Bristol Bones and Joints HIT look back on 2019-20

Directors Associate Professor Emma Dures and Mr Sanchit Mehendale provide an update on the 2019-20 activity of the Bristol Bones and Joints Health Integration Team (HIT).

The Bristol Bones and Joints HIT is a large and diverse team made up of patients, healthcare professionals and researchers from across the Bristol, North Somerset, and South Gloucestershire region. We are interested in musculoskeletal diseases, osteoporosis, and arthritis. Our shared interests across these health conditions include developing and implementing consensus guidelines, supporting self-management and peer networks and patient collaboration in clinical service development and research.

We see our role as a communication hub to capture and promote the clinical and research work that is happening across community, primary and secondary care settings. Within our team, we have members who lead on supporting non-medical healthcare professionals to get involved in research, strengthening the collaboration between patient networks across the region, and liaising with other HITs to share ideas, identify unmet needs and develop research collaborations. We work closely with the MAMBO (Musculoskeletal Management Measurement Behaviour Change and Outcomes) theme within the Centre for Health and Clinical Research (CHCR) at the University of the West of England (UWE).

Recently, we developed new guidelines for GPs on length of time on treatment for osteoporosis. These are now in use across the region. We have also started a study to produce a simple clinical checklist for use in primary care for older women with back pain. Our aim is to identify who needs a spinal radiograph because they are at high risk of an osteoporotic vertebral fracture.

Enhancing access to care and addressing health inequalities are issues that we have identified as priorities. We are developing research into how people with long-term musculoskeletal conditions transition from NHS-led care into community-based services and ways of promoting health literacy and patient activation in community settings. We are looking into developing “Shared Decision Making” pathways along with the Clinical Commissioning Group (CCG) to enable patients guide their treatment in musculoskeletal conditions.

We are also looking at mechanisms to collect PROMs (Patient Reported Outcome Measures) for a variety of musculoskeletal conditions, to understand the value and efficacy of surgical interventions that are currently available and to guide further treatment.