Guest blog: Improving quality in orthopaedic care

by Mark Brandreth, NOA Lead CEO and
CEO of the Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation
Trust

As the new lead CEO for the National Orthopaedic Alliance (NOA), I am proud to be part of a group of organisations and people who are working to drive improvements in orthopaedic care nationwide. I’m pleased to have been given the opportunity to contribute a guest blog to ARMA’s newsletter to share an update on our work with you. At Robert Jones and Agnes Hunt Orthopaedic Hospital (RJAH), our work with the NOA, and its vanguard work in particular, is vital to our future – and to the future of orthopaedic care received by patients across the country.…

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Biologics guidance document for Rheumatology Practitioners

The RCN Rheumatology Forum would like to report that in September 2017 the 4th edition of the RCN Biologics guidance document for Rheumatology Practitioners went live: “Assessing, managing and monitoring Biologic therapies for Inflammatory Arthritis

It is available online now as a downloadable PDF via our link: my.rcn.org.uk/RCNguidance.

Strategy Day

On the 17th Nov 2017 the RCN Rheumatology Forum are planning to meet for a (self-funded) Strategy Day where future projects and final details of the forthcoming RCN Rheumatology Nursing Workshop will be discussed.…

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The BOA’s Four New Commissioning Guides

The British Orthopaedic Association (BOA) is pleased to announce the recent publication of four revised commissioning guides with the Royal College of Surgeons of England. These NICE-accredited guides set out best practice care pathways to assist CCGs in designing optimal care for their populations. We are extremely grateful to all those involved in the rigorous development and accreditation processes. The guides, which can be found here, are:

  • Pain Arising from the Hip in Adults
  • Painful Deformed Great Toe in Adults
  • Painful Osteoarthritis of the Knee
  • Treatment of Carpal Tunnel Syndrome

Following the recent BOA and ARMA position statements on the rationing of elective orthopaedic services, we are urging stakeholders to consider these guides and to promote their adoption wherever appropriate with local CCGs.…

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ARMA Policy Position: Prevention of Musculoskeletal Conditions

Arthritis and musculoskeletal conditions affect the bones, joints and muscles, and burdens the lives of so many people.

Musculoskeletal conditions are now the UK’s the biggest cause of pain and disability, accounting for an astounding one-in-five of all visits to the GP. Furthermore, trends indicate that more people than ever will be affected by MSK disorders in the coming years, which is why preventing them has never been more important. For this reason, the Arthritis and Musculoskeletal Alliance (ARMA), an alliance of prominent health charities, professional and research bodies, has produced a Policy Position Paper on Prevention of Musculoskeletal conditions.…

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ARMA Policy Position Paper on Joint Replacement Surgery

In early August, ARMA has published a Policy Position Paper titled:

‘Rationing’ Access to Joint Replacement Surgery and Impact on People with Arthritis and Musculoskeletal Conditions [document opens in pdf]

It deals with the damaging nature of thresholds and scoring tools, the problems of waiting times and restricted access to surgery, and how patients with musculoskeletal conditions are affected.

The Alliance is drawing attention to worrying trends in treatment access and the paper makes clear the key outcomes we are seeking from CCGs and the NHS.

A new addition to the LUPUS UK range of publications

In July LUPUS UK released the newest edition in their range of publications, ‘LUPUS: Bone Health & Osteoporosis’.

The factsheet was kindly written by Dr David Armstrong (Consultant Rheumatologist, Altnagelvin Hospital, Londonderry).

This factsheet can be downloaded from the LUPUS UK website at www.lupusuk.org.uk/publications/ and physical copies are available from the National Office in Romford.

DMARDs guideline for prescriptions and monitoring

The latest guidance is out for the prescription and monitoring of non-biologic disease-modifying anti-rheumatic drugs (DMARDs). It’s aimed at primary and secondary care practitioners managing patients with rheumatic disease in the UK.

Significant updates include:

(1) Harmonisation of monitoring schedules, recommending that all DMARDs that require laboratory monitoring follow the same frequency of testing

(2) More nuanced discussion of the use of methotrexate in lung disease is provided, drawing from the two large meta-analyses recently published.

(3) Significant change is made regarding the evaluation of retinal toxicity for hydroxychloroquine users:

Lead author Dr James Galloway, Senior Clinical Lecturer at King’s College London says:
“These updates have two major focuses: firstly, streamlining monitoring schedules wherever possible, given the myriad of different regimens across drugs, and most of the schedule variations were somewhat arbitrary in their origins; second, to review and incorporate the evidence base available, acknowledging several key publications that have emerged since the first guidance.…

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