Self Care Week – Take Control Of Your Back Pain

As part of National Self Care Week (14th – 20th November) Sussex MSK Partnership East, the local NHS service for muscle, bone and joint problems, is focusing on taking control of back pain. One of the biggest barriers for many people who suffer with chronic back pain is the fear that doing too much will make their problem worse. However, the advice from musculoskeletal (muscles, bones and joints) health professionals, including our Extended Scope Practitioners, is to keep active. When you have hurt your back, try to avoid bed rest beyond a day or so as inactivity can make you sore and stiff. The lower back is incredibly robust with strong bones, ligaments and muscles but these can become ‘out of condition’ if we don’t use them. The key to managing your back pain and looking after your spine is to realise that your back is strong, but it may be sensitive. Movement is the key to making it feel better. You should not be afraid to do everyday tasks, including lifting, but you may need to start off gradually. The Chartered Society of Physiotherapy has put together some myths and facts which may help you become more confident about […]
Event for GPs: Exercise & Musculoskeletal Medicine – The Way Forward

The British Institute of Musculoskeletal Medicine WINTER SYMPOSIUM “EXERCISE & MUSCULOSKELETAL MEDICINE – THE WAY FORWARD” DECEMBER 3rd 2016 Jurys Inn, Kings Road, Brighton BN1 2GS The meeting will not only focus on the concept of patient empowerment by the teaching of behavioural strategies to encourage both recovery from injury and the maintenance of good general or musculoskeletal health to the benefit of the individual and community resources but also where, how, when and by whom should MSK services be best delivered when homeostatic mechanisms break down and active intervention is required. 09:15 Introduction: “Phenotype Fit for the Future” – Dr. Rod MacDonald 09:30 Posture and Pain: The Alexander Technique – Carolyn Nicholls – The Alexander Technique is a sensory re-education, not a therapy. It can help people unravel the distortions of mind and body that may be contributing to chronic pain. How is it learned? What studies inform it? How can we help ourselves? 10:15 Novel Exercise Prescriptions to Promote Improved MSK Health in the Elderly – Dr. Shamim Akhtar – An introduction to the use of Taichi Shibashi for health and well being. 11:00 Coffee 11:15 Old Wine in New Bottles – NICE’s OA guidelines and what they mean in […]
DGH Physios Offer Specialist Exercises Classes for Ankylosing Spondylitis Patients

The physiotherapy team at Eastbourne DGH runs a support service for local people with ankylosing spondylitis. The condition affects over 200,000 people in the UK, which means that some 250 people in Eastbourne may have the condition. A key part of the service is the provision of a specialist exercise programme, developed by the National Ankylosing Spondylitis Society. DGH Physiotherapist Karen Kenyon said: “Our service focusses on helping patients to help themselves. We tell patients that, alongside their medication, exercise is the single most important thing they can do to help themselves as the fitter and more flexible they are, the better they can deal with stiffness and pain. “But lots of patients are unsure of what they can do and are scared exercise might make things worse, so we have developed a bespoke exercise programme for people with ankylosing spondylitis. The exercises can be done at home without any need for specialist equipment. “For those who need extra motivation, we offer two weekly self-help exercise groups at the hospital – one in the gym and the other in the hydrotherapy pool. The groups are run by a physiotherapist with a special interest in ankylosing spondylitis so patients can discuss any […]
Dr Simon Thorp joins Sussex MSK Partnership East

Sussex MSK Partnership East (SMSKPE) has appointed a new Clinical Director, Dr Simon Thorp, who joined the service on September 6. Simon is a consultant anaesthetist and pain specialist and is bringing his knowledge and experience to further develop pain services in this area, as well as providing clinical support and direction to Sussex MSK Partnership East’s clinicians and administrative staff. He has been working at Brighton and Sussex University Hospital for over 20 years. He is also an honorary lecturer at Brighton and Sussex Medical School and brings with him a wealth of knowledge in pain management, orthopaedics and anaesthetics. Simon said: “I am delighted to be joining SMSKPE. My first priority is to meet with GPs, consultants and Extended Scope Practitioners. I want to listen to their views about the service and act on any issues raised. “My next priority is education. I plan to set up teaching programmes with Health Education Kent Sussex and Surrey and provide education which fits in with the stream of learning already happening across the NHS. “I am committed to continuing to develop the service and make sure we work together to provide the best care possible for our patients,” he said. […]
Free Community Wellbeing Events launched in High Weald, Lewes and Havens

