Quarterly magazine of BackCare, the UK’s National Back Pain Association
SUMMER n 2019
Straight talking
FREE TO MEMBERS
How primary school teachers can avoid back pain
also in this issue: Lifestyle Common mistakes that leave drivers with back pain Digital health NHS Apps assessment portal prepares to go live Care More requesting care but fewer are receiving it
www.backcare.org.uk
2 TALKBACK NEWS
TALKBACK l SUMMER 2019
TALKBACK NEWS 3
Early access to care will improve RMD outcomes THE workload for NHS rheumatology nurse specialists is compromising patient care, delaying access to clinics and advice lines, joint injections and prescriptions, health leaders have warned. A report1 by the British Society for Rheumatology and the charity National Rheumatoid Arthritis Society, reveals that patients are struggling to schedule appointments sooner than six months in advance, while three quarters of departments have reported rheumatology caseloads of more than 1,000 patients. There are many different rheumatic and musculoskeletal diseases (RMDs) and it is widely recognised that early diagnosis and prompt access to care can significantly improve longterm outcomes for patients, their quality of life and ability to work. Moreover, there is a risk that longer waiting times may see certain conditions deteriorate rapidly. The bigger picture tells a similar story. RMDs including rheumatoid arthritis, osteoarthritis and low back pain affect one quarter of the EU population (120m) and are the main cause of work loss, absenteeism and premature retirement. EULAR (European League Against Rheumatism) estimates that an extra one million employees could be in work each day if early interventions were more widely accessible for people with RMDs. At its annual congress in June, EULAR launched the Time2Work campaign to highlight the importance of keeping RMD sufferers
in work. The campaign is calling for greater access to early interventions to limit the pain, tiredness and immobility that make it difficult to keep working, and a greater awareness of the challenges people with rheumatic diseases face. Importantly, it also urges a review of the way we work, where small adjustments like flexible hours, improved access, home working and standing desks can make a huge difference. For EULAR, there are clear economic benefits to enabling a large proportion of people with RMDs to participate in the labour market rather than remain at home on sick leave. Investment in health research and innovation delivers a positive return too, it says, with a year-on-year return equivalent to 25 cents on every euro invested in research on RMDs.
Richard Sutton Editor
Contents
AHPs in new drive to improve outcomes
4
Epic feat by BackCare’s Marathon stars 10-13
Embedding osteopaths in a spinal unit 14-15
LETTERS TO THE EDITOR:
richard.sutton@backcare.org.uk 1) Specialist Nursing in Rheumatology: The State of Play Cover image: pressfoto/Freepik
We welcome articles from readers, but reserve the right to edit submissions. Paid advertisements do not necessarily reflect the views of BackCare. Products and services advertised in TalkBack may not be recommended by BackCare. Please make your own judgement about whether a product or service can help you. Where appropriate, consult your doctor. Any complaints about advertisements should be sent to the Executive Chair. All information in the magazine was believed to be correct at the time of going to press. BackCare cannot be responsible for errors or omissions. No part of this printed publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means without permission of the copyright holder, BackCare. ©BackCare
BackCare BackCare, Monkey Puzzle House, 69-71 Windmill Road, Sunbury-on-Thames TW16 7DT Tel: +44 (0)20 8977 5474 Email: info@backcare.org.uk Website: www.BackCare.org.uk Twitter: @TherealBackCare Registered as the National Back Pain Association charity number 256751. TalkBack is designed by Pages Creative www.pagescreative.co.uk and printed by Gemini West, Bristol.
How teachers can avoid back pain in the classroom 18-19
15% increase in obesityrelated admissions 20-21 TALKBACK l SUMMER 2019
4 TALKBACK NEWS
Image: javi_indy/ Freepik
NICE approves new treatment for musclewasting disease CHILDREN with the rare genetic disorder spinal muscular atrophy (SMA) can now be treated with nusinersen after NICE recommended it following agreement of a deal between the company, Biogen, and NHS England. Nusinersen (also called Spinraza) is the first treatment that targets the underlying cause of SMA. SMA affects the nerves in the spinal cord, controlling movement. This causes muscle weakness, progressive loss of movement, and difficulty breathing and swallowing.
Quality of life People with the most severe forms of SMA usually die before the age of two. There are currently no active treatments targeting the underlying cause of SMA so the condition is managed through supportive care which aims to minimise the impact of disability, address complications and improve quality of life. It is estimated there are 600 to 1,200 children and adults in the UK living with SMA. NHS will fund treatment with nusinersen for a timelimited period, allowing further data to be collected on its effectiveness. The treatment will be made available to the youngest and most severely affected (SMA type 1) patients immediately by Biogen. For older babies, children and young adults with less severe symptoms (SMA types 2 and 3), the NHS will begin to roll out nusinursen shortly after NICE’s final guidance is published.
TALKBACK l SUMMER 2019
AHPs at heart of new drive to improve health outcomes OVER the next five years, physiotherapists and other allied health professionals (AHPs) need to develop their skills, demonstrate their impact and raise their profile as public health experts. This is according to the UK AHP Public Health Strategy 2019-24 published in May by the AHP Federation. Fifteen professional bodies, including the Chartered Society of Physiotherapy (CSP) contributed to the strategy which sets out five goals that AHPs and their professional bodies could help to achieve by 2024. These include: l increase the profile of AHPs as valuable public health experts l demonstrate the contribution of AHPs to improved population-level health outcomes, using robust evaluation and research l develop the AHP workforce – so they have the
necessary skills to promote, improve and protect public health and wellbeing l build strategic connections between AHPs and system leaders at local and national levels l use the expertise of AHPs to improve the health and wellbeing of the health and care workforce. The new framework builds on the successes of the past four years, including preventive interventions such as CSP’s Love Activity Hate Exercise campaign and its Falls Economc Modelling tool. The AHP Federation collaborated with Public Health England, HSC Public Health Agency Northern Ireland, the Scottish and Welsh Governments and the Welsh Therapies Advisory Committee to produce the strategy.
TALKBACK NEWS 5
MSK specialists can help relieve pressure on primary care THE number of GPs per 100,000 people fell to just 60 last year, down from nearly 65 in 2014. The Nuffield Trust think tank produced figures for the BBC which show the first sustained drop in GP numbers for 50 years. This, at a time when there is increased pressure on GPs amid changes to the NHS and an ageing population. Musculoskeletal problems are addressed in 1 in 8 GP appointments and an estimated 29% of the UK population live with an MSK condition. Commenting on the new figures, the British Chiropractic Association said first contact practitioners such as chiropractors had a key role to play in relieving the pressures on primary care services. Catherine Quinn, President of the BCA said: “Some of our members work closely with the NHS and support GPs when they receive referrals, but this number needs to increase. For example, we know that 80% of people in the UK will suffer with back and neck issues during their lifetime and, of those, 32% will visit their local GP as the first action, when they could see a chiropractor instead. “Raising greater awareness about the support services available will help people move away from automatically choosing GPs as the first port of call.”
