Dr Emma Clark, Professor Ashley Blom and Professor Sarah Hewlett reflect on the Bristol Bones and Joints Health Integration Team's (HIT) work in 2013-14.
The Bristol Bones and Joints HIT covers three disease areas: osteoarthritis, osteoporosis and rheumatoid arthritis. Over the last year we have identified three overarching themes: information technology, patient and public involvement and patient self-management.
Analysis of the National Joint Registry undertaken by the University of Bristol has shown that cemented hip replacements have lower failure rates than uncemented hip replacements in the first ten years after surgery, and are likely to last older patients the rest of their lives. Our main achievement in osteoarthritis has been to implement these findings to increase the proportion of older patients receiving cemented hip replacements from 40 to 92 per cent across Bristol. This has resulted in better outcomes for patients and a reduction in costs at North Bristol NHS Trust of £170,000 per year. The West of England Academic Health Science Network (WEAHSN) has chosen to take this project forward on a regional scale.
In rheumatoid arthritis we have implemented standard drug monitoring programmes across the city, and in osteoporosis we have developed patient-based quality indicators for the pan-Bristol bone-densitometry DXA scanning service.
This year we have also focussed on communication across groups and across Bristol. We have held a number of meetings with the AHSN and the first of a series of workshops, each held at a different NHS Trust in the region, is planned for May. We recently ran a very successful second patient forum to decide priorities for musculoskeletal healthcare from the patient perspective. We also held an inaugural meeting for healthcare professionals and patients working to support self-management. We are starting work to engage with commissioners. In the near future we will be appointing a senior musculoskeletal trainee to help develop a ‘single point of entry’ website for patients, clinicians and researchers across Bristol who want local information about musculoskeletal disease, healthcare pathways or research.