Connect Health “Change” brings you the latest in a series of webinars to make and embed transformation in healthcare. Aimed at system leaders and clinicians across the NHS, the webinars provide practical solutions to the challenging issues we are all grappling with.
As part of the Connect Health Change webinar series, we present the Q&A summary from our panel who discuss Quality assuring the multidisciplinary MSK workforce in the post-COVID world.
Connect Health “Change” brings you the latest in a series of webinars to make and embed transformation in healthcare. Aimed at system leaders and clinicians across the NHS, the webinars provide practical solutions to the challenging issues we are all grappling with.
This webinar will bring together senior clinicians, system leaders, patients and experts will debate the standards, accreditation and workforce opportunities for the multidisciplinary MSK workforce.
Delegate feedback included:
- Great presentations, very informative. Brilliant community with open minds and vision. Thank you!
- Interesting to hear from 4 speakers who are currently working at the forefront of MSK work all working in different MSK healthcare organizations
- Good talk by Giles Hazan regarding ongoing standards – seemed to meet brief of webinar title
Watch the Webinar in Full
Chaired by:
Dr Graeme Wilkes, CMO, Connect Health
Q&A
Dr Giles Hazan, GPwER MSK Medicine, Sussex Partnership Foundation Trust, BASEM Education Committee Member, RCGP Representative (MSK) and Versus Arthritis Core Skills Trainer
Question 1: What does the future hold for how all these different clinicians can work and learn together?
Answer: Webinars like this really highlight the fact that there’s a massive overlap in terms of aspiration and how direction of travel isn’t there. For those of us have been on the sidelines, watching things like MSK, reform, and directions of travel from the field of osteopathy, it’s obvious that we’re all working towards a defined set of standards, striving for Clinical Excellence, for uniformity of care, for reducing variability. We are beginning to see the seeds of interdisciplinary working, and there are lots of facilitators for that; education and learning is a very powerful one. When you look at the seeds of what makes a really good interdisciplinary team, learning together is a really good tool.
Championing this, there are many others, PCRMM amongst them, that are starting to see us work together. The more these pathways align and converge, the more we’re going to see organisations combining and working together, without losing their defined roles and identity. It’s about building relationships, really.
Question 2: When will MDT working and organisations working together be business as usual?
Answer: It sort of depends on where you are. There’s a massive demand and not enough supply within the NHS at the moment, therefore you can see that as a driver for getting FCP roles out there that there’s just simply not enough GPs. Whilst that’s a reality, I think it’s a rather cynical way to look at this because the flip side is coming back to the point about being driven by Clinical Excellence and a model of care which as we’ve just seen from the other speakers, is exemplified by the best clinical outcomes. An MDT approach, which is rightly driven by outcome measures, strongly represented by patient reported outcomes, not just clinical outcomes demands the move towards MDT, and the financial implications will support that as well. In the majority of non-surgical management approaches I think it’s slightly variable around the country. You could argue in terms of the way that services are being commissioned, that is increasingly the rule rather than the exception.
Question 3: When will the framework be shared/complete?
Answer: All of that information and many other resources are going to be available through the faculty, sports and exercise medicine website. There’s going to be a defined area for diplomat members with a load of resources as well.
Keep watching in the next few months.
Question 4: How can we get people in senior roles?
Answer: It’s proving credibility and worth. I always see that as the natural consequence of good teamworking and more and more evidence of efficacy. There’s something about expectation and training leaders. Leadership isn’t something that happens just because you’ve got experience.
Versus arthritis has a very good programme of supporting leaders and developing leadership. It is not just experience, it’s looking at what makes a good leader and supporting them and it might come from within the different professions about leadership development programmes.
Uzo Ehiogu, Associate Director of Clinical Excellence, MSKR
Question 1: Do rehabilitation physiotherapists need to be diagnosticians in MSK practice or should they just concern themselves with rehab?
Answer: A physiotherapist who had an interest in rehabilitation also needs to be a diagnostician as well, and that may or may not be controversial. To give you a practical example, 2 weeks ago in our rehabilitation gym, a patient is referred to us with bilateral tennis elbow. After a neurological examination it turns out that she has upper motor neuron signs. We’re not there to decide why she has them, but we should be able to screen for appropriate referral.
Patients walking in off the street will be referred to physiotherapists for musculoskeletal rehabilitation. In my mind it’s unsafe not to be able to be a diagnostician, to be able to essentially do a comprehensive orthopaedic evaluation. Beyond that orthopaedic evaluation, there are other skills around the evaluation of performance, muscle performance and functional performance that they also need as well, but I don’t think it’s appropriate for us not to be diagnosticians in the musculoskeletal orthopaedic realm.
Question 2: What is being done/ can be done to influence employers to ensure more roles at senior level are created?
