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ARMA Newsletter April 2026
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Moving beyond BMI. Putting people before thresholds.
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by Adrian Bradley, CEO, Arthritis and Musculoskeletal Alliance (ARMA)
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I welcome the new report from Arthritis UK and Deborah Alsina’s powerful blog. It shines a clear light on an issue ARMA and our members have raised consistently: access to care must be based on clinical need, not arbitrary thresholds.
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For people living with musculoskeletal conditions, this is not an abstract policy debate. It is about pain, function and the ability to live a full life. When joint replacement is delayed or denied, people don’t just wait. They lose mobility, independence, and often their ability to work and participate in society.
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The persistence of BMI thresholds in some systems shows where policy has drifted away from both evidence and equity. Variation between systems creates a postcode lottery and risks compounding inequalities, particularly in communities where need is greatest and access to wider support is limited.
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Denied by BMI: How ICB policies are failing patients with arthritis
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Guest blog by Deborah Alsina MBE, Chief Executive of Arthritis UK
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Across England, people with arthritis are being left to wait in pain for joint replacement surgery that could transform their lives. Almost a fifth of ICBs are ignoring NICE guidelines and rationing surgeries based on a single arbitrary threshold, a patient’s BMI. Moreover, a further 54.7% have policies that restrict or alter access to surgery in some other way for those who are overweight or have obesity. Joint replacement surgery is not a lifestyle choice; it’s the bridge from living in constant pain to regaining independence.
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Our newly published briefing builds on ARMA’s 2017 position paper, which raised concerns about restrictions on access to joint replacement surgery and found that 47% of clinical commissioning groups restricted access to joint replacement surgery based on being overweight or obesity. Nearly a decade on, the same concerns remain. Decisions about surgery should be based on individual clinical need, in line with NICE guidelines, not BMI thresholds.
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ARMA Welcomes the Neighbourhood health framework
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- It sees neighbourhood health as more than NHS reconfiguration.
- It supports a prevention-first model.
- It values continuity, co-ordination and multidisciplinary care.
- It connects health to wider outcomes such as work, independence and participation.
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That is close to ARMA’s vision of putting the NHS in the context of the places and communities it serves, not treating health as something created by services alone.
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But it is also a missed opportunity.
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- MSK health is not named as a national priority condition. Once again it has gone missing. This is particularly surprising given MSK is one of the most common co-morbidities in people living with multiple long term conditions and often determines functional outcomes.
- The framework does not explain how neighbourhoods will generate better MSK health.
- Rehabilitation is under recognised. The irony is we have long said multidisciplinary MSK care is well suited to being at the vanguard of the neighbourhood health movement.
- The public health and physical activity opportunity is not yet fully developed.
For the 20 million people living with MSK conditions, this is deeply frustrating. Their voices are still not being heard clearly enough. Their pain and loss of function are not being prioritised.
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The Neighbourhood Health Framework encourages local leaders to redesign care around people’s lives. The question now is whether systems will respond to the prevalence and impact of MSK conditions in their communities.
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Neighbourhood health will not fulfil its promise unless MSK health is built in from the start.
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ARMA policy: a decade of MSK health
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Policy change is essential if the UK is to improve the health of the 20 million people living with MSK conditions.
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MSK conditions are the leading cause of pain and disability and a major driver of lost independence, worklessness and pressure on health services. Yet despite their scale and impact, MSK health is still not treated as a national priority.
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A decade of better MSK health sets out ARMA’s vision for turning ambition into practical change, from prevention and early intervention to neighbourhood-based care, better use of digital tools and a stronger multidisciplinary workforce. It highlights the opportunity to improve healthy life expectancy, support people to remain in work and reduce inequalities by putting MSK health at the heart of policy and system reform.
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Improving MSK health is not just a clinical challenge. It is central to the nation’s wellbeing, productivity and ability to age well.
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This paper sets out ARMA’s priorities for making MSK health a national priority and delivering a decade of better MSK health.
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ICBs ration surgeries with BMI thresholds
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Arthritis UK Urges ICBs to Scrap BMI Threshold Policies Used to Ration Surgeries
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Almost a fifth of ICBs in England are rationing joint replacement surgery based on a person’s BMI, an approach that contradicts NICE guidance for the diagnosis and management of osteoarthritis.
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These policies vary across England, creating a postcode lottery where patients may be denied access to life-changing treatment based on where they live rather than clinical need.
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Free SOMM Joint Injection Skills Workshop
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The Society of Musculoskeletal Medicine (SOMM) is hosting a FREE Joint Injection Skills workshop at their HQ in Liverpool on the Wednesday 13th May 2026, 9:30 to 4pm.