GPs needn’t be the first port of call for those with back and neck issues
Weekend mortality rate ‘no reflection on hospital care’ THE higher mortality rate for weekend hospital admissions should not be used as an indicator of quality of care due to the lack of data preceding patient admission and on the severity of their illness, a new study funded by the National Institute for Health Research has found. In this largest review of the scientific literature on the “weekend effect” to date, a team led by researchers from Warwick Medical School and Birmingham examined 68 studies covering data from more than 640 million hospital admissions across the world and concluded that, contrary to commonly held assumptions, the higher death rates among patients admitted to
hospital at weekends are unlikely to reflect in-hospital quality of care, and may be attributed to differential criteria for admitting patients and other factors in the community preceding hospital admission. While hospital mortality was found to be 16% higher for weekend admissions compared with weekday admissions on average, researchers noticed that such a “weekend effect” varied by type of admissions, with the effect being most pronounced for elective admissions and almost absent for maternity admissions. More importantly, they found that the urgency and frailty of patients at the time of admission, which can influence their risk of
death, has not been adequately taken into account in most studies that they reviewed. In a small number of studies where these factors were better controlled, the apparent weekend effect tends to diminish. Recent years have seen a focus on increased staffing as a solution to the “weekend effect”. However, the study found little association between weekendweekday differences in staffing level and weekend-weekday differences in hospital mortality in the small number of studies that looked into this. Researchers suggest that there are other factors affecting the mortality that should be investigated further.
TALKBACK l SUMMER 2019
6 TALKBACK DIGITAL HEALTH AND MEDTECH
Image: creativeart/Freepik
NHS Apps Library assessment portal prepares to go live
A DIGITAL assessment portal which will streamline and improve the process for developers seeking to have their app included on the NHS Apps Library has launched. The portal, which went live in May, is in public beta before going fully live in September. It will act as an online self-
service tool for developers – by making the process easier it is intended to accelerate the increase in the volume of apps on the library. It will also be the mechanism through which approved assessors will assess apps before approving them for inclusion on the library. There are currently more
than 70 apps listed on it across a wide range of purposes, including mental health, maternity, diabetes, sleep and healthy lifestyles. Ian Phoenix, Director of Citizen Technology at NHS Digital, said: “Health and care is one of the fastest growing segments in the apps market,
with literally hundreds of thousands of apps available in smartphone apps stores. “We know patients really value having an NHS library which they can use as a trusted source of information on which apps are safe and effective.” https://digital.nhs.uk
Robotic pets can perk up older care home residents ROBOTIC pets that respond to human interaction can benefit the health and wellbeing of older people living in care homes, a study from the University of Exeter Medical School has found. Researchers found evidence that “robopets” can provide comfort and reduce agitation and loneliness. Funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula (PenCLAHRC), the study also found that robopets increase social interaction with other residents, family members and staff, often through acting as a stimulus for conversation.
TALKBACK l SUMMER 2019
The systematic review brought together evidence from 19 studies involving 900 care home residents and staff and family members. Lead author Dr Rebecca Abbott, from the University of Exeter Medical School, said: “Although not every care home resident may choose to interact with robopets, for those who do, they appear to offer many benefits. Some of these are around stimulating conversations or triggering memories of their own pets or past experiences, and there is also the comfort of touching or interacting with the robopet itself. “The joy of having something to care for
was a strong finding across many of the studies.” Robopets are small animal-like robots which have the appearance and many of the behavioural characteristics of companion animals or pets. Five different robopets were used in the studies – Necoro and Justocat (cats), Aibo (a dog), Cuddler (a bear) and Paro (a baby seal). Some of the studies were on older people’s experiences of interacting with the robopets, while others sought to measure impact on factors such as agitation, loneliness and social interaction. https://medicine.exeter.ac.uk
TALKBACK DIGITAL HEALTH AND MEDTECH 7
DIGITAL skills should be part of the continuous professional development of all physiotherapy staff, says a landmark strategy developed with input from the Chartered Society of Physiotherapy (CSP). A Digital Framework for Allied Health Professionals, published by NHS England, can help managers identify the education and training requirements of staff. The aim is to support managers in creating a digitally literate and empowered workforce. The CSP was on the steering group for the framework, which sets out digital goals. They include that physiotherapy and other allied health profession services should be capturing records and care plans digitally. For instance, transfers of care should be supported digitally. The document says that if digital standards exist, use them. If not, physiotherapy staff should work with other professionals to make sure that content meets the requirements of those receiving the information. It is important that physiotherapists who have independent or supplementary prescribing responsibilities work closely with their information and digital teams. They should have the relevant access
Services should be capturing records and care plans digitally rights and prescribing details associated with their user profile. Unnecessary workarounds must be avoided. Another goal is for physiotherapy staff to keep up-to-date with developments in remote care. All physio staff should find evidence about remote systems and consider how they could deliver improvements. Used effectively, remote care can deliver better patient safety, clinical outcomes, staff experience, patient
experience and resource sustainability, the document says. Sue Hayward-Giles, the CSP’s assistant director practice development, described the framework as accessible and actionorientated. “As well as to helping you create a more digitally literate workforce, it will also support you to improve the digital capability of services.” www.england.nhs.uk www.csp.org.uk
E-learning tools to protect health and promote wellbeing E-LEARNING tools, with quick access to information and advice, are helping to improve approaches to preventing illness, protecting health and promoting wellbeing. Public Health England (PHE) has introduced a series of new e-learning tools to boost health and care professionals’ knowledge and skills in dealing with some of the biggest issues in public health. The new interactive e-learning tools, developed by PHE and Health Education England e-Learning for Healthcare, offer bite-sized information on key public health
issues to help professionals prevent illness, protect health and promote wellbeing. E-learning tools are now available for cardiovascular disease prevention, adult obesity, antimicrobial resistance, physical activity, social prescribing, giving children the best start in life and supporting those at risk of, or experiencing, homelessness.
Quick access The tools explain why each topic is a public health priority, with practical advice on how different skills, techniques and approaches can help professionals across the health and social care sector to
address the issues through their practice. Professor Jamie Waterall, Deputy Chief Nurse at Public Health England, said: “With prevention a major priority under the NHS Long Term Plan, it’s vital that every health and care professional has quick access to advice that will help them make the most difference through their everyday practice. “We know that health and care professionals are often time poor, which is why these tools are designed to be used flexibly, helping people enhance learning alongside their day-to-day roles.” www.e-lfh.org.uk
TALKBACK l SUMMER 2019
Image: katemangostar/Freepik
Digital skills should be part of CPD for all physio staff
8 TALKBACK LIFESTYLE
Common mistakes that leave van SEVENTY PER CENT of van drivers suffer from back pain and take an average of three weeks off work a year due to ‘Builder’s Back’, a survey1 by Volkswagen Commercial Vehicles has revealed. The resulting downtime costs companies an estimated £500 a day per van. Poor seat adjustment could be to blame for triggering back issues, especially as many drivers spend up to seven hours a day in their vans. Although most drivers adjusted their seats before driving, many committed common mistakes of positioning the seat too close to the steering wheel and angling the seat too far back. Prab Chandhok, chiropractor and member of the British
Chiropractic Association, said: “Many people now point to driving as a trigger for their back or neck pain, so it’s really important that your van is set up properly for your needs, to help ease the strain that driving – especially for long periods of time – can have on your back and neck.
