Webinars, Podcasts,

Implementing use of AI to support image interpretation for MSK (appendicular emergency care). Although being implemented in clinical, still only intended for research evidence generation stage

NICE publishes new guidance on use of AI to assist with interpretation of urgent care X-rays | SoR

NHSE Horizons 'designing the future of MSK'

A 2 day round-table event took place in London on 20th and 21st February to rethink how MSK services are delivered, as it is currently sub-optimal in the context of non-communicable diseases, long term conditions, personalised care and health inequalities. The way we deliver care. It was a very productive event and a springboard for furure collaboration with the MSK community.

Please find the slides below:

The Future of MSK CareDay 1

Some great reflections following the 2 days of the NHS Horizons 'designing the future of MSK ' written by AECC can be seen below by scanning the QR codes. It brings the conversations of the 2 days to life, showing how MSK care needs to be delivered very differently from the paradigm of non-communicable diseases, long term conditions and health inequalities.

ARMA Heath Inequalities inquiry

NHSE MSK Update 2023 - Andrew Bennett NHSE MSK National Clinical Director

FSEM Podcast - International Framework for Red Flags

The International Framework for Red Flags with Dr Laura Finucane: MSK MedicineFor this episode Giles talks with former colleague Laura Finucane, consultant musculoskeletal physiotherapist and specialist in spinal conditions, on the International Framework for Red Flags. Laura has been a consultant since 2006 providing care for NHS patients. Laura’s special interest is in serious pathologies of the spine and she has presented nationally and internationally. Useful Resources Referenced: https://www.macpweb.org/Cauda-Equina-Information-cards https://view.genial.ly/62b210b8c534710012aafcaa/interactive-content-red-flags-for-potential-serious-spinal-pathologies

Policy Documents and updates

Find out what is happening across the 4 nations

4 Nations Update- Meeting 04.10.25

Scotland

Continued updates and development of NHS Inform MSK pages including developing a hub format for landing page Muscle, bone and joint injuries / problems | NHS inform

Protected learning time for agenda for change staff in Scotland https://www.publications.scot.nhs.uk/files/pcs2024-afc-01.pdf - working groups within boards taking forwards implementation

AHP education and workforce policy review: recommendations- implementation work ongoing Supporting documents - Allied Health Professions - education and workforce policy review: recommendations - gov.scot (www.gov.scot) including a newly commissioned project to support Transforming AHP Roles - Advancing Practice- NHS Scotland | Jobs | Search here for your perfect career - Job Information | Apply for Senior Educator - Workforce, Education and Career Development Programme 10484BR

Health and Care (staffing) (Scotland) Act 2019- enacted on 1st April 2024 Health and Care (Staffing) (Scotland) Act 2019: overview - gov.scot (www.gov.scot) & Health and Care (Staffing) (Scotland) Act 2019 (legislation.gov.uk). Implementation reporting continues

NHS Scotland Rehabilitation framework - implementation work continues including a recent self assessment survey for completion by health boards Rehabilitation and Recovery: A Once for Scotland Person-Centred Approach to Rehabilitation in a Post-COVID Era (www.gov.scot)

Digital - a number of boards engaged in pilots with a range of digital providers inc Phio, Flok Health, Inhealthcare, econsult, ongoing other discussions

NHS Scotland "Centre for Sustainable Delivery (CfSD)" to explore whole system osteoarthritis pathways within Modernising Patient Pathways | The national Centre for Susta (nhscfsd.co.uk)

New module launched within Queen Margaret University MSc Advancing Practice Framework- "Advancing practice portfolio"- enable AHPs to develop portfolio's aligned to national advanced practice frameworks/ standards i.e. UK MSK AP standards Advancing Practice in Health Framework (qmu.ac.uk)

Scottish Government - programme for government 2024/25 launched Programme for Government 2024-25: Serving Scotland (www.gov.scot) - commitments re "Ensuring High Quality and Sustainable Public Services" - section 4, p32-41

Northern Ireland

CAHPO

Michelle Tennyson has set reintroduced an advisory committee for Allied Health Professionals (ACAHP).

Underneath this group there are several sub groups which will help informed the CAHPO position.

Department of Health; Northern Ireland

Mike Nesbit; Health Minister launched a reconfiguration framework for hospitals, setting out the key principles to underpin service reorganisation. Entitled “Hospitals – Creating a Network for Better Outcomes”, the document will be the subject of a public consultation.

