The go-to guide spreading best practice in MSK, falls, fracture and frailty services | Alison Gowdy

Alison Gowdy

With a growing and ageing population, services treating musculoskeletal (MSK) disease, falls, fractures and frailty are having to consider new, more efficient ways of delivering care. A new guide showcasing how services across the country are tackling this head on could prove a game-changer, writes Alison Gowdy.

The NHS isn’t great at sharing ideas or successes (or, dare I say it, what hasn’t worked!). The service improvement/development wheel is regularly reinvented without realising. Yet often learning from others can ignite innovation and start discussions about potential new work. That was our thinking in pulling together examples of best practice across four clinical areas that are priorities for the NHS.

Musculoskeletal disease (MSK), falls, fractures and frailty impact on all sectors of healthcare. Collectively, they have a significant detrimental impact on patients, families and carers, and are a major cost to the NHS, as demonstrated by these figures:

  • MSK accounts for 30 per cent of all GP consultations.
  • Falls are estimated to cost the NHS more than £2.3bn per year.
  • There are over 300,000 fragility fractures per year, at a cost to the UK of more than £4.4bn.
  • Frailty affects 14 per cent of people over 60 and 65 per cent of those over 90.

These service areas, under increasing pressure due to the growing and ageing population, are having to consider new, more efficient ways of delivering care. While there are many different clinical pathways and services to manage MSK, falls, fractures and frailty, they are not distinct from each other, with clear links and overlaps between them. It’s a complex landscape that can lead to difficulty and delay in agreeing how to improve services.

There are lots of fantastic examples of best practice scattered across the country, but these are not often pulled together in a way that makes it easy for others to understand what change has been delivered, the clinical and financial benefits, and resources or contacts for others who may wish to replicate or build upon the idea.

The key remit of the 15 academic health science networks (AHSNs) licensed by NHS England is to spread innovation and improvement across the health service more quickly and more widely. AHSNs have a wealth of experience and practical skills in working with NHS organisations to improve services, undertaking projects that have improved patient outcomes and made more efficient use of resources. Although it would be near-impossible to review and summarise all the improvement work going on nationally, the AHSNs are able to capture the work they are involved with.

Our MSK, falls, fractures and frailty report does exactly that, bringing together 30 examples supported or led by AHSNs from all sectors of the health service, as well as care homes. We hope this report is seen as the place to go for great case studies of how to improve services and outcomes for patients.

It is already helping to shape discussions within provider and commissioner organisations, across sustainability and transformation partnerships and integrated care systems, by providing examples of work that could be either be recreated ‘off the shelf’ or adapted and developed.

The report has been well received and shared widely, including by NHS Improvement, the British Geriatrics Society and the NHS England South Central Medical Directorate. If you work within MSK, falls, fractures or frailty and are considering improvement workstreams or potential changes to pathways, please have a look at it. I hope you find it useful.

And for those working in other complex and overlapping fields perhaps it’s given you a template to consider producing something similar to help the NHS get better at sharing ideas and triumphs!

Alison Gowdy is clinical innovation adoption manager at Oxford Academic Health Science Network. Follow her and the organisation on Twitter @alison_gowdy @OxfordAHSN

To find out more about all 15 AHSNs around the country, visit and follow @AHSNNetwork on Twitter.

Latest Tweets

Latest Blog Post

Tackling medicines wastage through a scalable initiative | Diar Fattah

14 / 12 / 2018 12.08pm

With estimates exceeding £300 million wasted every year in the NHS on unused or partially used medicine, Diar Fattah, associate director of medicines optimisation at Dartford, Gravesham and Swanley (DGS) CCG, believes savings and efficiency opportunities around medicines wastage are ripe for the taking.

Why Register?

Great reasons to register with NHS Confederation

  • Access exclusive resources 
    Access member-only resources and tailor member benefits and services
  • Personalise your website
    Select topics of interest for recommended content
  • Comment and recommend
    Rate and share content with colleagues
  • Never miss a thing
    Register now to keep your finger on the pulse of the NHS Confederation

Log In

To book events and access member only content you need to register with us.  This only takes a moment via our registration page. If you have already registered login using your email address and password below.