Sussex Community NHS Foundation Trust is introducing ‘Community Wellbeing Events’ which will run on a monthly basis across the High Weald, Lewes and Havens areas in East Sussex. The events are for local people to find out about support services that are available where they live. These include NHS groups, voluntary services, hobby and interest groups and more. The aim of the events is to help local people learn how to manage their health and wellbeing. • Find out more about local adult NHS community services and voluntary organisations/groups. • Obtain information on accessing a service. • Find out what community and specialist nursing teams do. • Find out about local groups and meet new people. For people interested in attending, simply just pop in – there is no need for you to book. On arrival please ask the receptionist for directions if you are unsure where you need to go. Monthly events will be held in Crowborough, Lewes, Newhaven and Uckfield . Further information is available at: http://bit.ly/2beGZ8Z
Local provision for people with pain conditions is changing

Sussex MSK Partnership East (SMSKPE) is the local NHS service for patients with musculoskeletal (MSK), Rheumatology and chronic pain conditions. We help people with diseases, injuries and pain relating to muscles, bones and joints. We are in the process of improving pain management services in EHS and HWLH CCGs What we offer now • Single point of referral through SMSKPE • Clinical triage • Choice between local providers for physiotherapy, psychoeducation, psychological support, medical intervention and psychological interventions What the full pathway will deliver • A single point of referral and clinical triage • Effective, evidence-based treatments with specialist clinicians • Support for GPs in their on-going care of patients especially those with long term conditions • Reduced waiting times for patients • Fewer referrals between providers How to refer patients for Pain Management • For new patients, please send referrals using eRS as per the standard SMSKPE process ( http://sussexmskpartnershipeast.co.uk/health-professionals/referral-process-guidelines/) • For patients who are already known to have a pain management concern and who require further review, please send referrals using eRS as per the standard SMSKPE process • For queries, please call our Patient Care Advisor Team on 0300 300 0003. We welcome your comments and involvement […]
Five Tips for Managing Foot Pain or Discomfort When Cycling

Graeme Hadlow is a past age group national duathlon champion, time trialist and third cat road racer. He has a special interest in cycling biomechanics and is currently working as a Podiatrist and Extended Scope Practitioner (Foot & Ankle) for Sussex MSK Partnership East. He advises the following tips to optimise cycling biomechanics. Always stop if changes are painful and see an expert if you are concerned. 1. Check your shoes We all know our foot size, but our feet often become wider as we age owing to changes in the joints, such as bunions. If we use shoes that are too narrow, compressive forces during the cycling downward or main power phase, from the shoe upper may rub against our toes causing blistering, inflammation or potentially ingrown toenails. It may also result in poor ability of the toes to firmly plant upon the base of the shoe to offer optimal stability and force during the down stroke. Over time small muscles in the foot can become weak leading to clawed toes, which can lead to overloading the ball of the foot and pain. Self-check: Take the insole liner out of your shoe and stand on it, raising your heel […]
Anyone for Tennis?

Tennis is a great way to keep active and can be played by people of all ages. But if it’s been a while since you last picked up a racquet, Steve Daly, Extended Scope Practitioner, has a few tips to help you enjoy your new found hobby without hurting yourself. Warm up and start off slowly As with any form of exercise or sport, it’s important to warm up your body gradually. Starting off gently gets the blood pumping to your muscles, increasing the flow of oxygen and preparing them for activity. This is particularly important for a sport like tennis which involves lots of sprinting, leaping, stretching and pivoting. These abrupt movements put a lot of sudden and unaccustomed pressure on muscles and ligaments and can cause the tissues to tear, but muscles that are warmed-up are more pliable and therefore less prone to injury. Tennis elbow is the injury that everyone’s heard of but elbows are not the only tennis injury. Ankles, knees, shoulders and wrists are all prone to injury if not warmed up properly. It’s important to do some gentle stretches to the muscles around all of these joints and also practice things like hopping and […]
Free training course for GPs, nurses and clinical staff only. Not open to the general public.

SHARING DECISIONS, COMMUNICATING RISK Date: Wednesday, June 15, 9.00-16.30 Venue: Ivy House, Ivy Terrace, Eastbourne Trainer: Dr Malcolm Thomas, EPI “Highly relevant to our service and to my clinical practice.” Dr Peter Devlin, Portslade GP and Clinical Director, BICS Shared decision making is all the rage. Except that we often have a “best buy” suggestion to make to patients, and likewise most patients quite like the doctor or nurse to give them an opinion. However, many chronic diseases and some more acute situations have two or more valid treatment options, and in these situations we need the patient’s input in order to reach a decision that is adequately shared. The benefit is that patients who feel involved in decisions are more likely to follow the plan. Sharing decisions, communicating risk is a full day seminar that: · Rehearses the “best buy” skills that increase effectiveness and reduce medico-legal and clinical risk · Uses a skills framework for improving consultations · Involves practical exercises · Includes lunch and refreshments · Counts for six hours CPD The course comes highly recommended by health professionals in Brighton where it has run several times during the last year. It is […]
Q & A with Mr Satish Ganesan

