We are delighted to announce the launch of Sussex MSK Health Brighton & Hove and West Sussex, our brand-new Musculoskeletal (MSK) service, which officially begins today – 2nd December 2024.

This launch marks a new chapter in delivering joined-up, person-centred care. Together with our partners Sussex Community NHS Foundation Trust (SCFT), we’re building on over 10 years of expertise in designing and delivering innovative long-term conditions services, including CQC outstanding MSK care. 

A new era of integrated care

The new community service covers Brighton & Hove and West Sussex, replacing Sussex MSK Partnership Central (SMSKPC), University Hospitals Sussex (UHSussex) and Coastal Sussex Integrated MSK Service (CSIMS).

Key highlights of our approach 

• Integrated care pathways: We connect primary, community, and secondary care, creating seamless experiences for orthopaedics, pain management, and rheumatology. 

• Patient-first design: Our care begins with meaningful “what matters to you” conversations, empowering people to make informed decisions about their health. 

• Equitable access: From digital self-management tools to flexible in-person and virtual appointments, our service adapts to meet diverse needs. 

• Improving outcomes: Focusing on reducing health inequalities, we ensure timely, high-quality care for all. 

What sets us apart 

• 10+ Years of quality: Building on a decade of pioneering MSK care, we have consistently delivered high-quality, patient-centred outcomes. 

• Collaborative innovation: Our partnership with SCFT exemplifies integrated working across the NHS and beyond. 

• Ambitious vision: This service is part of a five-year transformation programme, aligning with Sussex’s health strategy, Improving Lives Together.

Why it matters 

Musculoskeletal conditions are one of the most common long-term conditions in the UK. Affecting one in three people and significantly impacting their quality of life and independence.

As specialists in long-term condition care, we understand the importance of creating services that are easy to navigate, responsive, and effective at supporting people to live well. 

We’re proud to be shaping the future of MSK care, ensuring that everyone in Brighton & Hove and West Sussex has access to exceptional, personalised support. 

To learn more about our approach and the impact we’re making, visit Community MSK Services in Sussex – Here

As we approach the conclusion of the Sussex MSK Partnership Central (SMSKPC) service, we’re taking a moment to celebrate the extraordinary journey we’ve shared.

Over the past decade, this partnership has been more than a service – it’s been a community, a purpose, and a shared commitment to making a real difference in people’s lives.

To mark this special occasion, we’ve created a series of videos that highlight the many achievements of SMSKPC and the incredible people who’ve made it all possible. Each focuses on a key aspect of our journey, showcasing the impact and the values that have defined our partnership.

Celebrating 10 years together 

Our first video takes us back to May 2024, when we celebrated ten years of SMSKPC at our annual conference. This event marked a special moment for us – a chance to look back on all that’s been achieved, and to recognise the people who’ve made it possible. 

Over the past decade, it’s been our team’s commitment and shared purpose that have shaped our success, and May’s celebration was a reminder of just how much we’ve accomplished together.

Making an Impact Person to Person 

This video shines a light on the tangible difference our service has made to people and our communities – it’s the personal connections that have been at the heart of everything we do.

Showcasing the positive feedback and gratitude of those who’ve benefited from our service, these stories of care and support truly bring our partnership’s impact to life.

Living Our Values 

It’s the culture that has defined our service – a culture built on strong relationships, shared values, and a deep commitment to patient care. The camaraderie, teamwork, and dedication of our team highlight the connections that have shaped our partnership and made it more than just a service, but a community. 

From the kindness shown in small gestures and moments of support to the collaborative efforts that have made a big difference – and the friendships formed along the way – this video is a chance to honour everyone who has contributed to delivering SMSKPC.

Each individual’s hard work, passion, and care have made this service possible.

A celebration of togetherness 

As SMSKPC comes to a close, this series is our way of looking back with pride and gratitude. We’ve come so far over the last 10 years, and it’s all thanks to the incredible individuals hard work, passion, and care have made our service possible. Together, we’ve built something truly special.

We hope our work inspires others to see the power of community, the importance of shared purpose, and the enduring impact of truly personalised care.

Thank you to everyone involved in being part of this incredible story. 

Stay tuned as we celebrate this final chapter of the Sussex MSK Partnership Central journey and say hello to MSK Health.

