Let’s dispel the myth that “not much can be done” to treat Musculoskeletal disorders

Since the publication of this blog Dr Martin McShane has left NHS England.

NHS England’s National Medical Director for Long Term Conditions says a whole system approach is needed for patients with these agonising conditions:

Sometimes we don’t appreciate how important something is until we haven’t got it.

Musculoskeletal health and mobility is one of those things. There’s nothing like needing to do a series of stretches each morning before you can even put your socks on to fully appreciate how important it is to be able to move freely and without pain.

There is hardly a more widespread, expensive set of conditions than musculoskeletal (MSK) disorders, from back pain to osteoporosis to inflammatory arthritis. This is all the more striking given the enormity of their impact.

The latest Global Burden of Disease data shows that not only are they the single biggest cause of the rising burden of disability in this country, but that they are closely associated with a much increased risk of premature death, not to mention associated comorbidities such as depression.

Perhaps because ‘arthritis’ is so ubiquitous and ‘common’, the impact MSK disorders have is not appreciated nor addressed in ways which would maximally benefit individuals and the economy. There seems to be a misperception that “there’s not much that can be done”.

Effectively tackling MSK disorders is central to the whole system approach which is required to deliver person-centred, coordinated care for all people with long-term conditions. All too often the biggest barriers to this are very familiar ones of silo working, compartmentalisation of care and, crucially, lack of communication and trust – particularly at the local level, where care is delivered, and now also commissioned.

One way to overcome this is through networks of clinicians, commissioners and patients, working in partnership, pooling their expertise and using the best available evidence to deliver improved outcomes for people. None of us can deliver this on our own. As NHS England, we know that the only way to achieve this is by working in partnership with the people and organisations who have the expertise, the reach and the means to make change happen across an entire area as broad and diverse as MSK.

The Arthritis and Musculoskeletal Alliance (ARMA), as the voice of the MSK community, has been leading a project to bring people and knowledge together through MSK clinical networks over a number of years. In April this year, NHS England established a formal partnership with ARMA, and is actively supporting this project, which I believe provides a great example of joined-up working and how person-centred, coordinated care might be achieved in practice.

In September we jointly launched the MSK Knowledge Network, as a peer-to-peer forum for improvement for anyone leading on MSK redesign or commissioning in their local area. If that means you, make sure you’re involved. Being part of this network will enable CCGs not only to learn from each other but access and make use of key resources for improving MSK care, and for creating sustainable relationships in your locality through effective MSK clinical networks.

In addition, on 21 January 2016 ARMA and NHS England will be co-hosting a one-day seminar to build on and cascade the work of the project to date. If you are the Accountable Officer or MSK lead in your CCG, and you want to:

  • improve outcomes, increase value and reduce wastage in your local MSK economy;
  • access the best national expertise to drive improvement in key areas including metrics and workforce;
  • learn how to set up effective MSK clinical networks; and
  • find out practical solutions and learn from the experience of others;

…then this event is for you.

Make sure you don’t miss out by contacting

Dr Martin McShane was previously National Clinical Director for Long Term Conditions, since the publication of these blogs he has left NHS England.