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It will be an interactive training day, bringing together expert clinicians to provide practical, evidence-based guidance on injection techniques, hyaluronic acid therapy, and ultrasound application in musculoskeletal practice.
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NRAS launches Healthcare Champions Awards
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The National Rheumatoid Arthritis Society (NRAS) is marking a major milestone in 2026—its 25th anniversary—by launching the Healthcare Champions Awards, a nationwide initiative celebrating excellence across the rheumatology community.
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The awards highlight the dedication, innovation and compassion shown by professionals who support the UK’s 500,000 people living with rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA).
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Time to give all patients with RA the ‘Right Start’
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25 June 2026, 12-1pm
Webinar
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The National Rheumatoid Arthritis Society (NRAS) is encouraging healthcare professionals across the UK to refer patients with rheumatoid arthritis (RA) to its Right Start programme, a free support service designed to help people understand and manage their condition from the earliest stages to those who have lived with RA for a long time.
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HIPPOCRATES Prospective Observational Study
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Help the Psoriasis Association recruit for psoriatic arthritis (PsA) study
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A new study looking at the development of psoriatic arthritis (PsA) is looking for volunteers to take part – all from the comfort of their own home.
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The HIPPOCRATES Prospective Observational Study (HPOS), led by the University of Oxford in collaboration with University College Dublin, is part of a wider research project investigating psoriatic arthritis across Europe.
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RCC welcomes their new President, Stuart Smellie
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At their winter conference, Stuart Smellie formally began his term as President of The Royal College of Chiropractors (RCC). This follows a year serving as President-Elect. Bringing more than three decades of clinical experience, Stuart has had a longstanding involvement in postgraduate education, professional standards, and leadership roles. Having served as a trustee since 2010 and spending 15 years as their Director of Academic Affairs, he has contributed to the academic and professional development of the Royal College for many years.
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One set of Standards for Regulators
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BASRaT has welcomed the news that the PSA is introducing a single set of Regulation Standards to apply to both Accredited Registers and Statutory Regulators. This aligns the standards for BASRaT with regulators including the GMC and HCPC. The Professional Standards Authority (PSA) is the UK’s independent regulatory oversight body.
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Aftercare following steroid injection - patient info
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This easy‑read, high‑quality Patient Information Leaflet (PIL) has been developed to support both patients and clinicians following musculoskeletal corticosteroid injection (CSI) in clinical settings.
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Providing patients with clear, consistent aftercare advice following CSI is recognised as best recommended practice and should form part of standard care.
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BOA Annual Congress 2026 - Save the date
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The next BOA Annual Congress with the theme of ‘The Changing Faces of Orthopaedics’ is taking place at Olympia in London on 22nd - 24th September 2026. Abstract submissions are now open and close on Sunday 10th May 2026.
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Categories include, Education, Trauma, Hip, Knee, Developing World Orthopaedics, Medical Students, and more.
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ARMA Calendar
| 25 Apr 2026 |
iO Roadshow, Maidstone |
| 29 Apr 2026 |
SKILLs webinar: Arthritis UK info |
| 4 May 2026 |
NRAS Healthcare Champions nominations close |
| 5 May 2026 |
PCRMM Demystifying Rheumatology Blood Tests webinar |
| 9 May 2026 |
PCRMM Essentials of MSK Injections course |
| 9 May 2026 |
iO Roadshow, Swansea |
| 10 May 2026 |
Abstract submissions close for BOA Annual Congress 2026 |
| 13 May 2026 |
Free SOMM Joint Injection Skills Workshop, Liverpool |
| 27 May 2026 |
Arthritis UK SKILLs webinar: Paediatric MSK Presentations |
| 28 May 2026 |
FSEM Diploma in MSK Medicine exam |
| 20 Jun 2026 |
Psoriasis Association Annual Meeting 2026 |
| 24 Jun 2026 |
Arthritis UK SKILLs webinar: Menopause and Arthritis |
| 25 Jun 2026, 12-1pm |
NRAS Right Start Webinar |
| 27 Jun 2026 |
RCC Summer Conference, Birmingham |
| 5 Sep 2026 |
iO Roadshow, Edinburgh |
| 22-24 Sep 2026 |
BOA Annual Congress 2026, London |
| 3 Oct 2026 |
iO Roadshow, Leeds |
| 21 Nov 2026 |
iO Roadshow, London |
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We know that many people value our newsletter, webinars and the fact that we provide a voice for MSK health. We are increasingly asked: given that our membership is made up of organisations, how can an individual support ARMA? For this reason, we have set up a new supporter scheme.
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