Key adjustments “The key thing to remember is that there is no single seat that is perfect for everyone, so it’s practical to test the seat out fully before you buy a new vehicle. The more adjustable it is, the better.” Volkswagen has partnered with the British Chiropractic Association to help drivers understand the correct way to adjust their seats:
Height: Your thighs should be as parallel to the floor as your seat will allow, and where possible try to get your hips higher than your knees. You should also adjust the thigh support if you have one to ensure you have the maximum surface of your thighs touching the seat. Pedals: You should be able to push the pedals to the floor with a bend in your knees. 110°: Bring your seat all the way up so it’s straight and then take it back until you are comfortable while maintaining a 110-degree angle between your back and thighs. Lumbar support: This should be adjusted so you can feel it support the hollow in your back, but not so it’s causing
your spine to arch more than is normal for you. Head restraint: The height and angle of your head restraint should be adjusted so you can feel the centre of the support touch the middle of the back of your head, although it does not need to be touching at all times. Steering wheel: Once in correct seating position, bring your arm up in front of you and position the centre of the steering wheel to be in line with the fold of your wrist. Rear mirror: Lift up your chest by five degrees and then adjust your mirrors to help stay in an upright position on long drives. 1) Survey of 500 UK van drivers, October 2018,
Japanese radio station inspires 10-minute JAPANESE radio has provided the inspiration for a new programme of 10-minute workouts targeting inactivity in the over-55s. Sport England is investing £234,000 in the six-month pilot, 10 Today, which provides a series of easy and accessible 10-minute exercise broadcasts – for radio and online – which can be followed almost anywhere and at any time. Inspired by Radio Taiso, an established and evidence-based national daily exercise broadcast on Japanese radio, 10 Today has been produced and led by older people, for older people. It aims to increase physical activity among older people across the country, helping to reduce social isolation and improve the physical and mental wellbeing of participants. “All too often it can feel like the barriers to getting active grow as we age,” said Sport England’s executive director for tackling inactivity, Mike Diaper. “However, even small changes make a real difference.
TALKBACK l SUMMER 2019
“It’s not just about the physical benefits as this project aims to bring people together to reduce loneliness and strengthen mental health and resilience to enable more adults to lead happier and healthier lives.”
Full cost of inactivity The initiative has been put together in collaboration with the care and housing provider, Anchor Hanover, and the think tank Demos. Research conducted by the partners shows that alongside the cost implications to the NHS, inactivity also contributes to cognitive decline, reduced emotional wellbeing and loneliness. Anchor Hanover chief executive Jane Ashcroft commented: “Everyone should have a chance to live life to the full, regardless of age. It’s imperative that our older generations are able to exercise in a way that suits their needs, to improve their wellbeing and reduce strain on the NHS, which is a lifeline for so many.”
While there has been a rise in the proportion of adults aged 55+ doing more than 30 minutes of physical activity a week, more needs to be done. Anchor Hanover’s research found that 76% of older people wish they were more physically active, with 10 Today aimed at enabling them. Funded through the £10m Active Ageing Fund, the 10 Today sessions will be broadcast free on YouTube, as well as local radio stations Bradford BCB 106.6 FM and CHBN Radio 100.8 FM – community stations in Bradford and Cornwall. In addition to this, hundreds of older people across the country are being trained as 10 Today ‘champions’ to bring people together to take part in physical activity. ■ Physical inactivity in later life is expected to cost the NHS more than £1.3 billion by 2030. www.sportengland.org
TALKBACK LIFESTYLE 9
drivers with back pain Design helps optimise driving position Volkswagen’s Crafter van allows driver’s seat options for an optimal driving position. The ‘ergoComfort’ suspension seat features up to 20-way adjustment and softens bumps and jolts which can jar a driver’s back. The ‘ergoActive’ seat offers 14-way adjustment, including a massage function. www.volkswagen-vans.co.uk https://chiropractic-uk.co.uk
Image: pressfoto/ Freepik
exercise broadcasts for the over-55s
10 Today ‘champions’ will bring people together
TALKBACK l SUMMER 2019
Image: Virgin Money London Marathon
10 TALKBACK LONDON MARATHON 2019
Excellent performance by BackCare sends its warmest congratulations and sincere thanks to all runners who raised funds for the charity in April by taking part in the biggest London Marathon EVER!
A BIG shout out for Mo Davies who broke through the £3,500 mark to become this year’s leading fundraiser. Mo was closely followed by: Laura Purssell, Ian Jackson, Paul and Sean Richardson, Abigail Grand, Aron Burghart, Neill Hadden, Robert Montcreiff, Luke Oscar, Alice Pike, Myra Taylor, Lyndi Wiltshire, Paul Jones, Paul Logan, Robert Martin, Jon Murgatroyd, El Ogilvie, Adrian Gasser, Simon Wright, Abi Webb, Melanie Whittall, Arrun Saunders, Daniella Miranoa and Jon High. BackCare CEO Dr Brian Hammond said: “This was an epic effort from all our Marathon stars, especially those who were tackling this distance for the very first time. Having heard about the illnesses, injuries and other setbacks some had encountered during the long hard months of training, it was truly inspiring to see our runners reach the end of their journey – with hundreds of thousands of spectators lining the streets to witness their achievement. Brilliant!”
Mo Davies My first marathon completed and lifelong ambition achieved. I did it! However, it wasn’t without drama as I sprained my ankle at mile 12 at the first point of seeing all my family and friends. As I was running in memory of my brother and husband I did get emotional at times, but it inspired me to finish despite the pain. The atmosphere and support made it an incredible experience which will stay with me forever. Abigail Grand On Sunday 28 April I ran the 26.2 miles London Marathon and ticked it off my bucket list, something very personal to me and my relatives (my mother and uncle who had completed it many times between them). I have wanted to run the
TALKBACK l SUMMER 2019
London Marathon since I was about 8 years old (I’m now 41) and even more so after having my little boy back in 2017. The support was amazing and the weather was very kind. I ran my first marathon in a time of 4hrs 19mins. I was delighted with that and that my training paid off. I was able to keep an even pace, the crowd was electric and kept me going. To my utter surprise I did not even get one blister and felt good from start to finish, which is something I didn’t think was possible when I signed up to it. I also overtook Chris Evans at about mile 23. Having suffered with back pain, I was so happy to support such a great charity, which was relevant to me and raising more than my target. It was a brilliant experience and a day that I will remember for the rest of my life. Thank you BackCare for giving me the opportunity to fulfil my dream.
