delivering system change and place based care
TRANSCRIPT
Delivering system change and place-based care through MSK networks of care
Professor Peter Kay National Clinical Director MSK, NHS EnglandFederico Moscogiuri CEO Arthritis and Musculoskeletal Alliance (ARMA)Bernadette Kennedy Head of Integrated Falls and Bone Health Service , St George’s University Hospitals NHS Foundation TrustChristina Heaton, Nurse Consultant , Bridgewater Community Healthcare NHS Foundation Trust
30.9 millionworking
dayslost
One third of all
GP appointments
Third poorest quality of life
Main cause of physical disability
£5 billion of NHS spending
per year
Why is MSK Important?It affects more than 10 million adults and 150,000 children in the UK
Associated with a large number of co-morbidities, including diabetes, depression and obesity
Accounts for over 25% of all
surgical interventions in
the NHS
Good musculoskeletal health –healthy muscles, joints and bones working well together - is essential to carrying out daily activities with ease and without pain, and remaining, independent and socially and economically active for longer.
Our aim is:
Our vision is that there will be improvement in outcomes for people with musculoskeletal (MSK) disorders in the UK.Our mission is to work collectively and collaboratively with our member and partners to achieve this vision.
Capturing, interpreting and enabling the application of MSK knowledge
Influencing and raising awareness of MSK with decision-makers, practitioners and the public
Working in partnership to improve outcomes for MSK in key areas
Building a strong, diverse and vibrant MSK community
From community to movement
Knowledge into actionKnowledge
What are we doing to support improvements in MSK place based care?
Working with national partners
What are we doing to support improvements in MSK place based care?
MSK Programme
• Developing MSK Clinical Networks 3 key elements:
• MSK Knowledge Network: a forum for the sharing of information, resources and experience
• National guidance in key priority areas based on the best possible evidence– Establishing MSK indicators (metrics)– Workforce– Fracture Liaison Services
• Disseminating key resources– NHS Confederation: Developing MSK Networks resource pack
• Supporting the wider programme roll-out including Optimal Value Pathways and CfV resources (with NHS Right Care), GIRFT
What have we done so far?Co-producing and Sharing National Tools and Resources
Yammer MSK Knowledge Network Also utilising….
MSK Knowledge Network Webinars Series
Contact us at: [email protected]
NHS Confederation resource packNational MSK Seminar
What have we done so far?Supporting wider programme roll-out
Developing measures and optimal pathways
that drive improvement
Work as a Health outcome
Supporting healthy lifestyleand preventing ill-health
Transforming the MSK workforce to support person-centred care
What are our next steps?• Supporting the delivery of local MSK improvement aligning with NHS Right Care and
GIRFT
• Supporting the development of a sustainable regional network approach aligning with STP footprints
• Further developing resources sharing best practice and evidence for commissioners, providers and clinicians
• Pilot and test a competency framework for MSK workforce for rapid adoption and spread
• Further support the delivery of the Health and Work programme and MSK prevention programme
Delivering system change and place-based care through MSK networks of care:
Best Practice Examples
Self Referral and patient empowerment modelSept 2016 Bernadette Kennedy, Head of Integrated Falls and Bone Health St Georges University Hospitals NHS Foundation Trust
Vision for MSK services: EASY Access to a service developed by patients for patientsSelf Referral pivotal part of the model: to deliver to the right people, in the right place at the right timeEmpower them to mould service delivery that would work for them. What is different between us and traditional MSK physiotherapy = patient led service• Change in Culture for staff• Different choices for first contact• Different provision arms of the service – what matters to You and what intervention
model suits YOU• Ongoing Patient Empowered Supported self management
DVD – a visual: our bone health service
• https://www.stgeorges.nhs.uk/gps-and-clinicians/clinical-resources/bone-boost/
Integrated Falls Management & Fracture Liaison ServiceSept 2016 Christina Heaton, Nurse ConsultantBridgewater Community Healthcare NHS Foundation Trust
Integrated Falls Management & Fracture Liaison Service Christina Heaton Nurse Consultant
Falls & Balance clinic - over 18 yrs. with dizziness, blackouts, complex osteoporosis Fracture Liaison Service – over 50 yrs. with a recent fracture
MDT, multifactorial, physical assessment, environmental assessment, medication review, osteoporosis assessment utilising FRAX & NOGG,
investigations undertaken and providing therapeutic interventions &/or appropriate timely referral
Partnership working with local acute NHS trust, Mental Health NHS trust, Social Services, Leisure & Culture trust, NWAS,
GMFRS, Patient groups & charities
Key Performance outcomes
100% of patients assessed against NICE guidance
95% of patients assessed within 6
weeks
Referrals onto secondary care
Falls- 12%OP- 6%
Other - 3%
100% of patients started on
bisphosphates are follow-up
DNA’s FLS-10%Falls-5%
34% of patients referred for Dexa-
+ve Osteoporosis- 22%↓BMD- 44%-ve OP- 32%
‘Made to feel comfortable,
explained so I was able to understand
& allowed me to ask questions’
Patient
‘It seems to be working well, had a lot of
positive feedback’Orthopaedic Consultant
How can you get involved?
Join our Yammer MSK Community
Contact us at: [email protected]
Any Questions?