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Adopting the holistic approach
The chairman of the Arthritis and Musculoskeletal Alliance (ARMA) welcomes the publication of the new Musculoskeletal Core Capabilities Framework and explains the importance of the first contact practitioner role, collaborative working and a person-centred approach:
Musculoskeletal (MSK) conditions have a huge negative impact on the health of the population.
People with MSK problems making a first approach to health services can find it difficult to access the right support and some experience delays in getting the correct diagnosis and management, which can result in prolonged impact such as ongoing pain and work loss.
The Musculoskeletal core capabilities framework for first point of contact practitioners has been developed in partnership by the Arthritis and Musculoskeletal Alliance (ARMA), NHS England, Skills for Health, Public Health England and Health Education England to ensure that people with MSK problems get what they have expressed they want – rapid access to diagnosis and early management advice, being fully involved in their care through shared decision-making and self-management.
They want confidence in the advice they are receiving and in the capabilities of the health practitioner, their problems and concerns understood and responded to and they want a holistic approach to their problem.
This framework aims to ensure that the range of healthcare professionals who work with patients with MSK problems can play a full role in helping to manage any MSK problem appropriately at the first point of contact. Working in a team and sharing challenges, first contact MSK practitioners can ensure the person with an MSK problem gets rapid access to the right support without the person getting lost in what can feel like a maze of different care pathways.
The first point of contact is important to ensure that potential emergencies are recognised and that the next step in the pathway occurs seamlessly and as efficiently as possible. This will also help relieve pressures on primary and secondary care.
By making it clear what capabilities are required, we hope the framework will encourage training and development to increase the number of practitioners from different professions who will fulfil this vital role. Importantly, this is not about creating a new MSK workforce as many already fulfil this role, but is about recognising existing capabilities within practitioners’ scope of practice and ensuring services are delivered consistently by multi-professional teams. One challenge might be that we have all become too ‘specialised’ in healthcare, but the person with the MSK problem wants and needs a holistic approach to get the best outcome.
This framework of core capabilities offers clear definitions against which to improve and assure – for employers, clinicians, regulators, primary care training hubs, commissioners and practitioners themselves. It also emphasises the need for modernised skill sets that support person-centred approaches and include shared decision-making, prevention, and support self-management and focuses on what enables people to stay active and independent.
Most importantly it will give the public assurance of the capabilities of the person they are seeking help from.
There is a growing consensus across health and care for new approaches and targeted interventions to promote healthier ageing. This framework has been developed by the whole musculoskeletal sector – including patients and health professionals – collaborating on an issue we all agree is important. It is focused on the needs and expectations of people with MSK problems, with recognition by the health professions that there needs to be harmonisation of core capabilities across the sector to ensure that the right care is provided from that first point that someone presents with an MSK problem seeking a solution.
ARMA is pleased to have played a part in creating this framework that should make a real difference to patient outcomes.
Since Prof Woolf retired from nhs my condition has gone down hill I do not get the same excellent treatment I got from Mr A Woolf