Hospitals – Creating a Network for Better Outcomes can be read here - https://www.health-ni.gov.uk/publications/hospitals-creating-network-better-outcomes

DoH northern Ireland has invited Professor Bengoa to return , his report 'Systems, Not Structures', which signified a turning point in the Assembly's intent to transform our health and social care system, with a clear focus on creating a safe, high-quality and sustainable service for people across the North of Ireland.

We have recently received word that the MDT programme has received additional funding through the DoH transformation funding. Although the exact parameters of the funding has not been released as yet each HSC to looking at ability to support the roll out of the MDT teams across the remaining 10 federations. This will require investment in staff training and workforce planning

ARMA

Recently hosted Sue Brown as part of the Act Now dissemination workstream in northern Ireland.

AHP Research & Innovation Conference Report 2024

The conference was held in the Balmoral Hotel 11th September 2024

The event was aimed at Allied Health Professionals (AHPs) across the 14 AHP professions in Northern Ireland who have started or were preparing to start the journey as researchers in any capacity.

We received 76 abstracts and of which 48 translated to the conference presentation in the form of platform, rapid 5 and poster areas.

We welcomed 118 delegates from across N.Irleand with 100% agreement on making this conference an annual event.

Wales

Update from Wales - MSK strategic network launch happening on Tuesday 8th October with release of the living with arthritis and MSK conditions framework 2024-2029. We have A rheumatology clinical lead in post and will be launching a Clinical implementation network for rheumatology in November, they will focus on NEIAA short term and produce 5 and 10 year plans for the whole spectrum on rheumatology. We have a Clinical reference group for the primary and community care space coming online in November which will focus on prevention, early accurate diagnosis and treatment in that space and be fully integrated with lived experience and 3rd sector  stakeholders. The Bone health CIN achieved its targets for FLS and will be building on this with its 5 and 10 year plans, The Persistent Pain CIN is forming and working on consistent delivery of a pathway across the system.  Ortho and spines continue to progress their work on pathways and surgical capacity and productivity. HEIW have completed the capability framework for Primary and community care MSK, however are yet to commit to an implementation plan, the network hopes to endorse the process once the Implementation plan has been agreed. 

4 Nations update (meeting 14.06.24)

Scotland- Phil Ackerman/ Jenifer Dallas (Scotland)

Continued updates and development of NHS Inform MSK pages Muscle, bone and joint injuries / problems | NHS inform. Work underway to develop a hub format to improve navigation of the pages as a co-production approach with support versus arthritis
Health and Care (staffing) (Scotland) Act 2019- enacted on 1st April 2024 Health and Care (Staffing) (Scotland) Act 2019: overview - gov.scot (www.gov.scot) & Health and Care (Staffing) (Scotland) Act 2019 (legislation.gov.uk)
Triple helix partnership- NHS Health Innovation South East Scotland | Welcome (edinburghbioquarter.com) NHS Lothian & Flok Health to launch digital back pain service pilot
Other ongoing digital pilots including e-consult, Phio in some health boards
Other pilots- MSK community appointment days - NHS Lanarkshire
NHS Scotland "Centre for Sustainable Delivery (CfSD)" to begin support within the Modernising Patient Pathways Programme with focus on MSK Modernising Patient Pathways | The national Centre for Susta (nhscfsd.co.uk)- initial work to explore whole system osteoarthritis pathways
Versus Arthritis and partners submitted proposal to Cabinet Secretary for Health with a proposal for a framework for MSK health in Scotland
New development within Queen Margaret University MSc Advancing Practice Framework- "Advancing practice portfolio" to commence Sept 24- enable AHPs to develop portfolio’s aligned to national advanced practice frameworks/ standards i.e. UK MSK AP standards Advancing Practice in Health Framework (qmu.ac.uk)
AHP education and workforce policy review: recommendations- implementation work ongoing Supporting documents - Allied Health Professions - education and workforce policy review: recommendations - gov.scot (www.gov.scot)
Transforming roles programme (includes advanced practice) recommenced and work ongoing Transforming nursing, midwifery and health professions roles: introduction - gov.scot (www.gov.scot)
Ongoing discussion are scoping of a national digital platform for MSK
NHS Scotland Rehabilitation framework - implementation work continues Rehabilitation and Recovery: A Once for Scotland Person-Centred Approach to Rehabilitation in a Post-COVID Era (www.gov.scot)