Image: Virgin Money London Marathon
TALKBACK LONDON MARATHON 2019 11
BackCare’s marathon stars
Laura Purssell After one too many drinks over Christmas, my brother and I decided to sign up for the London Marathon without any previous running experience. We thought: “what could be so hard?” The following months showed just how physically and mentally hard it really was! Sibling rivalry and the amount of money we were raising for our charities spurred us on. On the day, the crowds’ relentless support, having all of our friends and family there to scream at us, and being able to cross the finish line hand-in-hand
I overtook Chris Evans at about mile 23! Abigail Grand
with my brother will go down as the London Marathon being one of the best days of my life. Needless to say, when we’d finished we looked at one another and said “never again!” However, fast forward 24 hours and there I was on Google looking at other marathons! On to the next one! Adrian Gasser I started to train for the London Marathon last July and needed every day as I was overweight and had to change my diet – I started with a run of one mile and had to walk some of it. Anyway, roll forward to the point I had lost four stone and ran hundreds of miles; my longest run before the marathon was 21.5 miles – no easy feat. On the day, I enjoyed every mile until the last three or four when I was getting tired. So I’m glad I did it. It wasn’t easy but an amazing experience and I might do it again next year. So, a big thank you to BackCare for letting me run for the charity. continued on p12 >
Image: Virgin Money London Marathon
Neill Hadden Ten days after my first London Marathon and my brain is already filtering out the pain but I can tell you that the last 10k was brutal! What an amazing experience, though. The crowd was incredible right from the start, shouting and encouraging, high-fiving and offering copious jelly beans all the way around. I lived in east London for nearly 20 years and knew the course really well, in fact I ran past my old flat and thought about all the years that I had watched the marathon wondering if one day I might take part. Well, that day has been and gone and it was truly one of the best experiences of my life. When things got difficult, I thought back to when I was unsure if I would regain full mobility and realised how lucky I was to be in a position to fulfil my dream. Highly recommend! 3hrs 59mins.
Runners pass The Cutty Sark in Greenwich
TALKBACK l SUMMER 2019
12 TALKBACK LONDON MARATHON 2019
BackCare’s stars
from p11
Luke Oscar What an exhilarating experience! Crossing Tower Bridge was my highlight as the crowd’s calling my name and words of encouragement lifted me! Seeing the views from the bridge over the Thames was phenomenal. The most challenging stretch was the last few miles. The training could only take me so far, it really was a case of mind over matter as my body was exhausted, but my mind was motivated to finish. The support of the crowds and the sight of Buckingham Palace carried me to the finish line. Stepping over the finishing line was a remarkable moment. I will always remember that feeling – I’ve done it! Thank you to all my sponsors in helping me fundraise for valuable research in reducing the impact of back pain.
Second chance An incredible 457,861 applicants have registered for a ballot place in the 2020 event, which will be the 40th edition of the race. For those missing out on the ballot, stay in touch with us as it will still be possible to register for one of BackCare’s guaranteed places.
TALKBACK l SUMMER 2019
For some, it’s hard but worth it...
For others, it’s all too much
Ways to prepare for a Loved the 2019 London Marathon and considering a new long-distance challenge? Versus Arthritis offers some training tips on how to avoid injury. WHETHER you’re new to running or preparing to complete a long-distance run, such as a marathon or half marathon, preparing well is important. If you’re doing a 10+ mile event, it can be a gruelling process, particularly in the training leading up to big day. To help, here are our tips on how to train and avoid injury. Fuel your body Long-distance runs use a lot of energy, so it’s important you give your body the fuel it needs. Try to eat foods high in carbohydrates before exercise, especially in the week leading up to the race. Potatoes, beans and brown rice are all good sources of carbohydrates. Your muscles need protein to grow and recover, which can be found in meat, fish, dairy products, nuts and legumes. About 3-4 hours before the race, eat a breakfast high in carbohydrates with some protein, such as porridge with fruit. Take a sugary snack, such as a banana or energy bar, to the start line. After the race, eat something high in carbohydrates and have a high-protein meal three hours afterwards to help boost muscle recovery. Make sure you’re drinking water whenever you feel thirsty and having at least a few sips every 15
minutes during the race. Use energy gels or drinks every 30 minutes during the race to keep your stores of carbohydrates up. Warm up and cool down There are different training programmes online to help you build up to a long-distance event. It’s important that you warm up before and cool down after exercise to avoid injury. A good warm-up should include a mixture of exercises that stretch and strengthen your muscles, as well as work on balance and landing techniques. Spend five minutes cooling down afterwards, stretching out your major muscle groups, particularly the hips, knees and ankles. Massage, compression stockings and a cold bath followed by a hot shower can help you recover, too. Listen to your body If you’re thinking about doing a long-distance event, you ideally want to start your training around three months before. You’ll need to gradually build up how often, how hard and how long you train for as you could risk an injury. You don’t have to give up other sports that you enjoy, you’ll just need to be careful not to over-
Images: Virgin Money London Marathon
TALKBACK LONDON MARATHON 2019 13
Runners pass through Canary Wharf
long-distance event train. If you start to feel excessively tired, or if your fitness or performance starts to decrease, you might have over-trained. Get the right equipment In the lead up to a big running event, it’s a good idea to go to a running shop to have your running style assessed and to get the right shoes. Having well-fitting shoes reduces the chances of blisters and other injuries and can help your running technique. Wear tight clothes, such as running tops and leggings, as these are less likely to rub and cause chafing. Apply petroleum jelly to certain areas more prone to chafing, such as the groin, armpits and nipples.
Treating an injury If you do pick up an injury, there are things you can do to help yourself. Small things like blisters are best treated by draining the blister but leaving the top in place to prevent infections. Blister plasters can be used over blisters to protect them and let them heal. If you get an injury, follow the PRICE principles (protection, rest, ice, compression, elevation) to treat it. It’s a good idea to see a healthcare professional, such as a GP or physiotherapist, about any injury so you can get advice and start the right treatment as soon as possible. Remember not to rush back to exercise before you’ve completely healed, as you could risk a repeat injury. www.versusarthritis.org
Thunderbirds enter the record books NO LESS than 38 world records were set as the more enterprising runners launched a series of historymaking adventures. Matthew Berry was the “fastest marathoner dressed as a zombie (male)” in 2:43:54 while the crowd saluted Charlotte Farge, Cey Uzun, Rob Jones, Helen Smith, Andy Moulden and David Brennan, who together carried their Thunderbird 2 outfit across the finish line in 5:59:33 to become the fastest marathoners in a sixperson costume. www.virginmoneylondonmarathon.com www.backcare.org.uk
Image: Virgin Money London Marathon
As ever, plenty of fancy dress runners took part
TALKBACK l SUMMER 2019
14 TALKBACK EDUCATION AND RESEARCH
Embedding osteopaths in a The Institute of Osteopathy has posted new research1 that looks at whether the inclusion of osteopathic practice in a multimodal NHS service within a secondary care spinal unit (Queen’s Medical Centre, Nottingham) is safe and effective and to gauge the patient experience of such interventions.
