Reflection from the national clinical co-leads for the Welsh national musculoskeletal clinical Network
Dr Meinir Jones, General Practitioner, Associate Medical in HDUHB;
Dr Rob Letchford, Consultant Physiotherapist MSK rehabilitation in CAVUHB
Six months into these new roles, we find ourselves reaching a peak of optimism and enthusiasm for the future. In the aftermath of a devastating two years that has negatively affected so many, and left previously stretched health services with unprecedented challenges, that seems a ridiculous position to hold. Perhaps it’s our optimism (given the positive effects on health we recommend that you try it out too!). However perhaps there’s good reason and we are reaching a tipping point that will move health and care to its next evolutionary chapter?
How did we end up here? The COVID pandemic offered an opportunity to seize upon the 2018 calls from A Healthier Wales for ‘a revolution from within’ which has been embraced by many. Our unique and unprecedented experiences during the pandemic have exposed strengths and positive change experiences, enabled community and clinical leaders to see the art of the possible and engage with enthusiasm. The addition of the national clinical framework sets the scene for this transformation. National clinical networks with a mandate and governance framework to put the lived experience, user, and health professional voice at the heart of the national NHS executive, will enable us to proceed at pace.
Are we ready for the challenge this will undoubtedly bring? We believe so. The journey towards co-production is moving at pace with communities coming together to understand what really matters, and how they can work together to achieve it. Charities such as ARMA are working to bring balance of opinion from lived experience and third sector voices. The concept of truly seamless services provided by balanced multidisciplinary teams is now widely supported.
Are we ready for the shift in approach that will be required? Our experience suggests that we are. We understand that medicine has enabled amazing outcomes, raising life expectancy and quality of life. However, we also appreciate the limits of the biomedical model, particularly with the emerging health and wellbeing needs of the 21st century. Increasing prevalence of multiple, non-communicable diseases has shown a clear need to integrate a holistic, person centred, public health approach. We know that’s not easy to do, however we can learn from our combined strengths to create a collective intelligence with a unified voice that shifts resources towards high value, health creating activities.
Do we have the knowledge, skills and infrastructure to do this? Perhaps not yet, however it is being built. New technologies support our learning system, providing guidance on risk, benefit and cost that can be disseminated to where it is needed. The shift towards person centredness and shared decision making is enabling this data to be utilised in real time and to inform our ongoing quality improvement. By doing so, we understand that we can improve value, utilising the resource we have, to reach the most people, and enable them to live the healthiest lives they can.
So, what will the MSK network for Wales do?
We will embrace the principles of A Healthier Wales to create a dynamic clinical network that will lead change aligned to a coproduced national MSK framework.
We will enable communities and health and care services to come together to provide the systems that support people with MSK conditions to live the best life they can and access the high value health and care they deserve.
No doubt this is a lofty vision, that requires transformative system thinking and action that will challenge all involved. However, it is one that we believe the public and the clinical community are ready to embrace. We believe we can look forward to a healthier Wales that will nurture our children and future generations. We hope to share some successes over the coming years.
Meinir and Rob
Menir @welshcake39