Earlier this year we commissioned an evaluation of our Community Appointment Days.

Laura Finucane, Clinical Director at Sussex MSK Partnership Central shares her reflections on the evaluation.

Why was it important to have this evaluation?  

When we commissioned this evaluation, our main goal was to get an independent and fresh perspective on what we had already observed. We needed an objective review to validate our findings and to dig deeper into the data – helping us to see what might have been overlooked.

Most importantly, we wanted to assess it all through the lens of health inequality, ensuring our work is truly making an impact where it’s needed most.  

The value of independent scrutiny  

One of the key purposes of this evaluation was to keep evolving. We wanted the data not only to validate what we were doing, but to inform and improve future Community Appointment Days (CADs), strengthening the overall offer.

This has been an invaluable process, continually shaping how we support our community. 

What have we learned?

A significant shift we’ve made is moving our health hub to the front of the patient journey. This simple change led to a dramatic increase in screening for blood pressure and diabetes – a real success in terms of uptake. But the evaluation also revealed some gaps, like the fact that many people weren’t engaging with the information provided. So, we’ve now placed extra resources on stewarding, helping guide people right from the front door.  

Data has become a powerful tool for us, highlighting areas that need further attention and helping us plan the next steps. We’re seeing the importance of exploring longitudinal data to understand long-term outcomes. And one key takeaway? Both people attending and staff have really valued the service, with many staff members appreciating the chance to step outside their usual routine and connect more deeply with people and colleagues.  

Importantly, this evaluation has paved the way for new initiatives, particularly in tackling health inequalities. We’re now focusing on reaching those who don’t typically engage with services, ensuring that our approach is as inclusive as possible. 

Applying our findings to future work  

Looking ahead, we’re keen to build on what we’ve learned. Our current model was developed with patients on waiting lists in mind, but our future plans aim to offer CADs as the first touchpoint in a person’s health journey with us. We believe this early intervention will help people understand what to expect and get the support they need sooner.  

We’re also strengthening our collaboration with the voluntary and community sector, ensuring our offer truly reflects the needs of our local population – and we’re using data to guide us every step of the way. 

Laura’s reflections on the project  

This project started with a bold vision in 2022, alongside Natalie Blunt, Managing Director of Sussex MSK Partnership Central.

We took a risk in trying something different, but with the focus on what matters most to people who access the service– staff thought we were a bit mad at first – but gradually, they came on board. Initially, there was a temptation to simply ‘lift and shift’ hospital services to the community, but we knew that wasn’t the right approach.

What we needed was a more radical change, and our staff fully embraced that challenge. 

The CAD continues to evolve, change and works because of the enthusiasm and dedication of the team. This has only been possible because of that commitment and the team effort. 

It was the culture of the organisation that allowed us to take those risks and pushed us to think outside the box. We were supported every step of the way.

For me, one of the biggest takeaways has been the sheer joy of working with our staff in such an engaging and inspiring way.

This journey has been full of learning, growth, and joy, and it’s something we’re all proud of.

You can read the Evaluation Summary or download the full Review and Evaluation document here.

We’re delighted to publish the Sussex MSK Partnership Community Appointment Days Evidence Review & Evaluation, and share our learnings.

As a not-for-profit, we’re always focused on learning from our work and pushing to improve our services, ensuring exceptional care reaches everyone. This review highlights the tangible impact CADs are having on MSK care delivery and reveals key insights that will help us build on this progress. 

One of the standout successes of the initiative has been the rise in Patient-Initiated Follow-Up (PIFU) rates. More than 50% of CAD attendees opted for this approach, a significant increase compared to the 12% seen in other services. Although national evidence on PIFU’s effectiveness is still emerging, these figures suggest that CADs are making a real difference in promoting long-term self-management.

How are Community Appointment Days making a difference? 

• Supporting self-care: Over 50% of patients who attended CADs were able to move to self-care after just one session, reducing the need for ongoing clinic visits. 

• Boost in Patient-Initiated Follow-Up (PIFU): More than half of CAD attendees opted for PIFU, compared to just 12% in other services. This shows that patients are taking charge of their long-term care. 

• Overwhelmingly positive feedback: Patients and staff alike have praised the expert advice, personalised care, and collaborative environment that CADs offer. 

