Musculoskeletal Health and Care across the
Pathway: A Regional Priority
Pre-meeting Activity: Reflecting on your current
Musculoskeletal Services – what needs to change?
This questionnaire provides the context for the Midlands
Regional Musculoskeletal Workshop and offers pre-meeting
activity to help with the day.
Following the Introduction you will be asked some questions in
relation to your own locality. Bring these answers with you on
the day to help think about local Right Care (RC) Data and
Getting It Right First Time (GIRFT) Data. Use the questions to
reflect on your knowledge of your own Musculoskeletal
services. Consider what needs to change.
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Context: Musculoskeletal Health and Care across
the Pathway: A Regional Priority
What is it?
This network meeting for the Midlands, hosted by the West Midlands Academic Health
Science Network, is part of the NHS England and ARMA Musculoskeletal Programme
delivered by regional showcasing of how we can “Get it Right First Time” creating improved
population health and more sustainable Musculoskeletal pathways though the sharing of
best principles, practice and a collective vision putting the person with musculoskeletal
conditions and their carers at the heart of all we do.
When: 21st March 2017
Where: The Studio, 7 Cannon Street, Birmingham, B2 5EP
Time: 09.30 – 16.30pm
Context
The community burden of musculoskeletal conditions is high and rising. Most commonly,
these conditions include arthritis and low back pain. The prevalence of inflammatory
arthritis, while around 2%, incurs huge economic costs to the individual and the system,
requiring early diagnosis in primary care and management with disease-modifying drugs to
maximise outcomes. It is the rising burden of disabling low back pain, osteoarthritis (OA) and
falls (especially in those with osteoporosis and skeletal fragility) that will drive current and
future demand for care, given that they are highly prevalent. This is evidenced for OA and
low back pain by data from UK general practice records, which indicate that over a 7-year
period 21% of all registered patients consult for low back pain and of the patients aged 45
years and over 35% consult for OA. They are both in the top 10 of the most common reasons
for presenting to a general practitioner (GP). Projected increases in such a burden as
identified by the Global Burden of Disease Project are likely to add significantly to the rising
demand for primary care and yet primary health practitioners do not just care for people
with musculoskeletal conditions and have many demands on their time. While mortality
does not tend to be high for this group, the significant impact on disability, social functioning
and employment has severe economic consequences for the individual and their community
and the problem is set to increase as the population ages.
There is at present a gap between the recommended musculoskeletal practice and day-today practice; surveys suggest that current care for back pain and OA is suboptimal when
judged against quality standards derived from national clinical guideline recommendations.
Regional Musculoskeletal Networks may be helpful in bridging this gap and guiding more
sustainable and efficient care.
Patients with musculoskeletal conditions and health care professionals indicate that they
want consistency of care and continuity of care, and yet this is frequently lacking. It is often
left to the patient with musculoskeletal conditions and their carer to be the coordinator of
their care across a range of services, and the ‘hard work’ of being a patient with
comorbidities in the health care system has been recognised. Specifically there are issues
arising from the need to (i) put the person at the centre of their care (ii) provide holistic care
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for people often with several long-term conditions (iii) provide care across services using a
multidisciplinary and multi-agency approach (iv) meet the ever-rising demand for
musculoskeletal care from an ageing population.
The Midlands Region has some excellent example of good practice. Existing Musculoskeletal
Networks – groups such as the Midlands Rheumatology Commissioning Network and local
ARMA groups, as well as Arthritis Research UK Centres of Excellence for Musculoskeletal
Research and NICE Fellows and Scholars – are already working hard to close the evidence to
practice gap. Regional Musculoskeletal Networks could offer a platform for local delivery
systems, STPs, CCGs to access patient, clinical and research expertise in existing networks,
with the support of NHS England and ARMA, to share good practice and tried and tested,
cost effective models of care.
Purpose of the Midlands Region-wide event
 To bring together best evidence and models of best practice and learn from
stakeholders about the needs of the Midlands Region in providing and receiving
Musculoskeletal Health and Care
 To enhance relationships between existing Regional Networks facilitating a shared
understanding of the value of working together to create musculoskeletal pathways
and services that support consistency and continuity of high quality musculoskeletal
care
 To address current gaps in and future demand for the provision of musculoskeletal
care for people within the Midlands Region
 To ensure that the right care is delivered at the right time by the right team in the
right place
Scope and Expected deliverables
An event to bring together people with musculoskeletal pain and arthritis and their carers,
system stakeholders and musculoskeletal networks to develop a Road Map for future
collaboration in delivering best care for musculoskeletal pain and arthritis for the population
of the Midlands.
Deliverables
 Increased STP footprint awareness of evidence based, musculoskeletal models of
care within the region
 Whole pathway improvements in musculoskeletal care within regional STP
footprints
 Implementation of good practice and best care principles within the region with the
support from NHS England and ARMA
 Strategies for meeting the ever-rising need for musculoskeletal care from an ageing
population
Reference
Dziedzic KS, French S, Davis AM, Geelhoed E, Porcheret M. Implementation of
musculoskeletal models of care in primary care settings: Theory, practice, evaluation and
outcomes for musculoskeletal health in high-income economies. Best Pract Res Clin
Rheumatol. 2016 Jun;30(3):375-397. [In 'Extending Evidence to Practice: Implementing
Models of Care for Musculoskeletal Health Across Settings' Editor-in Chief, A.D. Woolf]
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The following link contains the Right Care data that describes your locality it terms of
what is currently commissioned and the metrics that describe your providers of
Musculoskeletal (MSK) services.
https://www.england.nhs.uk/rightcare/intel/cfv/data-packs/mids-east/
What we would like you to do is to reflect on your MSK services and review your data
preferably with those who you will be attending the meeting with as well as those in
your local healthcare community.
Answer the following questions as individuals before the meeting to about your MSK
services using your local knowledge as well as the data provided. This will form the
basis of your group work at the meeting
What three things do you currently do well in MSK?
What does your data (RC and GIRFT) say about your MSK services?
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What three things do you currently feel are a challenge for MSK in your
services/STP?
What have you done already to transform your MSK services – how successfully?
What plans have you got for the MSK services in your area?
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What are the main challenges to your MSK services for the future?
What do you need to do next to transform your services?
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What support do you need to get where you want to be?
Have you signed up to the MSK Knowledge network?
The MSK Knowledge Network Hub is a digital platform that enables the MSK community to
post best practice case studies, discuss MSK issues, share ideas, awareness of MSK activities
and promote MSK publications and events. The platform also hosts work form the NHS
England and ARMA MSK Clinical Network Programme, including the MSK series webinar
recording and presentations.
To register https://www.yammer.com/signup
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