Answer: Fundamentally, it all comes down to leadership. We need more ambassadors and also we need greater awareness. We need to demonstrate impact as musculoskeletal physiotherapist in rehabilitation and that means that we need to write stuff. We need to shout loud and tell people about small projects, pilot studies, case studies, service evaluations. It’s basically getting in front of people who make decisions, whether that’s consultants, commissioners, managers and such like. We just need to be vocal and we need to keep being vocal.
Oliver Coburn, Registrar, BASRaT British Association of Sport Rehabilitators and Trainers
Question 1: How do you maintain accountability?
Answer: In terms of accountability for our registrants, there’s a CPD audit process, much like any of the other statutory bodies that you would imagine, and fitness to practice processes. What we’re actually doing is trying to take a preventative approach. So BASRaT is about to launch its own virtual learning environment in which we will put education free of charge out for our registrants to partake in. That education will be based on trends that we’re seeing in fitness to practice of issues that are arising. BASRaT as an organisation that is accountable to the Professional Standards Authority, we undergo regular reviews to ensure that we continue to meet their standards. Essentially, if we say we have a system and a process that we implement, they make sure that we’re doing that in the right way and that’s where BASRaT is accountable as well.
Question 2: What’s the pass mark?
Answer: It will fluctuate dependent on the questions.
Question 3: Could this exam be taken by graduates who are approaching, or who have just completed their degree?
Answer: Yes, as part of a pilot
Question 4: For those of us who graduated a while back, is there a recommended way to prepare and revise to take the BASRaT exam?
Answer: They are more than welcome to come and have a go at it as part of our data collection and pilot testing for new questions. They wouldn’t be sitting it for any purpose in particular at this point in time, because that’s not what it’s used for. But, we run pilots for newly written questions to check that they’re working as they should.
Question 5: When will MDT working and organisations working together be business as usual?
Answer: It’s happening in a lot of places already, and Connect Health has been one of the innovators in doing it. We see a lot of good MDT working in sport, and we see great MDT working in the MOD. When will we see a blanket across sectors and organisations? It requires quite a lot of bravery and quite a lot of innovation to actually do this, and it’s probably underpinned by lots of things that we’ve already talked about. An agreed standard, an agreed competency framework for different levels, etc so it does require development, but if there is a time to do it, the time is now. People just need to be bold in their thinking in order to take that on and follow the lead of other organisations that have done it as well.
Question 6: How can we get people in senior roles?
Answer: It’s tricky to from our perspective. How do we push people? A question we always get is how do we push people into advanced practice roles or FCP roles. Our position as a professional organisation is the MSK work, that’s where we fit, but I guess what that does is it frees everyone else up in terms of capacity within that workforce pathway to move people through.
Matthew Rogers, Head of Professional Development, The Institute of Osteopathy
Question 1: What are the next steps for osteopathy career pathways?
Answer: The next steps would certainly be to develop a project which looks at mapping all the career pathways that osteopaths could be involved with at the moment. Then it’s going to be looking at all of the competencies required for each different level of practice, whether that’s entry level or advanced practice or further afield, to try and demonstrate competency and reduce unwarranted variation across those different fields.
Question 2: When will MDT working and organisations working together be business as usual?
Answer: Having the sports therapist, the osteopathy practices and physios all working together and measuring the impact will be the benefit of them working together. The institute, from our point of view, provides consultancy, advice for any Trust that’s looking to encourage the uptake of osteopaths to support workforce supply in order to support that work. When I was employed in the NHS 15 years ago, there was one advert for an osteopath every two years. There’s now 30 or 40 new roles for osteopaths in the NHS advertised each month. I think that’s a sign that things are greatly improving, but it’s the work of organisations such as Connect Health who are really grasping the national strategies like the Long Term Plan and making it a reality with their MSK specialist roles rather than the role being related to a professional background. That’s going to make the difference.
Question 3: How can we get people in senior roles?
Answer: If you’re looking to get osteopaths into senior leadership roles, I think there’s two elements of it. Having ambassadors in the roles to demonstrate to osteopaths that they should consider applying for these roles and they will be accepted for interview for this sort of thing, and then raising awareness amongst providers and Commissioners that they should be considering including osteopaths.
In the application processes, some of the processes and adverts exclude osteopaths because they don’t mention that they’re looking for a General Osteopathic Council registered clinician. Osteopaths are regulated by the GOsC which is one of the nine UK statutory healthcare regulators, but that is often missed out of the essential requirements. They talk about the other registers but not the osteopathic registers. We need to be cautious of the language so that it doesn’t exclude appropriately trained and experienced clinicians.
Watch the webinar again, which includes further insight from the speakers including a full Q&A session, and read more about the speakers here:
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