS Long Term Plan means for MSK services. Members felt these are broadly the right priorities but that we should consider what we might be able to do about pain and about children and young people with MSK conditions.

Our webinar programme has taken a bit of break across the summer, but I’m pleased to say that we have two new webinars planned in September and available to book now. We also have plans for some exciting topics in October and November, so look out for those in future newsletters. Our webinars are a great way to learn from good practice and all the recordings are available to watch if you missed the live delivery.

We always like to hear from the commissioners, health care professionals, policy makers and others who make use of our information and materials. So if you love the newsletter, value our webinars or have thoughts on what we could do next to make a difference, do let us know by email or on twitter. The Green Paper and the PCNs give us opportunities which we must all engage with, because none of us can make the changes we need by ourselves.

23 July 2019

The Arthritis and Musculoskeletal Alliance, an alliance of prominent health charities, professional and research bodies, welcomed the publication of the Advancing our health: prevention in the 2020s consultation document from the UK Government.

The Green Paper recognises that for the last 30 years, problems with joints, bones and muscles have been the most common cause of years lived with disability in England and the Green Paper’s proposition includes increasing the join-up across mental and physical health services. It includes ensuring businesses are equipped with the knowledge and tools they need for musculoskeletal health, convening a reference group on this. The document also recognises the scale and cost of MSK conditions – to individuals and the economy – and the need to take further action.

We are pleased to see the importance placed on musculoskeletal health in the prevention green paper as there are effective ways to prevent many musculoskeletal conditions, which is why Public Health England recently published a strategic framework for musculoskeletal prevention. However, there also needs to be sustained financial and political commitment if we are going to improve health outcomes in the long term.