Training a whole Musculoskeletal service in Cardiff and Vale University Health Board

People with persistent joint pain often struggle to take part in work, physical activity and leisure. Musculoskeletal (MSK) conditions currently affect around 17 million people in the UK and are recognised as a leading cause of disability. They account for 14% of all General Practitioner (GP) appointments and result in approximately 10.8 million lost working days annually. The financial burden on the National Health Service (NHS) is substantial, with MSK conditions costing around £5 billion per year.

Bridges can make a difference for people living with joint pain or musculoskeletal conditions, by helping practitioners to integrate effective self-management support into their practice. Practitioners can also change the way they are working and feel less pressure in what are known to be busy, high-pressure environments.

Bridges has been working with Cardiff and Vale University Health Board on a large-scale quality improvement project to embed self-management support across Musculoskeletal services. 130 practitioners completed the Bridges Self-Management training, accessed our sustainability support, and were offered innovative tailored Refresher Sessions 18 months after they finished their training.

What was the impact?

Bridges practitioners completing the training:

• Felt more confident in having more difficult conversations with the people they were working with, through active listening and effective language. This supported personalised goal setting and a more equal partnership between the healthcare practitioners and the people they were working with.
• Confirmed they got to the heart of what matters most to the people they work with more quickly, reducing the need for multiple follow ups and therefore increasing their capacity as a service to treat more people.
• Noted how the small steps they were making to elevate their practice had a knock-on positive effect on the people they were working with to feel more empowered and confident to recognise their strengths in managing their health condition.
• This led to better engagement with the health care practitioner’s advice, this was noted particularly when health and care professionals were working with people with more complex and multiple concerns/problems.

Sustainability

A key learning from this transformational workforce project was recognising what sustains and spreads Bridges impact.

• Consistent visual and verbal reminders that became integrated into a “way of working” was the most effective way for Bridges to be implemented and sustained in practice.
• Bridges Champions’ engagement in sustainability activities such as our peer coaching, termly and refresher events served as opportunities to reflect on their implementation of this approach so far, and to hear from other practitioners about ways they are implementing Bridges to make it “business as usual” in their teams. 
• The level of engagement in the sustainability activities offered by Bridges was central to the widespread adoption of this approach across teams and services.

The additional support we offer to embed and sustain this way of working across services has far reaching impact for effective and efficient use of services, staff morale, professional fulfilment and that patients and families feel listened to, and more confident and in control of managing their health conditions.

Testimonials

Hear from Laura: ‘it gives me more time’

Our work across MSK pathways is running alongside our development of a co-designed Bridges book for people living with joint pain. This book, alongside new refined healthcare professional training on self-management for individuals with joint pain, is being used in a NIHR funded, randomised controlled trial run by Cardiff University called the TIPTOE study, which is testing the effectiveness of this intervention.