31 March 2015
Improving the management of osteoarthritis in general practice in the West Midlands through the implementation of key innovations – OA e-template; patient led self-management resources and practice nurse consultation.
Osteoarthritis (OA) is the commonest musculoskeletal condition in older people. NICE guidelines (NICE, 2014) prioritised core interventions: access to information and advice; exercise and physical activity; and weight loss (if overweight). Despite clear guidance on supporting patients in self-management, these guidelines have not been systematically implemented or audited against national standards. An implementation project in Shropshire CCG has built upon the findings from the MOSAICs research programme at Keele University. addressing the unmet needs of patients and healthcare professionals in the management of primary care for OA. The person-centred care theme is now able to offer the learning and toolkit from this pilot project across the West Midlands.
This programme encompasses:
This innovation will support primary care in addressing the unmet needs of adults consulting for OA. This will be achieved through the provision of innovations to support the systematic implementation of the NICE 2014 guidelines for OA at practice level. Practices have identified orthopaedic referrals as a high volume area and wish to adopt a NICE-recommended model of primary care for OA as an alternative to the more traditional pathway of x-ray, diagnosis, referral and joint replacement. Proactively managing OA improves the quality of care for patients, may reduce the incidence of arthroplasty and will improve outcomes following arthroplasty. The aim is to enhance patients’ quality of care without reverting to surgical treatment unless all core options have been explored.
This project aims to implement a model of supported self-management for OA, reduce clinical variation through the use of the OA e-template, train “trainers” to spread the adoption of the model OA consultation, and evaluate the impact of this at practice level and through patient audit of quality care.
The project seeks to deliver the following improvements:
The success of the innovation can be evaluated in a number of ways, including:
Rhian Hughes, Krysia Dziedzic and Helen Duffy
t: 01782 733976