Health Policy | ARMA

Guest blog: MSK First Contact Practitioner roles

MSK First Contact Practitioner roles; are they fit for the future for Primary Care?

by
Amanda Hensman-Crook FCSP, HEE AHP National Clinical Fellow, Consultant MSK Physiotherapist
Neil Langridge FCSP, Consultant MSK Physiotherapist
Laura Finucane FCSP, MSK Consultant MSK Physiotherapist
Chris Mercer FCSP, MSK Consultant MSK Physiotherapist

MSK First Contact Practitioner roles and the advancing practice agenda is moving at pace and as a result, there has been some anxiety around the MSK First Contact workforce. This has been expressed about several aspects of the roles, including:

numbers needed to ensure sustainability without wider destabilisation of the MSK workforce
where the workforce will come from with the requisite capability
concern about governance of the roles
who provides the supervision and support
a general need to understand the offer of the role to primary care
concern from other MSK professions that they are not included in the GP contract reimbursement scheme (DES) and where they might fit in the bigger picture.

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Health Equity in England: The Marmot Review 10 Years On

We know that musculoskeletal conditions are much more prevalent in deprived areas so the publication of this report is very relevant to addressing the social determinants of MSK health. It has been produced by the Institute of Health Equity and commissioned by the Health Foundation to mark 10 years on from the landmark study Fair Society, Healthy Lives (The Marmot Review).

The report highlights that:

people can expect to spend more of their lives in poor health
improvements to life expectancy have stalled, and declined for the poorest 10% of women
the health gap has grown between wealthy and deprived areas
place matters – living in a deprived area of the North East is worse for your health than living in a similarly deprived area in London, to the extent that life expectancy is nearly five years less.

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Postcode lotteries and transformations

by Sue Brown, ARMA CEO

February has been a month of mixed feelings for me. On the downside I continue to hear of rationing of NHS services by CCGs going against NICE guidelines. More positively I’ve been hearing about some ambitious work to transform MSK services around the country. We need some of this bold thinking if we are going to achieve ARMA’s goal of high quality, appropriate MSK services for everyone who needs them.

This month I spoke to someone in a hospital about hip and knee replacement.…

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Right on Time campaign

Versus Arthritis is campaigning to ensure that everyone who needs a joint replacement gets timely access to treatment. Hundreds of thousands of joint replacement operations take place each year. More than 90% of people who have hip and knee replacements have osteoarthritis.

At the end of February, Versus Arthritis released figures revealing that, in one year alone, almost 30,000 people with arthritis in England waited more than the guaranteed 18-weeks to start treatment. This has been featured in the Telegraph, with more coverage to follow.…

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NRAS accessing advanced therapies

Accessing Advanced Therapies (biologics, biosimilars, oral JAK inhibitors)

For some time, NRAS has been concerned that some Clinical Commissioning Groups (CCGs) have been artificially restricting access to advanced therapies (biologics, biosimilars/JAK inhibitors) and undertook a Freedom of Information request to all CCGs about this. Following discussions with NHS England on behalf of RA patients about this practice, which was felt to be unethical, NRAS is delighted to share with you news of the attached recently published statement from the NHS Regional Medicines Optimisation Committee.…

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GP contract agreement England 2020/21

The final version of the GP Contract which sets out requirements and funding for the new Primary Care Networks was published in February. Some significant changes were made in response to consultation, including one relevant to the delivery of “additional roles” which, amongst other things, will help fund the roll out of First Contact Practitioners. The two main changes are an expansion of the roles and an increase in the funding from 70% to 100% of salary. Many of the new roles are also important for MSK health.…

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NHS extends testing of non-urgent care waiting times target changes

If you are referred for specialist non-urgent treatment, you currently should expect to be treated within a maximum waiting time of 18 weeks. Over the last year, the NHS has been reviewing this 18-week target. ARMA has been involved in the advisory group looking at this change.

The NHS England board meeting on 30 January announced plans to extend the testing period for proposed changes to the 18-week elective care measure into 2020/21.

This joint response was issued by National Voices, The Arthritis and Musculoskeletal Alliance, Versus Arthritis, the MS Society, the Neurological Alliance and Healthwatch England.…

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NICE Quality Standard – Rheumatoid arthritis in over 16s

In January 2020, NICE published an update on the Quality Standard for rheumatoid arthritis in over 16s (QS33). This quality standard covers assessing, diagnosing and managing rheumatoid arthritis in over 16s. It describes high-quality care in priority areas for improvement.

NICE thanked organisations that submitted comments during the consultation period. All consultation comments were considered by the advisory committee (QSAC) and are documented in the minutes of this meeting.

Also available on the website is a summary of the consultation comments prepared by the NICE quality standards team and the full set of consultation comments.…

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Feedback on NICE behaviour change guideline

NICE is developing a guideline on Behaviour change: digital and mobile health interventions and ARMA has been invited to register as a stakeholder.

Behaviour change interventions have been considered in relation to the following areas:

eating patterns
physical activity
smoking
harmful drinking
sexual health
mental wellbeing

The consultation for this guideline opened on Friday 24 January. It will close at 5pm on Friday 6 March. If your organisation would like to have the opportunity to comment, you will first need to register as a stakeholder.…

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Third APPG for Axial Spondyloarthritis

The third meeting of the All-Party Parliamentary Group for Axial Spondyloarthritis took place on 29 January at Portcullis House in Westminster. The meeting focussed on the delay to diagnosis and included the launch of our Freedom of Information Inquiry report.

Huge thanks go to our speakers: Zoe Clark who gave an emotional account of her seven year wait for a diagnosis; Dr James Prior from Keele University who summarised the latest research into the area; Rebecca Adshead, physiotherapist at Whipp’s Cross Hospital, who gave an example of good practice, presenting on how the delay to diagnosis had been reduced locally; and finally Dr Raj Sengupta from the Royal National Hospital for Rheumatic Diseases presented the draft Gold Standard to Diagnosis.…

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