Mr Ganesan is a Consultant Trauma and Orthopaedic Surgeon with East Sussex Healthcare NHS Trust and a Consultant with Sussex MSK Partnership East’s Spine Service. He has a specialist interest in adult degenerative spinal disorders. What is your role with Sussex MSK Partnership East? I provide a service for patients with neck and spine conditions that need investigation and/or treatment by a specialist spine surgeon. Since October last year I have been running a regular clinic at Sussex MSK Partnership East’s Community Clinic located on Wartling Road, Eastbourne. What are the advantages of seeing patients in a community setting rather than in hospital? It’s a nicer setting – much smaller than the hospital, less crowded and therefore easier for patients to find where they are going, so many find it less stressful. There’s the added bonus that they don’t have to pay to park. Although one or two have been a bit surprised to see a Consultant Surgeon out of a hospital setting, in general they seem to appreciate the convenience of having an appointment closer to where they live or work. At what point in the patient’s journey do they see you? Most of the patients I see in […]
New Foot and Ankle Specialist at Sussex MSK Partnership East

Graeme Hadlow is an Extended Scope Practitioner within the new Foot and Ankle Service at Sussex MSK Partnership East (SMSKPE). His role is to assess and manage patients who have been referred to the foot and ankle service because first line interventions have been unsuccessful or there is diagnostic uncertainty. As an ESP Graeme is qualified to request appropriate diagnostic imaging, blood tests and carry out procedures such as guided injections and referrals for surgery when necessary. This means that most patients can be treated in a community setting rather than having to go to hospital. There are many advantages for the patients who are seen in a community setting through the SMSKPE pathway, rather than in hospital. Graeme said: “Patients will be seen quickly and usually conveniently closer to their home or workplace. They receive expert evidence-based opinions from clinicians who have access to investigations including x-ray, ultrasound and MRI. This service model provides a good patient experience, is cost effective and can reduce the waiting list load upon hospitals and staff. It’s a one stop shop service for MSK patients.” Alongside his role with SMSKPE Graeme is a clinical MSK lead for the podiatry team for East Sussex […]
New clinic for muscle, bone and joint conditions opens in Hailsham

A new clinic has been set up at Quintin Medical Centre in Hailsham by Sussex MSK Partnership East, the local NHS service for patients with bone, joint and muscular problems. Patients have a 30 minute appointment with a specialist clinician known as an Extended Scope Practitioner (ESP). ESPs are physiotherapists who have advanced knowledge of musculoskeletal problems and work closely with orthopaedic, rheumatology and pain consultants. One of the first patients to be seen at the new clinic in Hailsham was Christine Ann Patrick who lives in Polegate. She has been having problems with her neck and shoulder following a riding accident last year and was referred for further investigation by her GP. She said: “After my GP referred me I expected to have to wait for ages and then go to the hospital in Eastbourne. But my appointment came through very quickly and it was very easy to get to Hailsham. It is also a lot more relaxing to come to a lovely medical centre like Quintin than attend a hospital clinic. “I had a half hour appointment with Matt Daly, Extended Scope Practitioner, who was extremely helpful and I feel reassured that I am getting the right advice […]
Sussex MSK Partnership East Appoints New Clinical Director

Dr Ragnar Ingvarsson, Consultant Rheumatologist, has been appointed as Sussex MSK Partnership East’s Interim Clinical Director. Ragnar’s role is to provide clinical support and direction to the Partnership’s clinicians and administrative staff. Speaking about his appointment Ragnar said: “This is a real opportunity to develop new ways for clinicians in the local health community to work together for the good of our patients. I am particularly keen to provide a support service for GPs so that they can always get prompt advice and guidance on any MSK matter. I am already offering this for Rheumatology and am working with specialists from other disciplines to help them offer a similar service.” Another key project is to put in place a framework to support Extended Scope Practitioners with education and training to maintain competency and develop further skills. Alongside this, Ragnar plans to create a “hotline” that Extended Scope Practitioners can call for a quick response during a patient appointment. Ragnar commented: “There are times when an ESP may want a quick bit of advice or to ask a question of a specialist before making a decision about the patient’s next steps. If this can be resolved there and then, the patient […]
New Leader For Sussex MSK Partnership East