Helping to manage waiting times 

Although CADs weren’t specifically designed to reduce waiting times, we’ve seen another benefit: they’ve helped us keep waiting lists stable, a big achievement given national trends of increasing backlogs. 

Read evaluation in full 

We’re excited to share these findings with you. You can download the complete Evaluation Review and Report and dive into all the details. 

If you’re thinking of starting your own Community Appointment Days, check out our Essential Ingredients guide for tips on how to get started.  

Curious about how CADs work? Read more in our blog series:

• Community Appointment Days – An idea that rapidly turned into an innovation
• Community Appointment Days – What makes them tick
• What if we made community powered health, for everyone

Evaluation overview

Support for self-management: 

• CAD effectiveness: The initiative has significantly improved patient self-management, with over 50% discharged to self-care after just one CAD appointment. This suggests a reduction in the need for multiple follow-up appointments, potentially easing the burden on downstream clinics. 

• PIFU outcomes: CAD patients had a much higher rate (over 50%) of Patient Initiated Follow-Up (PIFU) as an outcome compared to other services (12%). Although the evidence base for PIFU’s effectiveness is limited, the higher rate in CAD indicates a positive impact on long-term self-management.

Patient experience: 

• Positive feedback: Patients reported overwhelmingly positive experiences, especially regarding face-to-face expert advice and personalised care. Despite some operational concerns like waiting times, patients felt involved and heard, meeting the initiative’s goal of enabling active participation in care.

Staff experience: 

• Professional development: Staff enjoyed the CAD events, appreciating the opportunity to spend quality time with patients, understand their needs, and provide tailored advice. The collaborative environment also fostered a sense of collegiality. However, there were some negative comments about operational issues, such as workflow and IT challenges. 

Adoption and attendance: 

• Good adoption: High conversion rates from invitations to attendance indicate strong adoption of CAD across different areas. However, attendance variations by age group suggest barriers for working-age adults, who may benefit from more advanced information and preparation. 

Exploration of broader health issues: 

• Broader services: Feedback indicates that CAD attendees could explore broader issues affecting their musculoskeletal (MSK) conditions giving people the opportunity to access support from other health and wellbeing services.

Impact on equity: 

• No perpetuation of inequalities: Analysis by age, gender, and deprivation suggests that the CAD initiative does not exacerbate inequalities. However, higher DNA (Did Not Attend) and cancellation rates among working-age adults indicate accessibility issues for this group. 

Waiting Times Impact:

Stable waiting times: The CAD initiative was not specifically designed to reduce waiting lists, but has shown a potential positive impact. From January to May 2024, the waiting list for Sussex MSK Partnership remained stable, while national trends show increasing volumes. Sussex MSK has also reduced the number of patients waiting over 18 weeks, outperforming the national average. Although a direct causal link between CAD and waiting list reductions cannot be confirmed, timing correlations and qualitative findings suggest a positive influence.

Potential long-term effect: Further analysis is required to determine CAD’s long-term impact on waiting times, but current patterns, combined with low Patient Initiated Follow-Up (PIFU) rates, indicate that CAD may contribute to sustained reductions if the initiative continues.

Limitations and recommendations: 

• Data and methodology limitations: The report is based on limited data from six CAD events without a comparator group. Longitudinal data and independent qualitative data collection are recommended for a more robust evaluation. 

• Key recommendations: 

• Commission independent qualitative data collection and follow-up with non-attendees. 

• Link CAD attendee data to primary and secondary care records to assess service utilisation. 

• Refine data on PIFU usage by CAD attendees, stratified by key demographics. 

• Maintain records of review and learning activities related to CAD and implement operational improvements. 

Background on MSK care: 

• Growing demand for MSK care: MSK conditions are a leading cause of disability in the UK, significantly impacting individuals and the healthcare system. The CAD initiative in Sussex aims to address these challenges by providing a comprehensive, integrated care model in a community setting. 

Conclusion: 

The CAD initiative has achieved its goals of improving patient self-management and staff engagement. There are opportunities for further operational improvements and more comprehensive data collection to enhance future evaluations.

Download the full Community Appointment Days Evidence Review & Evaluation PDF

If you’ve looked at our work at Here and you think we’d make a good partner for your next project or you’d like to share ideas, we’d love to hear from you. 