CHRONIC spinal pain is a major cause of disability worldwide and is associated with significant economic impact. Diagnostic clarity is often difficult and conservative treatments have failed to produce a single, most effective approach. Surgical techniques are unlikely to provide greater benefit and carry a greater risk profile. Therapy is therefore complex and often multimodal. Chronic spinal pain often causes patients to be repeat users of primary and secondary care services which is costly for the system. Therefore, there is an urgent need to
understand the condition better and advance conservative management in this field. The Spinal Unit at Queen’s Medical Centre, Nottingham, is a recognised national and international referral centre for complex spinal pathologies. Many of those attending the unit either do not need or cannot have spine surgery, and therefore require conservative management of their condition. The centre has been employing osteopaths at consultant level for more than 14 years and delivers multimodal, nonpharmacologic care to patients with chronic and complex spinal
pain comprising standard osteopathic manual therapy, rehabilitative exercise and pain neuroscience education. In total, 98.8% of patients have received previous treatment for the presenting complaint, including pain medication (71.3%), exercise therapy (79.5%) and invasive measures (injection and/ or radiofrequency ablation) (40.9%). And 15.4% of patients have previously undergone spinal surgery; 30.3% of patients are regularly using weak opioid analgesics at presentation and 16.1% of patients are regularly using strong opioids.
Mean baseline score
Mean change
Patients improving by 50%-100% from baseline (%)
COMI-LBC
5.9
2.1
59 (37.3)
COMI-NC
6.2
2.0
18 (31.6%)
NPRS Low Back
5.8
2.1
72 (45.6%)
NPRS Leg
4.4
2.0
76 (48.1)
NPRS Neck
6.4
2.3
25 (43.9%)
NPRS Arm
5.0
1.6
24 (42.1%)
ODI
36.8
10.5
60 (32.1)
NDI
44.4
14.5
21 (31.3%)
EQ5D-3L
0.4
0.2
–
Table 1: Outcome results from the QMC osteopathy service
Image: bedneyimages/Freepik
£25m funding to explore how social,
Non-communicable diseases account for an estimated 89% of all UK deaths
TALKBACK l SUMMER 2019
IN ITS first ever funding round, the UK Prevention Research Partnership (UKPRP) is investing £25 million into understanding and influencing the social, economic and environmental factors that affect our health. The funding has been earmarked for eight projects tackling the bigger picture factors behind the prevention of non-communicable diseases (NCDs) such as heart disease, obesity, poor mental health, cancer and diabetes. NCDs make up the vast majority of illnesses in the UK, accounting for an estimated 89% of all deaths. No single research funder has the resources or expertise to address these
complex issues on their own, which is why a partnership of 12 funders including charities, UK Research and Innovation (UKRI) councils and the UK health and social care departments established the multimillionpound UK Prevention Research Partnership (UKPRP) in 2017. UKPRP research grants aim to develop, test and refine new, practical and cost-effective approaches to preventing non-communicable diseases at this bigger picture level, which will in turn help to reduce health inequalities across the UK. This first tranche of awards has focused on two types of awards: l Consortia awards are big
TALKBACK EDUCATION AND RESEARCH 15
secondary care spinal unit The approach involved six-year data collection using the Spine Tango Conservative registry. A variety of standardised, validated outcome measures were used including numerical pain rating scale (NPRS), Oswestry disability index (ODI), Neck disability Index (NDI) and EQ5D-3L.
Results and evaluation A significant proportion of patients with chronic spinal pain experience a high level of improvement despite the threshold for improvement being set high (50% change). There were clinically significant improvements in pain, function and health related quality of life in this complex patient group. In terms of efficacy, 83.2% of patients reported that the intervention had “helped” or “helped a lot”; patient satisfaction was high – 96.2% of patients were “satisfied” or “very satisfied” with the care they received; the intervention was safe – therapeutic complications were rare (1.2%-7%) and
there were no serious adverse events. Furthermore, it reduced strain on medical and surgical colleagues and reduced the need for surgery which would result in higher risk of infection/ complication and longer recovery times, as well as being more costly for the system. The data supports the use of osteopaths to deliver a conservative spinal service in this setting. As the NHS reorganises to deliver conservative spinal services in primary care settings, this model can be deployed closer to the community with minimal expenditure, say the researchers. The findings were published in a peer review journal, the European Spine Journal (http:// rdcu.be/FYID). Full details of the administration of this data collection project are given in the paper and a previously published article (Morris, Booth & Hegarty, 2016). www.iosteopathy.org 1) Measuring the positive quality impact of embedding osteopaths in a secondary care spinal unit
There were clinically significant improvements in pain, function and health related quality of life in this complex patient group
Image: kjpargeter/ Freepik
economic and environmental factors affect our health interdisciplinary research programmes funded for five years to tackle a specific challenge to prevent people becoming ill (primary prevention). They aim to generate and implement new ideas that can deliver change at a population level. l Networks which are granted up to four years’ funding to develop new communities of researchers from diverse disciplines (including experts not previously involved in prevention research), to tackle NCD prevention. The eight awards (four Consortia and four Networks) will bring together leading researchers, as well as local and national
policy makers, charities, non-government organisations (NGOs) and the public. The research awards cover a wide variety of issues, among them: investigating the commercial determinants of health (ie the approaches used by commercial producers of tobacco, alcohol and food to promote products, influence policy and people’s choices); school food systems and their effects on the quality of children’s diets; improving the life chances of children in deprived areas in the UK; embedding health considerations in urban planning and decision-making processes; and developing new economic methods for judging the
effectiveness and costs and benefits in policy areas such as economic growth and housing. Professor Dame Sally Macintyre, Chair of the UKPRP Scientific Advisory Board and Expert Review Group Panel, said: “By investing in these interdisciplinary teams and drawing on a wide range of knowledge and expertise, UKPRP is supporting work that will have real life benefits for policy makers and the wider public alike.” A second UKPRP funding call for proposals for Consortia and Networks will be launched in autumn 2019. https://mrc.ukri.org
TALKBACK l SUMMER 2019
16 TALKBACK CARE AND CARERS
More people are requesting Rising disability among workingage adults and a growth in the number of people over 65 is putting rising pressure on the adult social care system in England, with more people requesting care but fewer people receiving it.
