by Sue Brown, CEO ARMA
Local and national
Another new Government, another new(ish) Secretary of State for Health. From an MSK perspective, what should their priorities be? There are a few things that need to happen nationally, but my first thoughts are that we don’t now need a multitude of new government targets and promises. A lot of what is needed is local and local systems need to be given the space to deliver.
At a local level there are three things I think Integrated Care Systems (ICSs) need to do to deliver on MSK.
Make MSK a priority.
ICSs all have to produce a strategy. That strategy must be based on evidence of local need. MSK is the biggest cause of years lived with disability in the UK. It impacts on individuals, health services and the economy. If that evidence does not point to MSK being the biggest burden on population and services then the right questions have not been asked.
Think transformation
ICS strategies should also address complex issues which need system approaches. What we need for MSK is not tweaking the existing processes. The places which will gain most will be those that grasp the challenge to rethink from the bottom up. Are we spending money on the things which will make the biggest difference? Are we thinking about what will improve things for patients, not just for the system? Are we realising the potential of investment in prevention, supported self-management, peer support, social prescribing and health coaching? Are we seeing community assets, leisure facilities, voluntary sector and communities as part of our system?
Think Equality
We must make sure that we invest most in those who need most. That’s a big challenge. Our aim should be to reduce the burden of MSK across the population and to achieve this we need to focus on where the burden is greatest.
Government’s role
It can’t all be down to local action and there are a few things the ICSs need from government to be able to achieve this.
A workforce strategy.
We need a strategy to grow our workforce and ensure they have the skills to address the needs of the population now – people with long term conditions who need long term support, not just acute health episodes. In MSK that must include maximising the use of the available workforce, and not ignoring professions like sport therapists who could make so much more contribution.
Set a vision, not more targets.
Then deliver the enablers of that vision, (which will include funding).
Stop demanding the impossible.
Be honest with the public about how hard it will be and how long it will take to recover the massive backlog in MSK services.
Things are undoubtedly tough right now; business as usual just isn’t working.
I talk to lots of people who are struggling to keep their heads above water and looking for a way out. But I also talk to lots of people whose reaction to the situation is to look for ways to change, who are excited at the prospect. Look at our guest blog for a great example of this.
In some ways ARMA’s vision for MSK seems further away than ever. In other ways it feels that the urgent need to change might just push things in the direction we need.