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.

New Musculoskeletal service set to transform care for patients in Sussex

“We are delighted to be awarded this contract along with SCFT as part of an innovative new Sussex MSK collaborative. Working closely with partners, professionals, patients, and our communities, this collaboration builds on our long-standing set of innovations that are leading the way nationally in how MSK healthcare is delivered. This marks another significant step on our journey to deliver exceptional care for those we serve. 

Our vision is to deliver the highest standards of patient care by providing equitable, personalised, and seamless services across the entire MSK pathway.” ~ Helen Curr, chief executive officer at Here.

Health and care partners across Sussex are delighted to announce that an innovative new Musculoskeletal (MSK) service is set to start for local people in December 2024.  

This is the culmination of four years of work and engagement with many stakeholders across the Sussex health and care system to design a transformed, integrated, MSK service for patients in Sussex.    

Following a robust procurement process, Sussex Community NHS Foundation Trust, working alongside University Hospitals Sussex NHS Foundation Trust and Here, have been awarded a new contract to deliver MSK services in West Sussex and Brighton and Hove; and East Sussex Healthcare NHS Trust, working alongside Horder Healthcare will cover East Sussex.  

The approach taken across Sussex is considered national best practice and is clear in its ambition to improve care and experience for local people.   

The new service will see a fully integrated MSK pathway across primary, community and secondary care for orthopaedics, pain and rheumatology, and include services such as physiotherapy, diagnostics, and surgical treatment.   

The new service will focus on improving access, experience, and outcomes for patients, with providers working together to ensure patients receive a consistent experience, feel supported throughout the whole pathway, and get the best treatment first time.   

Other planned improvements to Sussex MSK services, under this new contract, are: 

• Better communication and information for patients to empower them to be in-charge of their own care and make informed choices about treatment options 

• A more joined-up and coordinated care offering which breaks-down traditional barriers between organisations 

• Streamlining access to care and advice: providing much more choice about how people can access care, and that services are available in their community when they need them 

• Helping people to live and work well for longer and offer more personalised care, including supported self-management when they need it, via digital platforms   

• A more concerted and systematic approach to reducing health inequalities and addressing variation in terms of access, waiting times and service provision.   

• Offering a personalised model of delivery for outpatient appointments, including virtual appointments where clinically and personally appropriate (considering other factors relevant to the individual) and face-to-face appointments. 

The new service’s specification is fully aligned to Sussex’s five year health and care strategy, Improving Lives Together, by working to a new, joined-up, community-based approach to MSK care, by growing and developing the Sussex health and care workforce, by improving the use digital technology and information, and by maximising the power of partnership working across health and care organisations in Sussex.   

The specification and awarding of the successful bid were developed with a range of different partners, including patient representatives and Healthwatch. The service contract is worth around £41m per year of the contract – which is for five years, with the option of two additional years after the initial five.  

MSK conditions can affect joints, bones and muscles and sometimes associated tissues such as nerves. They can range from minor injuries to long-term conditions.

Over 20 million people in the UK, almost one third of the population, have a MSK condition such as arthritis or back pain.

Symptoms can include pain, stiffness, limited movement, and disability which affect quality of life and independence. 

In Sussex, MSK services are in high demand, so the new service is an important step for providing quality services for local people. For example, in 2019-20, over 172,000 referrals were made to MSK services, which resulted in 225,000 community appointments and 67,000 referrals on to secondary care.

Work is taking place at pace to implement changes which are required to develop the new service, which is due to go live on 1 December 2024.

World Stroke Day 2024

This World Stroke Day we wanted to share Alasdair’s story. In this video stroke survivor Alasdair and his wife Emma talk about their experience of what it was like to be invited to be a part of the Stroke Health and Wellbeing Service, and the difference this support has had on Alasdair’s recovery to date.

Delivering care to stroke survivors

The Stroke Health and Wellbeing Service was a pilot project set up as part of the National Stroke Service Model to test new, innovative ways of delivering care to stroke survivors. Working in partnership with NHS Sussex, Sussex Community NHS Foundation Trust, University Hospitals Sussex NHS Foundation Trust, NHS England, Stroke Association, Headway Sussex, Kent Surrey Sussex Academic Health Science Network.

You can learn more about the project on our service page – Stroke Care Pathway Design – Here

The project has now come to an end, but over the coming months we will be sharing more about this transformative pilot and its impact, showing what can be achieved through building strong, collaborative partnerships across the system, the role of Health Builders and the importance of including people with lived experience as a part of service design.

In the video above you’ll hear Alasdair talk about how much of an inspiration Shreddie, one of our Lead Health Builders was to him and his recovery. You can learn about Shreddie’s story in our case study – Health Builders, improving stroke services – 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 

Consultant stroke physician, Dr Ingrid Kane, reflects on provisions for stroke survivors, and how the Stroke and Wellbeing Pilot has improved the lives of patients in Sussex.

If we go back to the first Stroke and Wellbeing Service meeting we had together – which was a long, long time ago in a hall in Brighton, it felt like it was a moment of change actually being at that meeting – because you had so many people from the community, from the hospital, everyone was there explaining how they are part of this system.

In all the time I’ve been doing stroke, I’ve never had the opportunity to be in a room with all those different people who were all involved in the Stroke and Wellbeing Service, and for us all to chat and listen to people and listen to patients, and there are so many people doing so many good things – it’s just not all joined up.