NEW analysis from the think tank the King’s Fund shows that the proportion of workingage adults approaching local authorities for support has risen by 4% – more than 23,000 people – since 2015/16. At the same time, England’s increasing older population is fuelling greater demand for services. Together, this has led to more than 1.8 million requests for adult social care, up 2% since 2015/16. However, nearly 13,000 fewer people are receiving support and real-terms local authority spending on social care is £700 million below what it was in 2010/11. The figures are presented in the King’s Fund publication Social Care 360, which brings together, for the first time, analysis of data from all major, publicly available data sources to provide a comprehensive overview of the adult social care system in England. Successive administrations have pledged to reform social care and a much-anticipated green paper, promised by the current government and expected to set out the pros and cons of the different options for reform, has no release date nearly two years after it was announced.
The new analysis finds that 18% of working-age people now report a disability, up from 15% in 2010/11. The proportion of disabled workingage adults reporting mental health conditions has increased significantly from 24% to 36% in the last five years. This rise is mirrored by an increase in the number of working-age adults claiming disability benefits in recent years.
Unmet demand More older people are also approaching their councils for support, fuelled by an increase in the numbers of older people in the population. But the proportion of over-65s getting long-term social care from their local council has fallen by 6%. The authors suggest that this is partly due to a freeze since 2010/11 in the amount of assets people can hold and still be eligible for state-funded care. Unmet need among older people remains high, with 22% saying they needed support but did not get it. The report identifies a number of other key trends. l The amount it costs councils to pay for care per week is increasing. The average per week cost of residential and
nursing care for an older person now stands at £615, a realterms increase of 6.6% since 2015/16. l The number of nursing and residential care beds available for people aged over 75 has fallen from 11.3 per 1,000 to 10.1 per 1,000 since 2012. l There is a growing staffing crisis in social care, with around 8% of jobs vacant at any one time. There are 1.6 million jobs in social care, up by 275,000 since 2009. But 390,000 staff leave their jobs each year. l Fewer people who care for family members are receiving support from their local authority, but more are getting help through the national benefits system. Despite the huge challenges facing social care, those people able to access care and support services report high levels of satisfaction. In 2017/18, 90% of social care users said they were either extremely or quite satisfied with their care. Simon Bottery, Senior Fellow at the King’s Fund and lead author of the report, said: “This report shows that increasing need among working-age
Image: Freepik
Jobs expand in adult social care, but
TALKBACK l SUMMER 2019
ADULT social care is a large and growing sector in England: nearly 1.5m people work in an estimated 1.6m jobs (1.1m full-time equivalents) in around 21,000 organisations, according to social care workforce intelligence body, Skills for Care. More than three-quarters of social care jobs (78 %) are in the independent sector – the voluntary sector and for-profit sectors – with the rest split fairly evenly
between local authorities (7%), the NHS (6%) and those directly employed by service users (9%).
Consistent The number of jobs has increased by around 275,000 since 2009, though the rate is slowing. The annual growth has broadly tracked the growth in the older population in England. On average, one adult social care job is
TALKBACK CARE AND CARERS 17
care but fewer are getting it
Image: rawpixel/ Freepik
The proportion of working-age adults asking for support has risen by 4% adults, an increasing older population and high levels of existing unmet need are combining to put immense pressure on our care and support system, now and for the future.
“Yet there is little evidence that the government understands or is willing to act on these trends despite the impact on older and disabled people, their families and carers. “The social care green paper,
which still has no release date over two years after it was announced, is an opportunity to set out the fundamental reform we desperately need. But while the green paper is delayed, the government must focus on what
vacancy and turnover rates are high needed for every seven people over 65 and every three people over 75. This appears consistent with data from the Family Resources Survey, suggesting underlying need among older people has remained static over time, though in practice the relationship between jobs and the older population is unlikely to be as clear-cut since half of the public spending on social care is not on older people but on workingage adults.
If the number of jobs does continue to grow in line with the growth in the older population, the implications are stark: Skills for Care estimates the need for between 650,000 and 950,000 new adult social care jobs by 2035. The difficulty is in finding people to fill them – as made explicit in the box (right). n SOURCE: Social Care 360, using data from Skills for Care.
it can do to support people now. Putting more money into the system in this autumn’s Spending Review would help people to get the help they need while longer-term reform takes effect.”
Turnover rate of 30.7% a year Around 8% of jobs are vacant at any one time and 390,000 staff (30.7%) leave their jobs each year. Unpaid carers do the work of an additional four million paid care workers (ONS). www.kingsfund.org.uk www.skillsforcare.org.uk
TALKBACK l SUMMER 2019
18 TALKBACK WORKPLACE
It’s notoriously difficult for adults to get comfortable while working at low heights with young children. Trying to reconcile the demands of learning and the health needs of teaching staff during the school day is a challenge. Lorna Taylor, physiotherapist and director at the consultancy Jolly Back, offers some helpful tips...
How can primary school
‘
ALL primary and early years staff should have access to an adult height desk and chair for administration and regular computer/laptop use. If space is an issue, a height adjustable, mobile laptop table or overbed table are good, affordable options. When working at a computer or laptop, the screen should be level with the top of your eyes. A screen raiser, separate mouse and keyboard will be needed if using a laptop regularly. A height adjustable chair is required and can accommodate a variety of users. Chair arms are only required to assist users to get in and out of a chair and are not required for use at a desk. If chair arms are required, choose drop-down arms so they do not obstruct the user getting close to the desk. This applies if working from home, too. If regularly using a computer/ laptop/mobile device for work, a DSE risk assessment is required
by law. This explains the concept of “ergonomics” and helps prevent injury. Your Health and Safety officer at school will be able to advise. The Healthy Working Move initiative www.ergonomics4kids. co.uk is a free and easy place to start looking for straightforward ergonomics advice. The Healthy Working Move online programmes (apps: Move4kids and Move4Teens) offer simple and effective advice for educators, parents and children. It’s recommended that staff take a look at these for themselves and for their students.
Prevention The highest risk factor for experiencing back pain is already having had it. This makes prevention essential! Staff should be comfortable before they begin an activity and should STOP and move position if they start to feel uncomfortable. Arrange and
Staff should have access to a low, mobile chair if sitting and working at low children’s tables
TALKBACK l SUMMER 2019
organise classrooms and set up learning environments to make sure stooping, bending over and awkward postures are reduced to a minimum. For example, move bookshelves which obstruct the interactive whiteboard, ensure cupboards have clutter free access, can washing up happen in an adult height sink or in a raised bowl? All staff should have access to a low, mobile chair if sitting and working at low children’s tables. The discs of the spine are extremely vulnerable to twisting and shearing forces which occur when sitting on low static chairs or children’s furniture. The Jolly Back chair has been specifically designed for use in schools and nurseries. It is a low, mobile chair with height adjustable back rest and forward sloping seat which help users to get their legs under low tables and improves comfort. It’s advisable in rooms with very low tables, where adults need to spend long periods of time using the table, that a couple are raised up with “furniture raisers”. These can be easily found through an internet search. Children can work standing at the slightly higher tables for part of their day. Ask students to access their own resources, especially if low down to reduce staff stooping and bending over. A litter picker with magnetic pick up can help reduce repetitive stooping, too. It’s okay to stand upright when talking with young children at points throughout the day rather than bending to their height every time. When using a whiteboard, if it’s located high on a wall, a whiteboard step can assist use and reduce over-stretching. A remote whiteboard pointer and controller can also help staff as
TALKBACK WORKPLACE 19
Images: pressfoto/ Freepik
teachers avoid back pain?
