Lockdown, leadership and the road to recovery
Taking on my first management and nurse lead role at the Rheumatology Department in Salisbury ten years ago has definitely been full of ups and downs but nothing quite like the rollercoaster of the past 6 months!
One of our trust values at Salisbury NHS Foundation Trust is Responsive; being able to react quickly and positively, offering a flexible service. Well never has the department had to be quite this flexible!
At 8.30pm on 23rd March, Prime Minister Boris Johnson made an unprecedented address to the nation announcing the beginning of lockdown, and for many, the face of our service changed overnight.
A department normally busy with patients fell quiet as all consultations, other than urgent, were conducted over the telephone- a new way of working and communicating with our patients. The advice line, always an important service for the patients suddenly went crazy. We went from manning the telephone for 3 hours each working day to it being open all day every day except Sunday. People were understandably concerned about their conditions, treatments and their risk of contracting COVID -19.
Responding to the challenges of offering our service in a different way, I found my leadership style shifting slightly from one of facilitation to one more directional. It was important to support the team through the huge changes including staff shielding, accommodating working from home, departmental social distancing and more recently, the slow introduction of more face-to-face appointments taking place.
Not only has it been important to support the patient’s expectations during this time but also the staff who suffered with the uncertainty of the situation and the constant changes that we brought in frequently. Team communication was vital and one way we supported this was by forming a team WhatsApp group named ‘chat rheum’. It worked so well, especially during the height of the pandemic when things changed daily.
As a department we were fortunate as none of our nurses were redeployed, although all were ready to go and the consultants were only needed for a short period so we were able to remain open as a service throughout lockdown and now we are starting on the road to recovery.
The advice line has gone from worries about COVID to worries about conditions. Many patients managed throughout lockdown but now want and need to be seen again. We are slowly opening up to more face-to-face consultations, especially for urgent referrals and those patients experiencing flares, but about 60% still remain telephone consultations and I feel this will be our new normal.
The resilience and responsiveness of the Rheumatology team at Salisbury has been challenged more than ever before but we all rode the roller coaster together, supporting, communicating and caring for our patients and colleagues. We were in it together!
New student award launched
We’re excited to share that we’ve been working with the British Society for Rheumatology (BSR) to launch a new award aimed at students. The award aims to promote rheumatology as a career to the next generation of clinicians.
Two awards will be made and as a winner, you will receive:
- Certificate of achievement.
- Opportunity to present your work at the BSR Annual Conference as a poster or ePoster.
- Complimentary one-day registration for the BSR Annual Conference.
- Return economy travel.
- Two nights' accommodation up to the value of the official conference hotel.
You can find full details of how to apply on the BSR website.
Standardising data in community and primary care MSK services
Given recent changes to NHS services in response to the COVID-19 pandemic it is more important than ever to evaluate the quality of care provided and to capture any changes in quality associated with new ways of working.
Standardised data is essential in order to identify variation in Musculoskeletal (MSK) service performance (including outcomes and costs) and requires the consistent use of a specific set of metrics. National data collections exist for orthopaedic surgical procedures (National PROMs Programme) and for early inflammatory arthritis (NEIAA) but routine collections are lacking in MSK community and primary care services.
A team of academics at Keele Primary Care Centre Versus Arthritis led by Consultant Physiotherapist Roanna Burgess have developed an evidence-based set of core metrics to recommend as a standardised dataset for use in UK community and primary care MSK services. This recommended dataset is now being taken to consensus nationally and we would value your input (details outlined below).
The primary aim is to reach consensus on the minimum dataset (core outcome set) that should be collected across MSK services in order to enable effective service evaluation and benchmarking.
The secondary aim is to support the development of methodology for a national audit of community and primary care MSK services.
How Can You Help?
Our musculoskeletal research team at Keele University is asking people who work in/manage or have recent experience of receiving MSK care within a community or primary care MSK setting (e.g. GP Practice, Physiotherapy Clinic) to complete this short survey to help us finalise a short-list for a standardised dataset for routine MSK service evaluation and benchmarking in this setting.
The survey is fully anonymised. Please click the link below to take part:
We would also be grateful if you could forward this invitation to any other Clinicians/Managers with expertise in this area or to friends and family who have recently received MSK care in this setting that you feel would be keen to participate.
Further information about this project including the proposed list of metrics can be found on the Keele website (bottom of the webpage).
To contact the research team please email Roanna Burgess: email@example.com
Without understanding, often advice about the best way forward makes no sense
Richard Pell, Campaign Director for Flippin’ Pain™ tells us why the campaign is important.
Why is Flippin’ Pain™ needed?
Persistent pain is complex. It affects a THIRD of people in the UK, with sufferers consulting their GP 5 times more frequently and reporting high levels of dissatisfaction with treatment.
What is Flippin’ Pain™?
Flippin’ Pain™ is a public health campaign, championed by Connect Health, supported by NHS Lincolnshire CCG and inspired by the Pain Revolution movement in Australia, flippin’ the way people think about, talk about and treat persistent pain.
How does Flippin’ Pain™ help people?
What is particularly striking about persistent pain is the extent to which it is dominated by misinformation and misunderstanding. This has a significant deleterious impact on everything from public and patient expectations and satisfaction, to treatment approaches and outcomes. Flippin’ Pain™ gives people an understanding of persistent pain that is aligned to the best scientific knowledge, enabling them to make better healthcare and lifestyle choices.