I’m involved in the care of stroke patients from when they come in to the front door, right until they leave the hospital and on into outpatients and following them up in clinic. As a workforce, we’re a big team, we’re a busy team, and we’re all trying to do different things and there’s never enough time. We don’t have enough staff to do all the work that we would like to do and that we should do.

The Stroke and Wellbeing Service has really made an impact and it’s something that I would love to see continued because it’s made such a difference to people.

I think by having these other roles, it means that it frees up a bit of our time to be able to maybe concentrate on other things and let those other conversations that need time. let them happen through a single point of contact. I know when I have the time to spend more time with patients and their relatives, they get a lot out of that – one size doesn’t fit all.

It’s so difficult knowing how, for that individual, they can best navigate the system. And you only get to know that by getting to know people a bit better and having the time with them.

And you might try one thing that doesn’t work, then you move on to something else. If you’ve got the time to do that, that’s what makes all the difference.

When we get reports of people saying they feel abandoned when they go home, that’s not unique to Sussex, that’s wherever you happen to have your stroke. So I think the people that have been part of the system, the single point of contact with a stroke support worker is important. It can be used anywhere, it can be transferred to anywhere in the stroke system. And similarly, the health builders I think they are so important within the hospital, but also in the community as well.

The stroke pathway doesn’t stop when people leave here. It continues all into the community and it can continue for many months. And that was one of the things that we talked about when we first met is how do we get that true integration from acute into community and how can we get it to continue. Health builders, you just need more of them and more of those groups, and that could again apply to anywhere in the country and to any types of community groups, any age. All of these roles could be moved into other systems.

GP and clinical lead for the Memory Assessment Service (MAS), Dr Rachel Duncan, speaks about stroke research and the particular challenges stroke survivors experience.

There isn’t really a proactive offer from primary care to stroke survivors. So really, the ball is in the court of the stroke survivor to contact primary care with a particular problem. But we also know that this can be challenging because of capacity issues and difficulties with access. And you’ve also got a group of people who have cognitive, mood and energy problems, often in that time after they’ve had their stroke.

So all those factors make it a challenge for them, possibly to engage a lot with primary care. We know there’s a gap, we feel that we should somehow be doing more, but we don’t really know what that more looks like or how you could even provide that in the current healthcare arena when everybody is so pressured, and services are struggling to meet the needs.

Out of those early discussions out of the case studies and the service mapping and identification of any gaps locally, came the idea of a stroke support worker, and the idea that people who’ve had lived experience have got so much to offer somebody who’s going through this sudden new diagnosis. A solution that isn’t completely clinically focused, but that meets those needs, to me, would make a lot of sense from a health economic point of view.

I’ve seen first-hand what difference it can make to patients coming through the service to have that support element embedded within our clinical team and how personalised and holistic that can be. Having that kind of support service really is of huge benefit to clinicians as well, because it does spare a lot of clinician time.

I think the fact that our local findings and learning really were mirrored by this larger study, the IPCAs study that I mentioned before, I think that’s got to be very powerful to hopefully, in the future, take this forward and have these kind of roles embedded across lots of different chronic illnesses. But I think stroke’s a good place to start.

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.

The Brighton and Hove Memory Assessment Service (MAS) supports people before, during and after diagnosis.

At the beginning of 2020 we spoke to Elspeth, one of our service users, about the events that led to her Alzheimer’s diagnosis and she explains in her own words how much joy she now gets from life.

“You see, I’m okay at talking but I can’t do things. I can’t write, I can’t spell anymore.”

“I started to have disasters, in my in my flat, I was just turning on the bath water and leaving it, and I used to flood the floor. I had terrible disasters with my cooking – I nearly burnt the building down – and it was absolutely terrifying. And I thought this isn’t normal loss of memory. This is quite serious loss of memory. So I just sort of realized then that I think I probably might have Alzheimer’s.

“When I said, ‘I’m forgetting things, all sorts of little things’, they would say, ‘don’t be silly, we all do that’. They dismissed it.

Elspeth: Am I right to tell you all this?
Here: Yes, please do!

“Well I said, ‘I’m sorry, but I’m going to the doctors and I’m going to say I’m forgetting everything’.

“And (the doctor) said, ‘would you like to go and have a little test?’ It’s like a little, ‘what does this remind you of, and will you draw something’ – and I didn’t do terribly well. Then she said, ‘we could offer you a scan’ and I said, ‘yes, please give me a scan’ – because I have to know.

“What was my reaction to getting the news? It was almost relief, because there’s a reason for my behavior. I never once had a fit about it and thought ‘Oh, my God’. I thought, well, it is what it is.”

Everything seems so lovely to me now

“I’m really, really happy. It’s one of the nicest times of my life with all the struggle and stuff I’ve had. I’m not a sort of miserable person.

“I’m more aware of nature. I just bought a pound bunch of daffodils and they’ve all opened out in my lounge, and I can’t think of anything more beautiful to see in the morning when you wake up, the simple things.

“I said to Penelope the other day, ‘this must just be like when you’ve taken LSD!’ And she said, ‘My God, I hope you don’t really know what that’s like!’ She nearly collapsed when I said that!

“Everything seems so lovely to me now. Everything is there, but you have to know how to join the club first. Some will just go off and say, ‘no, I don’t want to do that’ or ‘I don’t want to go’. And that’s such a shame if I don’t try it, isn’t it?”

What has made the difference to you?

“Just me appreciating life. Because I’m not going to have it much longer anyway at my age, and I just want to cherish every day.”