Staff should be comfortable before they begin an activity and should stop and move position if they start to feel uncomfortable this can be used to operate the equipment while standing. Lifting and carrying books and resources need great consideration! A wheeled trolley case or crate may ease the manoeuvre of books and equipment if there are limited stairs. Use ramps to wheel equipment where available, it will only take a few extra minutes and can really help your back. It’s beneficial to push trolleys rather than pull them. Make sure manual handling training has been completed and is up to date. If carrying a single strap bag (including a handbag), wear it across your body (not on one shoulder) and swap sides
Make sure stooping and awkward postures are reduced to a minimum regularly. Two bags of similar weight carried in each hand or a rucksack worn on both shoulders are also other good options. Try to repack your bag every night so you are only carrying what you need. Back pain and emotional wellbeing are interlinked. It’s essential you feel supported at work and voice concerns if
you’re feeling cumulative strain injury (aches and pain coming on over time). If you are finding an activity difficult, it’s highly likely colleagues will be, too. Prevention of injury is key, so it really does help to speak with your line manager. Rest and movement breaks are essential to health so it’s important to take them. Try to limit sitting to 30 minutes before a stretch and move. Think 30:30 (30 minutes sitting to 30 seconds moving). A supportive leadership team and workplace culture are essential to protect and improve staff health and wellness. Does your organisation have a wellbeing or wellness group or
could you start one to discuss ideas and share new initiatives? There are always solutions! A classroom and workplace risk assessment can be requested (contact your Health and Safety officer) if you are experiencing pain. Recommendations can hugely improve your working environment when implemented. As with all areas of physical and mental health, back health is improved with good nutrition, exercise, adequate sleep and hydration. Remember, you are important! Improved health and happiness gives us all the ability to cope with challenges and enjoy the day. www.jollyback.com
’
TALKBACK l SUMMER 2019
20 TALKBACK IMPROVING OUTCOMES
Image: Ijeab/ Freepik
Four million under-65s have untreated
Doctor checking arterial blood pressure
Sharp increase in obesity-related hospital admissions ADMISSIONS to NHS hospitals, where obesity was recorded as either a primary or secondary diagnosis1 increased by 15% (94,000) on 2016/17. The Statistics on Obesity, Physical Activity and Diet, England, 2019 is an annual collection of new and previously published figures on obesity, including hospital admissions, prescription items, prevalence among adults and children as well as physical activity and diet. New figures in the report show that around two thirds of the admissions where obesity was recorded as either a primary or secondary diagnosis in 2017/18 were for women (66%). Of the 6,627 Finished Consultant Episodes for bariatric surgery in 2017/18, 79% of the patients were female. The number of items prescribed by primary care for obesity treatment decreased by 8% from 401,000 items in 2017 to 371,000 items in 2018 and
TALKBACK l SUMMER 2019
Child obesity over twice as high in the most deprived areas continues a downward trend since a peak of 1.45 million items in 2009. The net ingredient cost saw an increase for the first time in five years, rising from £6.9m in 2017 to £8.1m in 2018. Adult obesity prevalence stood at 29% in 2017, an increase from 26% in 2016. Prevalence of child obesity in both Reception and Year 6 was over twice as high in the most deprived areas than in the least deprived areas; 13% compared to 6% in reception year, and 27% compared to 12% in Year 6. 68% of men and 64% of women aged 19 and over met the government’s physical activity guidelines for adults in 2017/18; 21% of men and 23% of women were
classed as inactive in 2017/18. And just 20% of boys and 14% of girls were meeting the government’s physical activity guidelines for children. Women (32%) were more likely to consume the recommended five portions of fruit and vegetables a day, than men (26%); 18% of children consumed the recommended five portions of fruit and vegetables a day in 2017. 1) A secondary diagnosis of obesity does not necessarily indicate obesity as a contributing factor for the admission but may instead indicate that obesity is a factor relevant to a patient’s episode of care.
n 711,000 hospital admissions where obesity was a factor in 2017/18 n 10,660 hospital admissions directly attributable to obesity https://digital.nhs.uk
TALKBACK IMPROVING OUTCOMES 21
active, and I was on a climbing wall when I suffered a stroke. It was a big shock to me, as in my mind a stroke was something that mostly affected older people. When I got to hospital I found out that my blood pressure was through the roof. I don’t know how long I had high blood pressure for, but I suspect for quite a long time. The warning signs were there – I had high blood pressure after a minor car accident but put this down to being in the accident itself. “My life was very busy and I felt very stressed at times, and I wish I had taken high blood pressure more seriously. It is the hardest thing about what happened – that there is a good chance I could have avoided it by acting on early warning signs.” If you’re over 40, getting your free NHS Health Check is a simple way to find out your blood pressure as well as your risk of other serious conditions. www.bhf.org.uk
Rheumatology care compromised due to nurse workload
Image: rawpixel.com/ Freepik
FOUR million people under the age of 65 in the UK are living with untreated high blood pressure, according to new estimates from the British Heart Foundation. Around 1.3m of these people are under the age of 45. If untreated, high blood pressure can significantly raise the risk of heart attack and stroke. It is also associated with an increased risk of vascular dementia. High blood pressure, often referred to as a silent killer, does not usually have any symptoms, meaning that many people are unaware they are living with one of the risk factors most commonly associated with heart attacks and strokes. However, if detected, the condition can be easily treated by a combination of simple lifestyle changes and medication, depending on the individual. Gwynneth Clay, 56, a project manager from Edinburgh, suffered a haemorrhagic stroke in 2016. “I have always been quite physically
Image: rawpixel/ Freepik
high blood pressure
Ready meals and convenience meat products continue their clear upward trend, with a highest ever estimate in 2016/17
THE excessive workload for NHS rheumatology nurse specialists is compromising patient care, according to a new report. More than eight in 10 nurses (85%) surveyed said that there were aspects of care that their team was either unable to provide or was much delayed because of workload. Examples of delayed care include providing urgent access to clinics, responding to calls on advice lines, joint injections and prescriptions. In the joint report1 by the British Society for Rheumatology and the charity National Rheumatoid Arthritis Society (NRAS), nurses said they felt “overwhelmed”, “stressed”, “tired” and “lacked support”. The nurse specialist role can incorporate many elements, including making diagnoses, physical examinations, starting treatments, prescriptions of medicines, improving physical, psychological and social functions and referrals for investigations.
