Bristol Bones and Joints HIT update 2020-21

Co-directors Emma Dures and Sanchit Mehendale recap Bristol Bones and Joints HIT highlights from 2020 -21.

This year, we have created new self-management support resources that patients can access via the rheumatology pages of the North Bristol NHS Trust and University Hospitals Bristol and Weston NHS Trust websites. Topics include exercise, emotional wellbeing, pain and fatigue, relationships and family and finances.

We are promoting the use of self-management apps, including GetUBetter and Joint School, and providing ESCAPE-pain courses in gyms: 10 education and exercise sessions for people with osteoarthritis (OA) of the hip and knee. We are also supporting a Health Optimisation pilot with One You in South Gloucestershire for people with OA of the hip and knee, to help people lose weight and stop smoking.

Many people living with musculoskeletal conditions, especially inflammatory rheumatic conditions, have been shielding this year. We have been liaising with patient support groups to share peer support resources and ideas during the pandemic, and set up informal Zoom coffee mornings every six weeks to help patients stay connected. With the Bristol Royal Infirmary (BRI) Rheumatology Patient Advisory Group, we launched a Facebook page, and provide printed and e-newsletters on patient-related issues, clinical developments and research updates.

In September, the BRI Rheumatology team launched Early Arthritis Clinics, to see patients with suspected inflammatory arthritis quickly, as research shows that early treatment improves outcomes. The clinics are one stop, so that if patients need an ultra-sound scan or any additional tests to make the diagnosis, where possible these are performed on the day. The team are working to incorporate administrative support, nursing and occupational therapy within the clinic offering.

We have supported the delivery of integrated services within trauma and orthopaedics across BNSSG to make the most efficient use of the infrastructure and avoid service duplication, which would benefit both the elective and non-elective pathways. This will not only help address the significant delays in treatment due to the pandemic, but will also develop evidence based, standardised pathways, improving outcomes across the system. The BBJ HIT have had meetings with the core team and liaised closely with the patient representative partners. Visit the patient self-help resource directory.

North Bristol NHS Trust has used the expertise of the rheumatology non-medical prescribing team to develop a remote therapy clinic service. This has increased consultant capacity to prioritise seeing new referrals and responding to the changing demands of the pandemic. It has enabled the team to triage patients to determine the most suitable consultation medium as part of an adaptive hybrid clinic model, using a disease activity tracking app and video calling technology, undertaken in consultation with patients. The app, developed with industry partners Living With Ltd, allows patients to securely record and report rheumatoid arthritis symptoms. The aim is to improve clinical information during clinical consultation, optimise appointment timing, and promote remote monitoring and teleclinics.