June 2019 network news

MSK Champions cohort 2

We’re delighted to have recruited 14 remarkable individuals to form our second MSK Champions cohort:

Nimesh Patel - Orthopaedic Surgeon (S8) (Exeter)
Kay Stevenson - Consultant Physiotherapist (Stoke on Trent)
Bethan Forgie - GP (Specialist interest in Rheumatology) (London)
Ady Sweeney - School Occupational Health Physiotherapist (Norwich)
Jonny Moses - Clinical Project Manager/Lead Senior House Officer (Middlesex)
Laura Gotting - Extended Scope Practitioner (Surrey)
Larry Koyama - Darzi Fellow (South Croydon)
Johan Holte - Consultant Physiotherapist (Sussex)
Keisha Dell - Service Manager- Connect Health (Wolverhampton)
Diarmaid Ferguson - Advanced MSK Practitioner (Northumbria)
Alison Kent - Lead Nurse and Department Manager (Salisbury)
Claire Speer - Physiotherapy Manager (London)
Anna Doran - Advanced Physiotherapy Practitioner (Wrexham)
Lynsey Hetherington - Musculoskeletal Extended Scope Podiatrist/ MSK Service lead (Gateshead)

These individuals have been recruited to champion change in MSK healthcare and will commence their training in June at the prestigious Ashridge Executive Education. Through an 18-month leadership development programme they will be supported and coached to deliver a service improvement programme in their local area.

Recruitment for our next cohort will be in 2020 - so watch this space for updates!

Care and Support Planning – The Year of Care Partnership

In 2014, Arthritis Research UK published a report ‘Care Planning in Musculoskeletal Health’ which recommended that care and support planning (CSP) be made available to people living with MSK conditions. Since then, NHS England has identified CSP as a key component of a comprehensive model of universal personalised care to be implemented as part of the NHS Long Term Plan.

The project ‘Bringing MSK conditions in from the care planning cold - a feasibility study’ conducted by Year of Care Partnerships (YOCP) and funded by Versus Arthritis, was commissioned to work out how CSP for people with MSK conditions could be achieved in practice.

YOCP has worked through two project phases with six general practices from across the UK and Scotland and over 400 patients to understand the issues of practical delivery and develop the tools and resources to overcome these. We are now working to capture the extensive learning in a final report to be completed in summer 2019.

Overall, people with MSK conditions who attend CSP give very positive feedback. 100% of people asked would be likely or extremely likely to recommend CSP to a friend or family member who had the same conditions as they had.

“That’s the first time I’ve talked about the pain and the loneliness”

 “Usually you come in, get tablets, go out...you think is this ‘it’ now? Will I always be like this? It’s so helpful to talk”

All of the practitioners involved in the delivery of this programme feel it is a worthwhile thing to do and would like to continue including MSK conditions in their CSP recall. They have found that CSP enables previously undisclosed topics related to MSK symptoms, daily living and overall function to be raised and recorded, revealing a large amount of remediable unmet need.

“It feels like a new channel of communication has been opened”

YOCP is now working with Versus Arthritis to scope a further phase of work to build on the learning so far, promoting personalised care and demanding more for people with MSK conditions.

If you are interested in being involved in this work or finding out more please e-mail healthservicesimprovement@versusarthritis.org.

Policy and Public Affairs Team launches new report on home aids and adaptations

Last month we published a new policy report looking at the impact of home aids and adaptations for people with arthritis, and the barriers that people face when trying to access them.

Read the full report here, which includes powerful stories from people with arthritis who benefit from aids and adaptations.

Ollie from the team tells us more.

“We found that aids and adaptations – from perching stools and grabbing tools, to grab rails and stairlifts - can help people with arthritis, and related conditions such as back pain, achieve a better quality of life and maintain their independence in the home.

60% of all people with arthritis, across all genders, ages, and severity of condition, used an aid or adaptation. Of those, 95% felt that these products had a positive impact on their lives.

Our campaigner, Jennylyn, told us: “Aids and adaptations have taken away the stress of everyday life, and I feel so much better. It has meant the difference between being able to cook healthy meals or not. The aids mean that my fatigue doesn’t get in the way and it’s opened up my word again. I’ve gone from being totally restricted to being able to lead a ‘normal’ life.”

Ollie continues: “Too few people with arthritis know of the support available. We are campaigning to make a difference”.