To get in touch email: collab@hereweare.org.uk 

The importance of personalised care

Personalised Care Week, organised each year by the Personalised Care Institute, is always an opportunity to talk about personalised care – what it is and why it matters.

In many ways, it is extraordinary that in modern health services we need to. After all, what could be more personal than health? What other service needs to be so uniquely tailored to your life?

The decline of individualised healthcare

But over the past century, healthcare has been less individualised – as we focus on better science and better efficiencies, healthcare has become less personal, more remote, and much more transactional than ever before.

In the late 20th century, when New Public Management approaches grew, the NHS, like many organisations, sought to make sure they used their skills, capabilities and resources to the best effect for our populations. So far so good, perhaps.

Except key elements of the market approach fall down in healthcare.

Efficiency and productivity vs. personalised care

In the last few years, conversations about health and care have been resolutely focused on the pressures and demands.

We have been more focused on efficiency and productivity than ever before. And it is impossible to conclude anything other than this is not working.

We are better at pathways, better at flow, have better medicines, more skilled clinicians, better hospital sites. But the health of our nation is failing, and in the words of our own health secretary, the NHS feels broken.

At the heart of this we find an issue illuminated by the language of design – we have fallen in love with solutions, rather than the problem.

With 80% of the determinants of health sitting outside of healthcare services, our focus on better tech, quicker care, slicker pathways may be misguided. In fact, we may be increasing demands – both on services and on the people who receive them.

The role of personalised care in treating multi-morbidities

So Personalised Care Week is a good time to remember this, especially as we focus on multi-morbidities. If you are living with two or more long-term health conditions (like 15% of the population), nothing will be more important than someone taking the time to understand what will improve your health, and how treatment can fit your life.

To deeply understand rather than assume what the problem is, by spending time with those affected. These insights lead to very different definitions of what the challenges are, unlocking solutions that will allow us to tailor healthcare for each and every one of us.

Hospices have always formed part of my landscape. For a time in Sydenham, St Christopher’s was my next door neighbour, where I grew up in Cornwall, our little back lane now leads to the beautifully designed and uniquely delivered Little Harbour, and I now drive past the stunning new build of St Catherine’s on my way back and forth to my office.  

As a healthcare professional, I have long been inspired by the way palliative services resolutely embody the very best of personalised care – with a relentless focus on living, on what is important, on what matters to you and those around you as life comes full circle.  

Supporting the hospice sector

Watching the challenges in the hospice sector over the past year has been heartbreaking when you see so clearly the powerful work they do, both to individuals who need their love and care, and to systems who need training, reminders, and inspirational examples of how care can and should be different.  

As an organisation Here’s purpose is ‘Exceptional care, for everyone’. We deliver services, but over the years we have also developed offers to support others to deliver exceptional care.

Our focus on data and analytics has long underpinned our innovative services.

Partnering with St Gemma’s Hospice

When we work in partnership we seek likeminded organisations, and it is no surprise that we have started to find these in the hospice sector. We feel privileged to support the work of St Gemma’s Hospice and to share our learning in this new partnership.

In our work with St Gemma’s, we want to bring the full breadth of our experience into the partnership. We will provide a mixture of infrastructure (a cloud-based data warehouse, Power BI), coupled with analytics and other technical expertise.  

Our goal is twofold: to streamline St Gemma’s existing reporting processes for greater efficiency, and to harness data-driven insights to better quantify and demonstrate their impact.

By harnessing this data analytics work, we want to help other organisations work more efficiently, empowering them to provide exceptional care not only to the people they support but also to the dedicated staff who deliver care.

Think we could support your organisation? Feel free to get in touch at collab@hereweare.org.uk if you’d like to discuss working in partnership with us.

Our work at Here focusses on bringing together service improvement, lived experience and data.

Last June we joined the Sussex Health Equity Fellowship, a brand new programme created by Sussex Health and Care and partnered with Kent Surrey Sussex Academic Health Science Network.

We were extremely keen to be involved and were thrilled that of the eight places offered two of our team were accepted onto the programme.

Fern Bolwell, Learning Lead and Tom Golden, Business Intelligence Analyst at Here both took part in the programme. We felt that having people from both an operational and data and a analytics perspective would of huge benefit due to how equity learning could be used by these different skills areas.

