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MusculoskeletalJul 11, 2022

Service users and carers help to shake up MSK services in wake of 'devastating' Covid-19 pandemic

People with musculoskeletal (MSK) problems and their carers are helping to influence the delivery of services in England that desperately needed reforming in the wake of the Covid-19 pandemic.

That is a claim made in an NHS England publication – titled Working in partnership with people and communities: statutory guidance – that was launched last week (7 July).

The claim is made in a specialist case study – one in a series featured in the NHS England publication – which is titled ‘The difference made to the NHS England Musculoskeletal Services (MSK) programme by the Musculoskeletal Lived Experience Group (MSK LEG)’. 

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Telephone and video consultations became the norm for people with MSK issues

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Lockdown's 'devastating effect’

The case study says that the first Covid-19 lockdown had a ‘devastating effect’ on the provision of MSK services across the country. ‘Face-to-face consultations became a rarity, replaced by telephone and video consultations. MSK clinicians had to quickly learn new skills to assess and treat patients in these unfamiliar formats. The number of patients treated by MSK clinicians was significantly reduced as therapists were re-deployed to care for Covid patients.’

As it became clear that MSK services would need dramatically remodelling – not only to cope with the effects of the pandemic, but into the future – opportunities to create ‘new and better MSK services’ arose. 

The case study suggests that involving people who used services and their carers was a crucial component in the ‘large-scale re-modelling' required. ‘Without their involvement it could easily result in services that people didn’t want or were not sufficiently accessible to them.'

MSK recovery group established

As a result, an MSK recovery group was established in June 2020, with lived experience partners working alongside healthcare professionals. This evolved into the MSK lived experience group (MSK LEG). ‘Each member of the new MSK LEG has experience of a relevant MSK condition and were rigorously interviewed and appointed after an open and accessible selection process.’

The case study notes that the MSK LEG has already co-produced its own terms of reference and provided feedback on various pieces of MSK-related work. For example, group members helped to shape the evolution of the #BestMSKHealth Collaborativeprogramme and some of them presented alongside the national clinical director and MSK clinicians at a range of events.

‘The MSK LEG team has been developed from strong principles of co-production and has already made a difference to the recovery and advancement of MSK services throughout the UK.’

While involving people and communities is a legal requirement, working with them also supports the wider objectives of integration including population health management, personalisation of care and support, addressing health inequalities and improving quality [NHS England]

NHS England policy shift

In a foreword, the publication notes that the 2022 Health and Care requires partners in integrated care systems to work together to improve physical and mental health outcomes. ‘These new partnerships between the NHS, social care, local authorities and other organisations will only build better and more sustainable approaches if they are informed by the needs, experiences and aspirations of the people and communities they serve.’

The statutory guidance is aimed at integrated care boards, NHS trusts and foundation trusts, and has been adopted as policy by NHS England.

The publication notes: ‘While involving people and communities is a legal requirement, working with them also supports the wider objectives of integration including population health management, personalisation of care and support, addressing health inequalities and improving quality. 

It adds: ‘The legal duties provide a platform to build collaborative and meaningful partnerships that start with people and focus on what really matters to our communities. However, the ambition is for health and care systems to build positive, trusted and enduring relationships with communities in order to improve services, support and outcomes for people.’

The guidance is structured around 10 principles

  • centre decision-making and governance around the voices of people and communities
  • involve people and communities at every stage and feedback to them about how it has influenced activities and decisions
  • understand your community’s needs, experiences, ideas and aspirations for health and care, using engagement to find out if change is working
  • build relationships based on trust, especially with marginalised groups and those affected by health inequalities
  • work with Healthwatch and the voluntary community and social enterprise sector
  • provide clear and accessible public information
  • use community-centred approaches that empower people and communities, making connections to what works already
  • have a range of ways for people to take part in health and care services
  • tackle system priorities and service reconfiguration in partnership with people and communities
  • learn from what works and build on the assets of all health and care partners – networks, relationships and activity in local places


 To download a copy of Working in partnership with people and communities: statutory guidance, visit: https://www.england.nhs.uk/publication/working-in-partnership-with-people-and-communities-statutory-guidance/?s=03

Author: Ian A McMillan
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