Help us to widen access to these life changing products – send the report to your local councillor and ask them to pass a motion demanding better information and advice services for people with arthritis.

Which types of exercise are best for the treatment of osteoarthritis?

Many clinical trials have successfully highlighted the effectiveness of exercise for osteoarthritis treatment, and as such exercise is frequently recommended in order to relieve pain and improve function. However, researchers have since questioned whether certain types of exercise are more beneficial than others.

Using data from 103 clinical trials, a recent study has been able to assist in answering this question. This systematic review, undertaken by our funded researchers, assessed the effects of different exercise types on specific patient-centred outcomes, including pain, self-reported function, objective performance (e.g. walking speed) and quality of life.

The researchers found that all types of exercise significantly improved each of the measured outcomes compared to usual care, with the largest improvements seen in pain and function when either aerobic (e.g. swimming, jogging) or mind-body (e.g. tai chi, yoga) exercise was undertaken.

The novel finding that mind-body exercise is as effective at relieving pain highlights the potential benefit of exercise that might be able to influence central pain mechanisms, as other forms of exercise, such as strengthening and flexibility, tend to address deficits solely at the joint level.

Mixed exercise (defined as any exercise programme consisting of more than one core exercise) was seen to be the least effective option in this review, though it was still significantly more effective than usual care. The researchers suggest that this may arise from increased complexity of the programme, resulting in poor implementation and adherence.

The researchers conclude that exercise therapy, in any form, has clear benefits for people with knee and hip osteoarthritis, but that effectiveness is dependent on both the type of exercise and the type of outcome required. With this in mind, they hope that these findings will help guide healthcare professionals in their prescription of exercise type based on the specific treatment outcomes that are needed for each individual patient.

More information can be found in the published article here.

Musculoskeletal Health Bulletins now available on LG Inform

Versus Arthritis and Public Health England (PHE) have joined together to produce a Musculoskeletal (MSK) Health Bulletin on the Local Government Association’s (LGA) ‘LG Inform’ platform. The report is designed to support health and wellbeing boards and their partners in understanding the local needs and service provisions for people with MSK conditions.

The report presents a collation of existing indicators available on LG Inform relevant to MSK health. This includes modelled prevalence estimates for osteoarthritis, back pain, and rheumatoid arthritis from the Versus Arthritis Musculoskeletal Calculator and key risk factor indicators from Public Health England, Sport England, Ministry of Housing, Communities & Local Government, and NHS Digital. Users can select a local authority area and see how they compare to similar areas as identified by CIPFA (Chartered Institute of Public Finance and Accountancy).

Click here to view the report.

For further information please contact data@versusarthritis.org.

Thank you to reviewers

Since becoming Versus Arthritis we have transformed who we’re talking to and how we’re talking to them and you have been instrumental in supporting us with that change. Your skill, knowledge and expertise has been invaluable and for that we would like to say thank you!

Thank you for helping reshape our information on knee pain - Professor of Rheumatology and Director at the Arthritis Research UK Pain Centre, Nottingham, Dr David Walsh; Physiotherapist Nicola Scrafton.

Thank you for advising us on our content about painkillers and NSAIDs – Superintendent Pharmacist Edward Dandy; GP Anish Kotecha; Consultant Rheumatologist Dr Benjamin Ellis – who also advised on our new opioid painkilling patches information.

Rheumatology Clinical Nurse Specialist Sonia Trigg; GP Kevan Thornley; and MSK Project Manager Steph Mclintosh for their help on our most recent azathioprine booklet.

Our latest information on allopurinol was based on the guidance of GPs Dr Maurice Williams and Dr Gaynor O’Grady.

Thank you to Consultant Paediatric Rheumatologist Gavin Cleary and Lead Pharmacist Octavia Aragon for advising us on our sulfasalazine booklet.

We’d also like to thank Hon. Consultant Rheumatologist, Professor Christian Hedrich and Consultant Paediatric and Adolescent Rheumatologist Dr Clarissa Pilkington for their advice on our booklet about adalimumab.

We always need help from professional reviewers so we can deliver the best and most up-to-date information and guidance to people with arthritis.

We’d really appreciate any advice you can give us. If you’d like to find out more about becoming a member of our professional reviewers’ panel, please register your interest by e-mailing content@versusarthritis.org.