Accurate, evidenced and up to date people-orientated websites are hard to find. Flippin’ Pain™ is one of only a handful I recommend to people with persistent pain. The contributor journeys resonate and provide hope and light at the end of a very lonely tunnel.
Why is Flippin’ Pain™ important to healthcare professionals (HCPs)?
Many HCPs tell us they struggle to know how best to support people with complex persistent pain and have long waiting lists for specialist services. Flippin’ Pain™ helps facilitate a shift in patient expectations towards sustainable evidence-based approaches such as combined physical and psychological therapies and self-management, as opposed to passive higher risk interventions such as medicines and surgeries.
Why is it different?
Other web resources tend to focus solely on pain management interventions. Flippin’ Pain™ is different: its focus is on engagement, education and empowerment; an enabler or a precursor to engaging with evidence informed management approaches. It’s fun, easy to navigate, very accessible, written in non-medical language and was co-produced by people living with persistent pain and healthcare professionals.
What should HCPs do now?
Versus Arthritis branches and groups go virtual
Our branches and groups have gone virtual, maintaining support and friendships through Facebook, WhatsApp and by participating in a successful programme of ‘virtual events’ covering a range of topics including pharmacy, mental wellbeing, physiotherapy and physical activity. We’re continuing to explore further sessions, co-designed with branch and group members as well as healthcare professionals.
Although our Information Hubs are paused, our volunteers remain busy upskilling in their roles with guest MSK healthcare professionals attending their support meetings. Volunteers have also diversified to deliver our new ‘Patient Voice’ volunteer role - developed during this period in response to external demand, to provide MSK patient insight to healthcare educators and their students. Our 1:1 service continues via phone with up to 4 weeks of volunteer self-management support for those who are unable/not ready for a group setting.
Our Training Volunteers continue to deliver self-management courses virtually. We’ve been delivering a condensed version of our 6-week Stanford Accredited courses since June. Courses are facilitated by 2 volunteer tutors with up to 6 participants to allow for shared learning. Our 2 week Challenging Pain course will reach even more people and act as a stepping-stone to the 6-week course.
To find out more about our services contact Anna Lyons, Living Well with Arthritis Service Manager, firstname.lastname@example.org.
We’re ‘keeping people moving’ through our virtual Tai Chi for Arthritis sessions and encouraging people to keep their step count up with online support from Paths for All, that accesses virtual walks with audio/video clips. Our newsletter to volunteers has been a great success; we know it reaches far and beyond with participants supported by partner organisations using the content for their weekly self-management focus.
Our branch and group network has worked hard at keeping people connected through welfare calls, virtual gatherings and ensuring the most vulnerable are linked to local support and COVID-19 response teams. Links with our ESCAPE pain facilitators are helping to facilitate the planning of our first ESCAPE-Pain programme in Scotland, when we are safe to do so!
For more information please contact Carol Graham, Partnership and Learning Manager, email@example.com.
During COVID-19, we’ve continued to support people living with MSK conditions by continuing to deliver virtual support groups. We’ve worked hard to ensure our content is varied and engaging and our virtual sessions have included hand massage, aromatherapy, gardening and virtual walks.
We’re using Funding from the Welsh Government to develop the CWTCH Cymru Project, which will enable us to develop our support and activity groups, workshops and information hubs even further. CWTCH will enable us to help more people across Wales connect with others, providing early intervention and prevention, transforming the way people’s needs for care and support are met, ensuring that nobody will have to live with the pain, fatigue, and isolation that arthritis causes. In response to COVID-19 we will deliver a Core Skills digital offer for healthcare professionals, until it becomes safe to deliver our face-to-face workshops.
For more information contact Wayne Morgan, Living Well Manager firstname.lastname@example.org.
We provide peer support and support with self-help for people across England with all forms of arthritis including lupus, gout and fibromyalgia. We also have information stands in healthcare settings.
During lockdown, our staff and volunteers have been working hard supporting people with arthritis in a range of ways from online peer support and social media to telephone calls and posting useful resources and information. Some physical activity has continued online such as Tai Chi and seated exercise and we’ve also linked people to a wide range of physical activity resources. We have a growing network of local support groups. To find one in England, search on our In Your Area pages.
Our Living Well with Arthritis Commissioned Services in England guide people with osteoarthritis of the knee and/or hip through a Shared Decision-Making process to determine which treatment options are right for them. It also improves care by empowering people to be closely involved with their own care planning. More than 6,500 people have accessed our services across England.
For more information about our commissioned services please see: LWwA Commissioned Services.
To find out more please contact Lauren Williams, Living Well with Arthritis Service Manager email@example.com.
Sign our Impossible to ignore campaign petition
It's not 'just aches and pains', and it's not 'just wear and tear’. It’s not alright – it’s arthritis, and it can steal someone's family life, independence and even the ability to move freely. Sign our petition now to demand that UK governments don’t ignore the needs of people with arthritis.
As lockdowns ease across the UK, people with arthritis need clear communication about when they will be treated and the assurance that they can receive care and services safely during the ongoing pandemic. Now is the time for all of us to demand that our policymakers, politicians and health authorities can't ignore the needs of people with arthritis.
Our new campaign, Impossible to Ignore, is calling for:
- UK governments to address the needs of people with arthritis as they plan to restart treatment and services.
- A commitment to involve people with arthritis in shaping treatment and services.
- National plans to bring down joint replacement waiting lists safely.
- Local planning to make sure that people with arthritis get the communication, advice and support they need to manage their pain.