Wales- Update on the MSK capability Framework consultation- Rob Letchford (apology)/ David Price-Smith

Wales MSK Capability Framework Consultation Version - English.pdf

Northern Ireland- Helen Welch

Encompass has launched in Belfast Health and social Care trust. This is the second of the 5 trusts in N.Ireland to move to a single digital care record for every citizen in Northern Ireland who receives health and social care.
N.Ireland has a new incumbent Health Minister; Mike Nesbitt after Robin Swann stepped down on the 29th may 2024.
- - The Department of health has published the latest Health Inequalities Annual Report must be essential reading across all parts of public life in Northern Ireland.
  - Health inequalities ‘a challenge to us all’
  - The 2024 Health Inequalities Annual Report is published here:
  - https://www.health-ni.gov.uk/publications/health-inequalities-annual-report-2024
There is continued ongoing discussion regarding health service education and training places. Initial direction from the previous health minister was that the level of pre-registration education places will be the same as last year in each of the following areas: Nursing and Midwifery – 1,025, Allied Health Professionals (AHP) – 335 and Social Work – 285.
Planned cross boarder Advanced practice day with ICSP and CSP planned for autumn this year. FCP leads in N.Ireland have been asked to contribute to a session.
Discussions are ongoing with N.Ireland CAHPO Michelle Tennyson and AHP lead/ HoS to identify ways that AHPs can support primary care pressures.

England- Andy Bennett (Apology)

MSK Update from 4 Nations (8 Dec 2023)

England:

· NHS England » Musculoskeletal orthopaedic approach to referral optimisation (Oct 2023)

· See video link for recording for NHSE MSK update (by AB) https://youtu.be/qHeT2yj5q8w

Northern Ireland:

1. N.Ireland has appointed a new CAHPO – Michelle Tennyson – previously Assistant Director Allied Health Professions and Personal and Public Involvement · Public Health agency northern Ireland. She is currently transitioning into the post and will be a keen advocate for AHP development in N.Ireland.

Unfortunately, the government has not returned to Stormont yet.

2. The Public Health Authority in N.Ireland have a current focus on public health and are undertaking pieces of work following on from the emerging whole systems approach AHP day earlier in April

These include:

Accessible communication
Hard to reach populations
Early years public health work in schools
A model for good practice
Take 5 steps to health-through an AHP lens

Once these workstreams have finalise I will share with MSK partnership group.

3. Med3 developments

Currently the Department of Health are scoping the implementation of Med 3 for Nurses, physiotherapist, pharmacists and occupational therapists. This is only in the draft consultation stage at present. There are some operational issues specifically related to N.Ireland that need addressed however there is broad support of the proposal with aims for roll out in 2024.

4. Implementation of Encompass

South Eastern trust is the first trust in N.Ireland to “go live” with encompass. Encompass is a Health and Social Care programme that will create a single digital care record for every citizen in Northern Ireland who receives health and social care. It will be in use across all Health and Social Care Trusts in Northern Ireland to create better experiences for patients, service users and staff, giving patients and service users the ability to view and update their health information online wherever and whenever they like. It will also make it easier for Health and Social Care staff to view important information about their patients and service users both in a clinical setting and while working in the community.

5. Initial planning stages of N.Ireland AHP research and innovation conference : embracing a population health approach. Proposed date June 2024

Scotland:

Continued updates and development of NHS Inform MSK pages Muscle, bone and joint injuries / problems | NHS inform
AHP education and workforce policy review: recommendations- awaiting implementation guidance Supporting documents - Allied Health Professions - education and workforce policy review: recommendations - gov.scot (www.gov.scot)
Health and Care (staffing) (Scotland) Act 2019- Provisions in act come into force April 2024 Health and Care (Staffing) (Scotland) Act 2019: overview - gov.scot (www.gov.scot) & Health and Care (Staffing) (Scotland) Act 2019 (legislation.gov.uk)
Transforming roles programme (includes advanced practice) to recommence and awaiting implementation guidance Transforming nursing, midwifery and health professions roles: introduction - gov.scot (www.gov.scot)
New NHS Education for Scotland Multiprofessional Advanced Practice toolkit launched Advanced practice toolkit | Turas | Learn (nhs.scot)
New "Right decisions" service available and continues to be developed- The Right Decision Service is a 'Once for Scotland' source of digital tools that enable people to make safe decisions quickly ‘on the go’, based on validated evidence. It provides health and social care organisations with tools to build decision-ready guidance, pathways, risk scoring tools, shared decision aids and other decision support resources. These tools are all delivered through this Right Decision Service website and mobile appRight Decisions | Right Decisions (scot.nhs.uk)
National 4-week MSK waiting times target- atm statistics constrained by quality assurance data from several NHS boards. Public Health Scotland working collaboratively with each NHS board to resolve- Allied health professionals – musculoskeletal waiting times in NHSScotland - quarter ending 30 June 2023 - Allied health professionals – musculoskeletal waiting times in NHSScotland - Publications - Public Health Scotland
Innovation hubs- 3 hubs across Scotland as "Innovation test beds"- examples of MSK services working with innovation hubs testing MSK digital 'solutions' NHS Health Innovation South East Scotland | Welcome (edinburghbioquarter.com)

Wales:

Allied Health Professions Framework for Wales (gov.wales)

Professional Framework for Enhanced, Advanced and Consultant Clinical Practice - HEIW (nhs.wales)

Quality statement for musculoskeletal health [HTML] | GOV.WALES

UK Musculoskeletal Advanced Practice Standards

U.K. Musculoskeletal Advanced Practice Standards, Sept 2022The Standards outline the minimum knowledge, skills and behaviours required of all clinicians working at advanced practice level within the MSK specialty.

MSK First Contact Roadmap to Practice

First Contact Practitioners - Roadmaps to PracticeIndividuals working in First Contact Practitioner roles in Primary Care will collect evidence as they progress through the two stages that are described in the FCP Roadmaps. This evidence, normally collected in a portfolio, and verified through an educational process and clinical supervision, will provide the assurance that the individual meets the FCP Roadmap requirements. The documents below are the current version of the roadmaps, these are being currently being revised.

Access the NHS England MSK Support Self-managementToolkit and many other resources on the Musculoskeletal Services-Community Health Services - Future NHS platform

(Remember to sign up to the Futures website to get your password for free access to these online resources)

Click this link for the NHS England musculoskeletal health website for access to NHSE publications including the MSK improvement framework.

NHS England Musculoskeletal orthopaedic approach to referral optimisation ( published October 2023)

Consultant Practice Capability & Impact Framework

Consultant - Advanced PracticeMulti-Professional Consultant Practice Capability and Impact Framework supports identifies capabilities required by consultant practitioners

MSK Resources

Act on axial SpA toolkit for healthcare professionals

As part of our Act on axial SpA campaign, NASS want to build a sustainable support network for Health Care Professionals who are working in support of the campaign, delivering change and promoting the provision of axial SpA care. This page includes a toolkit for healthcare professionals working in MSK and a link to our peer to peer network, for those with a special interest in improving axial SpA diagnosis time and services.

https://www.actonaxialspa.com/peer-to-peer-network-and-hcp-toolkit/

Time flies: tools to help make the most of consultations

we put together a set of values-based quality standards to help health care professionals understand what people want from their appointments. We’ve now developed a toolkit to help health care professionals to make the most of their time with their patients, and to ensure that both get what they need from appointments. The toolkit includes information on collaborative agenda setting and templates for focus forms and management plans.

https://nass.co.uk/homepage/health-professionals/aspiring-to-excellence/time-flies-tools-to-help-make-the-most-of-consultations/

Rheum for Improvement Podcasts

As part of the Aspiring to Excellence quality improvement programme, NASS has developed six CPD accredited podcasts dedicated to service improvement in axial SpA care. Episodes are available on all good streaming platforms, including Spotify, Apple and Castbox.

https://nass.co.uk/homepage/health-professionals/aspiring-to-excellence/rheumforimprovement/

Supported Self-Management Programme

Our Supported Self-management Programme gives people with axial SpA the skills and tools they need to confidently manage their symptoms and live well with the condition. It has been developed in partnership with people with axial SpA and healthcare professionals. NASS also runs regional online sessions in collaboration with local NHS services so please get in touch if you would like us to run a session for your patients.

https://nass.co.uk/homepage/health-professionals/self-management-programme/

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