The NHS Mandate (2018) outlines the need for NHS transformation, with NHS England supporting leaders to drive forwards real improvements in patient care and patient outcomes. Tackling unwarranted variation is highlighted as a priority objective within NHS policy aiming to reduce the ‘unacceptable’ care and quality gap. Versus Arthritis (VA) in line with these objectives supported the development of the Musculoskeletal Health Questionnaire (MSK-HQ) to measure overall health status in Musculoskeletal (MSK) patients, and published the MSK Recommended Indicator Set in 2016. This indicator set defines a shared UK MSK vision, and reflects agreed objectives for MSK health systems; ensuring comparisons in care are made over time, providing information on quality, and supporting quality improvement initiatives both locally and nationally. Specific data capture across the MSK health system was envisaged to enable and support quality improvement in areas such as early diagnosis, delivering of coordinated care, and empowering people with arthritis and MSK conditions to self-care.
A number of national audits are already in place to capture this data in specific areas outlined within the indicator set, such as; the National Early Inflammatory Arthritis Audit (NEIAA) in the area of ‘Rheumatoid Arthritis’, the National Hip Fracture Database for the area of ‘Fragility Fractures’, the National PROMs Programme hip and knee data for the area of ‘Osteoarthritis’, with additional data on prevalence and spend reported and compared by NHS RightCare in MSK focus packs. The area however where there is no national audit or dataset to provide comparative data is within community and primary care management of non-inflammatory, non-surgical MSK conditions. For these non-surgical, non-inflammatory patients at present we do not have national data to support the indicators listed under ‘Musculoskeletal Health Outcomes’ within the Versus Arthritis Indicator set, including data on health gain (MSK-HQ) or utility scores (EQ5D), or other key metrics such as the percentage of patients whose work is affected by MSK conditions, and the satisfaction of patients treated for MSK conditions in these settings. We also do not have a case-mix model that would allow us to appropriately compare MSK health outcomes for the purpose of benchmarking and quality improvement. This project therefore aims to identify and agree a list of core MSK metrics to collect alongside the newly developed MSK-HQ in community and primary care settings in routine practice for the purpose of audit, evaluation, and service improvement to support service transformation.
Mrs Roanna Burgess (Keele University and Sandwell and West Birmingham Hospitals NHS Trust)
Dr Jonathan Hill (Keele University)
Dr Martyn Lewis (Keele University)
- Core indicator set
- Consensus meeting
Intervention: Community and Primary Care focus
Initial survey/s followed by a consensus meeting of key stakeholders.