by Sue Brown, CEO ARMA
I have just finished facilitating one of our regional meetings bringing together stakeholders to talk about what’s happening at the local level with MSK services. It’s clear there is a lot of willingness to do something, despite a lot of confusion around who leads on MSK at an ICS level. A lot of questions were asked at the meeting. Where are the MSK targets being reported? Are the ICBs aware of what’s happening? We’ve got a case to introduce a Fracture Liaison Service, but how do we get anyone to listen? And practical suggestions such as the possibility of setting up an MSK community of practice.
It’s clear that this is the picture across England. Confusion, a feeling that MSK lacks a profile at ICB level, lots of variation in what people can expect from services. And lots of enthusiasm from people wanting to help.
This blog on NHS strategies makes the point that an ICS strategy is not like a strategy for a hierarchical organisation. There are very few levers that an ICB can pull to ensure organisations follow the strategy. That makes how you develop a strategy more important than the strategy itself. “People own what they help to create”.
If we want strong MSK strategies delivering system change, rather than individual hospitals and services developing their approach in silos, then we need all those players around the table. The change will be delivered, not by senior executives but by the healthcare professionals and managers in those services, so they need to own it too. Not to mention the importance of people who are going to use the services, who after all have the biggest stake in this, being directly involved from the start.
ICBs are new, ICSs are complex, MSK cuts across every bit of the system. Large numbers of people with MSK conditions have other long term conditions too, meaning they engage with a whole raft of NHS specialties. There is a lot of frustration at the confusion and lack of progress. Communication is difficult in such a complex environment.
My feeling when I talk to those working in MSK services is that despite all this, there is a will to make change happen. ARMA has no levers to pull at all, but we can put people in touch with others who want to make change, so that they can work together. I am sure that good things will come of our NW meeting as a result. And we will keep saying that MSK matters, it needs a higher priority, and it needs those living with MSK conditions to be at the heart of the work. Our influencing work to drive MSK up the ICB agenda will continue.
We are holding virtual regional meetings like these in every area. Everyone with an interest in better MSK services is welcome. Check if we have one for your region yet and find out more about the project on our website.