In this blog, Fern shares her more about the Fellowship and reflects on what both she personally and us as an organisation have learned from the experience.

What is the Health Equity Fellowship? 

The Health Equity Fellowship is a nine-month programme delivered by NHS Sussex and Health Innovation Kent Surrey Sussex. The programme aims to equip participants with the skills and knowledge to become key change agents within their organisations, promoting a focus on equity and reducing health inequalities. 

The Fellowship is delivered through a mixture of lectures, webinars, action learning sets, mentoring and connection to each other’s knowledge and experience. Alongside this, Fellows complete a work-based project with a goal of improving health equity.

‘We know that our society is not fair and equitable, and many people face

 

 

 

systematised and institutional discrimination and cannot thrive in the conditions in which they live. We recognise the structural and cultural inequalities that are embedded in our wider society, and that this impacts our work in health and care. We recognise the inequities in the healthcare system and we want to work to address those.’ 

I have always been passionate about justice and fairness in society and ensuring everyone’s voices are heard and acted on. My professional goal is to realise this mission through the work that I am doing with Sussex MSK Partnership and ensure that health equity is always considered in each decision for the patients who need it most.  

For me the opportunity to be a part of the Fellowship came at a key moment of change for the Sussex MSK Partnership as we looked to the future and worked on how to deliver healthcare differently.

What skills did we bring?

Sussex MSK Partnership had already set aside dedicated project groups to focus on health equity. This work has been divided into 3 workstreams – Data, Staff Support and Community.

I work across each project group and was able to see where each intersected and supported the other. We first focused on an evidence-based approach through both community outreach and data gathering to ensure the changes we make, make a difference where it is most needed.

The way we work at Here meant we were able to be agile and encouraged to be innovative and forward thinking in approaches to delivering healthcare. 

What have been the results? 

The Health Equity Fellowship gave me the opportunity to grow my capability in population health, innovation and evaluation. My understanding increased in applying an equity lens to change initiatives. As well as expanding my network and connecting me to experts in a wide range of relevant areas.

Following the fellowship, I presented at Sussex Partnership Foundation Trust and Sussex Medical School’s Anti Racism event to showcase our work at Sussex MSK Partnership. 

I felt truly inspired by the dedication of the team leading the Fellowship and emboldened by their hope, even when honestly discussing the real challenge and shocking impact of inequity and prejudice.  

During the 9 months of the Fellowship I was able to work on: 

• Community Appointment Days (a patient journey offered in the community alongside VSOs).  

• Improving our data capture and reporting to be able to see, at a glance, differences between access, experience and journey of different groups of patients.

• Used our data to inform where we should be supporting our community, through this evidence, we connected with Crawley Asian networks. 

• Shared the learning from the fellowship and delivered training for all Here colleagues on health equity. 

• Simplified the interpreter booking process to address inequity.

• Created a new process to ensure patients with adjustments were flagged on our systems so that we can proactively support their needs.

What is our learning and what are we taking forward from this? 

The Fellowship experience has extended my confidence, competency and language to challenge and advocate for health equity in projects, process, the workplace and the wider world. 

I actively seek out to surface where there are challenges for patients and colleagues based on protected characteristics.  focused on fixing, improving and most importantly sharing the learning and awareness for future prevention of inequity.

I am grateful to those who speak up and teach me. It has shifted my vision to a world where I am no longer blind to inequity. 

Earlier this month Sussex Health and Care Fellowship held a webinar to share more information about the programme, Fern was invited to talk and share her experience – you can watch it in full below.

How can you get involved?  

The Sussex Health Equity Fellowship is now recruiting for a new cohort of Fellows – details on how to apply are below. 

1. Health Innovation KSS website: https://healthinnovation-kss.com/news/sussex-health-equity-fellowship-opens-for-applications/ 
2. LinkedIn: https://www.linkedin.com/feed/update/urn:li:activity:7224325761082552320
3. Twitter: https://x.com/HealthInnov_KSS/status/1818563477654417445
   
4. Applications close on 2nd September 2024, 11:59pm

PRosPer – Long Term Conditions eLearning course has just launched, featuring a case study highlighting the impact of Community Appointment Days.

Sophie Wickins, Clinical Project Manager at NHS South, Central and West (SCW) approached Georgi Daluiso-King, from Sussex MSK Partnership to contribute to the programme upon discovering Georgi’s exceptional work in Personalised Care and her involvement in Community Appointment Days (CADs).