Sussex MSK Partnership East has appointed Geoff Bailey to the role of Managing Director. He takes over the reins from Interim Managing Director, Stephen Cass. Geoff has 30 years’ experience in the healthcare sector, most recently with Nuffield Health where he headed up its Brighton Hospital. He was previously based in Berlin as Head of Global Marketing for the pharmaceutical firm, Bayer. Although his career has taken him all over the world, Geoff grew up in Sussex and is delighted to have the opportunity to develop healthcare services in parts of his home county. He said: “I am joining the Partnership at a very exciting time. A lot of hard work has gone into creating the structure of the service so this next stage will focus on refining and development. Key areas are working with providers to cut waiting times and opening more clinics in the community so that patients can see specialist MSK practitioners closer to where they live.” An early priority for Geoff is engaging with patients and the people who work in the local health community. He said: “I am looking forward to getting out to meet our patients and the health professionals who care for them. […]
Introduction of PROMs and PREMs to Measure Patient Experience and Outcomes

We have recently started measuring patient experience and outcomes (PROMs and PREMs) to help us evaluate the effectiveness of our service from the patient’s perspective. For the PROMs, we are using the new Arthritis Research UK Musculoskeletal Health Questionnaire. Our experience will contribute to the joint NHS England/Arthritis Research UK trial. Once patients have been referred to us and given an appointment to see a clinician, they are asked to complete a PROMs questionnaire. The questions focus on how the condition is affecting their quality of life and provides a benchmark for comparison. The patient will receive a follow up PROMs questionnaire three months after discharge (six months if they have had surgery) so that we can measure how beneficial the patient feels their treatment has been. We are also measuring the patient’s experience of their journey through the service – from their initial appointment with their GP right through to discharge. Once patients have been referred and received their first appointment with a clinician, they are asked to complete a PREMs questionnaire: Were they given enough information? Did they feel involved in decisions? Did they understand the proposed treatment? Were they able to ask questions? Was the waiting time […]
New Consultant Leads Rheumatology Service Development at Sussex MSK Partnership East

We are delighted to welcome Rheumatology Consultant Dr Ragnar Ingvarsson to Sussex MSK Partnership East. He is dividing his time between the Partnership and Eastbourne DGH’s Rheumatology department, where he is running regular clinics. A key part of Ragnar’s role with Sussex MSK Partnership East is to help redesign Rheumatology services. All Rheumatology referrals to Sussex MSK Partnership East are now reviewed by Ragnar, which helps to ensure that patients are offered appropriate treatment for their condition as soon as possible. Over the coming months Ragnar will be setting up Rheumatology clinics out in the community so that local patients can be seen, diagnosed and offered the treatment they need more quickly and closer to where they live. Ragnar began his medical studies in his native Iceland and went on to complete his training in Sweden. His most recent post was Consultant Rheumatologist at Lunds University Hospital in Sweden. He has a specialist interest in Systemic Lupus and is leading a research project on its epidemiology in southern Sweden. When he is not working Ragnar can often be found in the kitchen. An accomplished amateur chef, he has written two cook books and presented his own show on Icelandic TV […]
Update on MSK, Rheumatology and Pain Management Services

Sussex MSK Partnership East now provides a full service from referral to discharge for patients with hip, spine, knee, shoulder and elbow conditions. This means that patients will usually be referred to an Extended Scope Practitioner (ESP) specialising in their particular condition who will determine the most appropriate care pathway, which may include self-management, physiotherapy, surgery or a combination. The multi-disciplinary approach means that patients are assured of getting the most appropriate treatment in a timely manner. Our aim is to make your patient’s care as straightforward as possible, by providing one point of contact and endeavouring to treat them closer to their homes. ESP and community clinics for foot, ankle, hand, wrist, pain management and rheumatology services will be launched by the end of the year but patients with these conditions should still be referred to Sussex MSK Partnership East and we will triage and refer them to an appropriate local service or consultant. Since the launch of the service, Sussex MSK Partnership East Extended Scope Practitioners have seen 1,696 patients between April and July. The Sussex MSK Partnership East Clinical Referral and Assessment Service has received and processed 11,908 referrals in the same period.
Education Session on Referring Patients with Lower Back Pain

Extended Scope Practitioner (ESP) Matthew Carr, who specialises in spinal conditions, was invited by the Meridian Surgery in Peacehaven to give an education session on lower back pain to the GPs and practice nurses. His talk covered the taking of a subjective history, exploration of serious pathologies and making accurate and concise objective assessments. He also touched on psychosocial factors and how behavioural patterns associated with pain can be assessed and managed. Matthew commented: “Some 30% of GP appointments are for MSK related conditions and of those, around 40%-50% are for back pain. That’s a significant proportion of a GP’s workload, so most doctors and practice nurses have a lot of experience in this area. However, having just 10 minutes to assess a patient can be a challenge – this includes taking a subjective history as well as carrying out an objective assessment – so my aim was to provide some tips and tools for assessing a patient in a short time frame and determining the next steps for making an appropriate referral.” The group discussed serious pathologies, including referral of suspected Cauda Equina and how to rate the level of concerns of different red flags, which ones – or […]