February 2018 network news

Shining a light on good practice: Haywood Hospital and Research News

The Haywood Hospital, located in Stoke on Trent, has a catchment of 500,000 patients and provides specialist multidisciplinary services for rheumatology, musculoskeletal interface, osteoporosis and chronic pain.

The ethos of the Haywood Hospital promotes innovations in patient care, service delivery, patient engagement, education and research. Multi-disciplinary working is embedded in the service. Regular service away days are effective and engage the whole team in service development; this year, for the first time, the Musculoskeletal Interface Service away day was led and facilitated by a patient.

There is a strong commitment to educational developments for undergraduates, doctors, nurses and health professionals. Bespoke degree and masters modules in physical assessment, psychological needs and joint injections are hosted by Keele University and involve professionals and patients in their delivery. Innovative roles for physiotherapists have been developed, these include clinical development posts and knowledge mobilisation roles.

The Keele Haywood Academic Rheumatology Group encompasses several joint clinical-academic appointments and delivers an ambitious applied research programme across rheumatology and musculoskeletal services, to the benefit of patients. Recent studies include trials investigating the management of shoulder pain, carpal tunnel syndrome and hip osteoarthritis.

The Haywood Rheumatism Research and Development Foundation is a local charity which enhances the lives of people with arthritis, and provides funding to support research, education and innovations in care at the Haywood. An example is the Patient Information and Resource Room, a unique resource, staffed by volunteers, that enables patients to access information pertinent to their individual needs.

Our unique service design and commitment to evidence based care is recognised nationally and locally, specifically by the King’s Fund and recent Best Practice award by the British Society of Rheumatology.

Research News; Shoulder pain study

Painful shoulders account for 2.4% of all primary care consultations in the UK, and can impair ability to work or perform everyday tasks. Many patients with sub-acromial pain are treated with, and will respond to, non-operative treatment alone, however surgery is often used as a treatment. In 2010, over 21,000 people had this type of surgery in England – an increase of nearly 750% in 10 years. A recent study suggests that this surgery may offer no medical benefit compared with other treatments and should be taken into consideration with patients considering surgery and could influence the decisions made by health providers.

Health Improvement: Escape Pain

ESCAPE-pain is a rehabilitation programme for people with chronic joint pain, that integrates educational self-management and coping strategies with an exercise regime individualised for each participant. It helps people understand their condition, teaches them simple things they can help themselves with, and takes them through a progressive exercise programme so they learn how to cope with pain better.

Robust evaluation shows that ESCAPE-pain reduces pain, improves physical function, improves the psychosocial consequences of pain and reduces healthcare and utilisation costs. Research trials followed patients for up to 30 months after the end of the programme, and demonstrated continued improvements. Patient feedback is consistently positive.

The programme is currently available in over 50 sites across the UK and it continues to spread. It is easy and inexpensive to set up, and can be delivered in a range of settings, from NHS physio departments to leisure centres to community or church halls.

Escape Pain was adopted as a case study in NICE's Quality, Innovation, Productivity and Prevention programme in 2013 and delivers the NICE's core recommendations of exercise and education for the management of osteoarthritis.

It was originated by Professor Mike Hurley with a grant from Versus Arthritis, who have also endorsed the programme and are supporting its rollout. Prof Mike Hurley has recently been awarded the NIA fellowship 2017.

For more information on the programme and training dates please visit the escape-pain website or email hello@escape-pain.org.

We are looking to recruit sessional trainers to co-deliver the ESCAPE-pain training course to clinicians and exercise instructors who will then go on to implement the ESCAPE-pain programme in their locality. For more information please contact Fay Sibley on fay.sibley@nhs.net.

Core skills in musculoskeletal care workshops

This year, to support the continuing professional development of the musculoskeletal workforce we have partnered with two organisations Cogora and Red Whale to launch two new training opportunities.

Core Skills in Musculoskeletal Care

Core Skills in Musculoskeletal Care is an interactive, practical workshop aimed primarily at GPs or frontline healthcare professionals who see people with musculoskeletal conditions. The hands on one-day workshops are for small groups of around 12 to 15 delegates. The aim of the Core Skills workshop is to ‘get the basics right’. It focuses on the most common musculoskeletal conditions seen in primary care, and aims to equip practitioners with the skills and confidence to diagnose and manage these patients effectively.

The workshop is structured to focus on three core areas: spine, lower limb and upper limb. In each of these sessions small groups of participants are taken through hints and tips on history taking and given a demonstration of key examination skills, as well as provided with the opportunity to practice these. Groups then discuss suitable treatment and management plans for case studies, and are able to share experiences from practice.

Versus Arthritis commissioned Cogora as the delivery partner to ensure efficient event management and quality assurance of the Core Skills in Musculoskeletal workshops. Cogora are the organisation behind PULSE, so work extensively with GPs across the UK, producing and delivering education and training and have an extensive network of 220,000 healthcare professionals.

MSK and Chronic Pain

The content of the day focusses on understanding the biopsychosocial aspects of complex and chronic MSK conditions and explores appropriate management strategies. The GP trainers take delegates through the latest evidence and guidance on the MSK conditions and persistent pain and contextualises this into a framework to help manage these conditions.

Sign up here.

Launch of our new Leadership Programme and internship scheme 2018

We are delighted to announce that Versus Arthritis has recently partnered with Ashridge Executive Education, part of Hult International (a top business School which specialises in working with third sector and NHS), to help us design and deliver a bespoke leadership programme for MSK Clinical Champions, consisting of multi-disciplinary health care professionals.

The main objective of the programme will be to drive improvement in MSK care for patients and carers across health systems by developing leaders of change. We are currently consulting, developing and designing this programme and anticipate that we will be able to tell you how you can apply for this exciting initiative in Spring of this year. Watch this space for further updates.

Internship scheme 2018

Applications are now open for our nurse and allied health professional internship scheme. This internship scheme provides fantastic opportunities for occupational therapy, podiatry, physiotherapy and nursing final year students/recent graduates who have an interest in clinical research into the personal impact of arthritis and musculoskeletal diseases. Successful interns will have the opportunity to develop their research skills first-hand in a leading centre of arthritis and musculoskeletal disease research whilst receiving supervision, evaluation and mentorship in research.

The internships are for eight weeks full-time from 2 July to 24 August 2018. Placements will take place at five research institutions renowned for arthritis and musculoskeletal disease research:

  • Leeds
  • Southampton
  • Salford
  • Oxford
  • West of England, Bristol

For further information please see our page on the Nurse and allied health professional internship scheme.

Inflammatory arthritis toolkit

Inflammatory Arthritis Toolkit, developed in partnership with the British Society for Rheumatology, can help GPs improve standards of care in both new and established inflammatory arthritis.

National audits have shown that diagnosis of inflammatory arthritis frequently occurs late; we know that delayed recognition in General Practice contributes to this, with only 18% of referrals occurring within the NICE quality standard timeframe. Evidence shows that delays in diagnosis contribute to worsened patient outcomes; simply put, the longer a patient goes without treatment following disease onset, the more severe their disease is likely to be.

The RCGP/BSR toolkit aims to give busy GPs all the resources they require to improve practice and reduce this delay in diagnosis. From links to the latest evidence about inflammatory arthritis, through signposting to resources to improve skills in history taking, examination and managing comorbidity, to explanations of NICE quality standards and suggestions for audit.

The quality of care offered by UK General Practice continues to rank as some of the highest in the world. Resources such as the RCGP/BSR Inflammatory Arthritis toolkit allow GPs to continue to improve standards of practice and outcomes for patients.