SCW’s Cancer and Long Term Conditions Team have developed the new PRosPer (Prehabilitation, Rehabilitation and Personalised Care) for Long Term Conditions eLearning for Health module on behalf of NHS England.

This collaborative piece of work was developed using the clinical and service redesign skills from within the SCW team and front-line clinicians doing amazing work in the field.

The case study is included in the Strategic Level module, which follows on from the 2 earlier modules (Foundation and Intermediate).

The case study states:

Sussex MSK Partnership Central is a joint venture delivered by Here (a not-for-profit social enterprise) and Sussex Community NHS Foundation Trust. 

 

They have truly embraced the PRosPer principles for improving services for people with LTCs. They have addressed every element of the House of Care through the development of their services.

Combining these insights and in-depth understanding of transforming clinical services, the module aims to provide practical examples and opportunities for clinicians, clinical leads, commissioners and people with strategic decision-making powers in developing the knowledge required to deliver quality improvements in their services and influence system change.    

We are pleased to confirm that this session is now live on the NHS Learning hub:    

Session link: https://learninghub.nhs.uk/catalogue/PRosPer-long-term-conditions?nodeId=7616 

Programme/catalogue link: https://learninghub.nhs.uk/Catalogue/PRosPer-long-term-conditions 

Have an idea or a project you think we could work together on? We’d love to collaborate with you!

Get in touch at: collab@hereweare.org.uk

Laura Finucane, our Clinical Director at Sussex MSK Partnership Central, is also President of The International Federation of Orthopaedic Manipulative Therapists (IFOMPT).

This year the International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) – the world conference of musculoskeletal and manual physical therapy, celebrates its 50th year as a global leader in Orthopaedic Manual Physical Therapy (OMPT) excellence. The event welcomes experts from all over the world to its conference in Switzerland to explore:

1. Innovative models of care in musculoskeletal and manual physical therapy
2. Physical therapy futures – emerging areas
3. Expertise in musculoskeletal and manual physical therapy

“Sharing ideas and initiatives among colleagues and experts is crucial for developing excellence and helps pave the way for reducing musculoskeletal disorders globally – and enables people to bring new ideas into their local services.

 

This is my fourth and final year as president, and the 50th anniversary of IFOMPT, and I am excited about the discussion and debates and learning about the initiatives taking place around the world and turning those ideas into practice.” ~ Laura Finucane president of IFOMPT and Clinical Director for Sussex MSK Partnership.

Laura has been involved with IFOMPT for the last 18 years, serving on the executive committee for the last 12 years and president from 2020-2024.

Also attending from Sussex MSK Partnership Central are Andrew Kemp and Stephanie Hemmings.

Andrew is an Advanced Practitioner and Stephanie is a research and Audit Lead, Senior MSK Physiotherapist and Lecturer in Physiotherapy at University of Brighton.

They will be presenting a poster titled “Equity factors in trials of physiotherapy for meniscus tear: A systematic review”​  and Stephanie will also be presenting on our nationally celebrated Community Appointment Days (CADs).

The International Federation of Orthopaedic Manipulative Physical Therapists Incorporated represents groups of Manipulative and Manual Physical Therapists around the world who have completed stringent post-registration/post-graduation specialisation programmes in the field of neuro-musculoskeletal disorders.

Last Monday, colleagues from Sussex MSK Partnership Central supported University Hospital Sussex to see 240 people at their own Community Appointment Day (CAD).

Held at the Sports Centre at University Of Sussex in Falmer, the CAD supported people from Brighton through strengths- based What Matters to You conversations, and tailored advice, guidance, and rehabilitation depending on their individual needs.

Community providers were also on hand to offer additional support and to connect people on a wider basis with their health and wellbeing. Including SCFT Living Well Programme, Freedom Leisure, Aging Well, MIND, Together Co Social Prescribing, Brighton and Hove City Council and Sussex Integrated Care Board.

The feedback from those who attended was hugely positive and it was great to support people in the community.

“It was so wonderful to be listened to. Everyone was so kind. Please thank everyone as I now understand more about my condition and can be proactive in my recovery.” – Feedback from attendee

Look out for further CAD updates over the coming months.