MSK Reform #5 Exerting Influence

This is the final section of the MSK Reform overview. CLINICIANS  MSKR proposes a trusted communication infrastructure for private, professional discussions with accountable users and administrators  The aim of this communication strategy is to improve evidence based practice and collaborative sharing of experience. For many osteopaths working on their own and in small practices this would be welcomed. A common complaint is clinical variation across MSK practice, it is hoped this would reduce that variation.  MEDIA  MSKR will develop and support a credible network of media-trained MSK experts available to Continue Reading »

MSK Reform #4 Aspiring to Clinical Excellence

DEFINING EXCELLENCE  MSKR propose that Clinical Excellence is delivered by clinicians who value:  Patient-centred care  – patient needs, goals and outcomes central to care  Uninterrupted time to articulate story and work with them to identify meaningful, personal goals  Embrace complexity, all aspects of care in patient’s best interest  Options clarified and decisions reasoned  A holistic biopsychosocial model  – holistic, all-encompassing recognises and values all possible contributing variable in line with Clinical Excellence  Communication skills  – collaborative but persuasive  Identify common ground, communicate coherent, scientifically robust route to patient goals  Empowerment  Continue Reading »

What are your standards for Cauda Equina Syndrome?

Cauda Equina Syndrome is rare but it is one of the most serious conditions we are likely to come across in clinic and missing or delaying this diagnosis can have life-changing consequences. Question and Safety Net Always screen back pain patients for bowel and bladder and sexual function changes and saddle anasthesia. There is a need to be really clear about what symptoms you are looking for – difficulty going, difficulty stopping, going without realising, knowing when you have stopped. Numbness in a saddle distribution is also a key symptom. Continue Reading »

MSK Reform #3 Reforming Clinical Education

This is the third article in a series looking at the proposals of MSK Reform from an osteopathic perspective. The education work I do is as a visiting post-graduate lecturer so my insights on this section are limited. I’d be pleased to hear the thoughts of any with more insight into the application of these proposals in an osteopathic context. MSKR propose a clinical education online learning resource to support clinical educators offering MSK placements.  In osteopathy not all clinical educators have teaching qualifications and some may not be applying Continue Reading »

MSK Reform #2 Reforming Clinical Governance

REFORMING CLINICAL GOVERNANCE  This is the second in a series looking at the proposals of MSK Reform and applying them in an osteopathic context. The first article is available here.  Clinical governance is the means by which healthcare “continuously builds quality of services and safeguards high standards of care by creating an environment in which excellence in clinical care will flourish.”  There needs to be a synergy between bottom up and top down aspirations for improvement.  The reforms aim to provide assurance that:  MSK services in the UK are continuously Continue Reading »

First Contact Practitioner #2

I’ve been working as an FCP for just over a week. Of course, it’s all training and supervision to begin with but I thought I’d bring a few insights into the role.  Patients The patient group is diverse with lots of acute presentations but also some chronic. Last week I saw a ruptured biceps tendon for the first time. One patient was referred for DVT investigations and I viewed a few injections which was interesting. Other than that it’s plantar fascitis, acute back pain and lots of shoulder pain as Continue Reading »

MSK Reform for Osteopaths

Reforming our relationship with Evidence MSK Reform ( is a movement which has recently published their manifesto. It is the culmination of 2 years of collaboration recognising that MSK is a huge area of healthcare spending and work days lost, and that there is a need to reform MSK practice to improve patient care. There needs to be more consistency of care, more preventative work and professions working together to improve MSK care in the UK. This project emphasises joined up working between healthcare professions striving for MSK reform. In Continue Reading »

First Contact Practitioner #1

I have just been appointed as a First Contact Practitioner in West Essex. I hope to share on the blog some insights into the role as I get established for anyone that is interested in pursuing the role. What is a First Contact Practitioner? This is a fairly new and developing role based in GP surgeries. Patients can make an appointment directly with a First Contact Practitioner. They will then be assessed for their musculoskeletal problem and given appropriate exercises, advice or referral. This is my understanding at the moment Continue Reading »

Are you first aid trained? Do you need to be?

In the recent chiropractic court case the coroner recommended that first aid training should be compulsory for chiropractors. You may have wondered whether it is compulsory for osteopaths? Is it compulsory? The standards state that you must comply with health and safety legislation and that you should have appropriate procedures in place in the event of a medical emergency (D5). The health and safety executive provides comprehensive advice on first aid provision available here. There is a lot of flexibility for interpretation. Whether you are self-employed, working from home Continue Reading »

How can we maintain good apples?

The Professional Standards Authority (the Ofsted of healthcare regulators) has commissioned research into professional boundaries and sexual misconduct. It is important to understand the risks in these areas in order to maintain professional standards. GOsC has been working on research into boundaries with the Chiropractic council, recognising this is a high risk area for complaints.   This article will discuss the PSA reports and as the GOsC boundaries work develops we’ll discuss that in a future newsletter. From recent courses I’ve run it has been highlighted that these are important Continue Reading »