Struggling The report reveals that patients are struggling to schedule appointments sooner than six months in advance. Long waiting times can lead to irreversible damage for patients with conditions like arthritis, where prompt treatment is vital. Ailsa Bosworth, Chief Executive of the NRAS, said: “Patients tell us that rheumatology nurse specialists are a lifeline for them, helping them to manage and alleviate both the physical and psychological suffering. “Currently, nurses are struggling to deliver even a core service and don’t have sufficient time to innovate or develop professional practice.” Rheumatology covers all musculoskeletal conditions that affect the joints, bones and muscles, and includes rarer autoimmune diseases and back pain. Three quarters (78%) of departments surveyed reported that their rheumatology caseload was more than 1,000 patients. 1) Specialist Nursing in Rheumatology: The State of Play
www.nras.org.uk
TALKBACK l SUMMER 2019
22 TALKBACK COMMUNITY
European “Musculoskeletal health in Education” launch MSK conditions go on the national agenda MUSCULOSKELETAL conditions have, for the first time, formed part of the Government’s remit letter setting out its priorities for Public Health England (PHE). Last year, PHE made musculoskeletal conditions one of its priority programmes and so MSK professionals are encouraged to see “workfocused musculoskeletal prevention activity” on the 2019/20 national agenda. This summer, PHE will publish its five-year prevention plan for musculoskeletal conditions. The strategy has been put together with partners including Versus Arthritis.
Delegates from more than 15 countries work in education, occupational health and safety management A EUROPEAN campaign dedicated to improving the musculoskeletal health of young people has been launched across more than 20 countries. The aims of the #YoungMSD collaborative project are to improve ergonomics in education and promote musculoskeletal health for teachers, children and young people. This will help protect teaching professionals currently working, those entering the profession and the future workforce. EU-OSHA, an organisation that focuses on making Europe a more productive place to work and ENETOSH (the European Network for Education and Training in Occupational Safety and Health) collaborated on the scheme. Lorna Taylor, education-based physiotherapist and founder of Jolly Back, was part of a diverse working group of delegates from more than 15
countries working in education, occupational health and safety management. She said: “I’m looking forward to taking an active role within the #YoungMSD project which runs until 2022. I’ll be looking at low-height working for early years and primary teaching and support staff, along with sharing initiatives to improve activity, technology use and posture for children.” Resources created will be translated into 25 European languages to be shared. n Jolly Back’s scheme to provide ergonomic solutions for low-height working in Trent Vale Infant & Nursery School was commended in the HSE’S 2018 “Risk-reduction through design” Award. www.jollyback.com www.ergonomics4kids.co.uk
Conference to evaluate “whole systems” THE countdown has begun for the Public Health England (PHE) Annual Conference 2019, taking place at Warwick University on 11-12 September. The conference brings together more than 1,500 participants from a wide range of organisations to learn and share knowledge and experience to help improve public health.
TALKBACK l SUMMER 2019
This year’s programme focuses on some of the areas where PHE can make the greatest improvements in health and reduce health inequalities, including promoting a smokefree generation, giving children the best start in life, tackling antimicrobial resistance, supporting place-based health and producing world-class science. Sessions include, “Taking a whole
systems approach to tackling obesity, inactivity and other lifestyle risk factors”. A growing number of local areas across England are beginning to deploy systems approaches to tackle public health issues, including obesity and sedentary lifestyles. This has in part been driven by programmes such as Public Health England’s whole systems approach to
TALKBACK COMMUNITY 23
Reducing MSD-related ill health in the construction industry
A MIDLANDS warehouse firm has been trying out special “exoskeleton” suits that minimise the physical stress of carrying heavy items. Is this the way forward for manual handling tasks and what will it mean for the population?
ACTION is needed to tackle the huge Work-related ill health by burden of bone, joint and muscle illness type conditions on people in the construction (Source: LFS annual average estimate industry, says a new report from the 2014/15-2016/17) Arthritis and Musculoskeletal Alliance (ARMA). Physically demanding work means the construction industry has one of the highest Other rates of musculoskeletal disorders costing illness £646 million every year – accounting 20% for more than three-quarters of all occupational ill-health costs. The ARMA report followed a roundtable meeting of industry Stress, leaders. The key issues identified were depression prevention and the need for early or anxiety support. 15%
Star letter
Preventive measures
Adrian Shah-Cundy from VolkerWessells UK, a speaker at the roundtable, said: “This is a challenging subject due to the physical nature of our activities but, as the figures demonstrate, as an industry we still have a way to go to improve working practices and preventive measures. “We welcome the opportunity to work with, and learn from, a diverse range of stakeholders for the betterment of health and wellbeing.” The industry panel concluded that all employers need a musculoskeletal disorders action plan, developing awareness of bone,
Musculoskeletal disorders
65% joint and muscle problems beyond just manual handling. There needs to be greater awareness of MSDs, with open conversations encouraged and support provided when employees are struggling. There should also be routine monitoring of employee musculoskeletal health and wellbeing. http://arma.uk.net
Image: jcomp/ Freepik
approach to public health obesity and Sport England’s Local Delivery Pilots, who are working collaboratively to support local areas and develop and share learning about whole systems working. Matt Hancock MP, Secretary of State for Health and Social Care, will give a keynote address on the second day of the conference. www.phe-events.org.uk
Introducing exoskeletons into the workplace
I’m not entirely sure about these – having a mixed employment background as health and safety manager and a podiatrist with special interest in full body bio-mechanics. My honest opinion is we just don’t use our bodies enough to help protect them from MSK injuries. What we also have are broken bodies from a rich history of physical incidents, broken bones, sports injuries, operations, car crashes, lifestyle etc. All these events leave a mark and a modified movement pattern. During my time as a safety manager most MSK injuries reported at work which I investigated, I could nearly always identify an underlying previous event that potentially could have been the real root cause to the new injury occurring. Not always work related. The less we ask our bodies to do and the more technology we have doing stuff for us, the more our MSK systems “switch off” and devolve. Our MSK system is millions of years old and built to do physical work. We certainly need to protect people at work but I am a strong believer in education and helping people identify the specific weaknesses and restrictions in their own bodies, so we can implement strategies to predict and prevent future MSK injuries. Darren Kerr, Bedford n SEND your letters to: richard. sutton@backcare.org.uk
TALKBACK l SUMMER 2019
24 TALKBACK NEWS
BackCare Awareness Week 7-11 October 2019
BACK PAIN IN GOLF Golfers are the focus of this year’s BackCare Awareness Week, 7-11 October. Low back pain is a common golf injury and recurrent episodes can hinder your enjoyment of the sport and have a huge impact on your life in general. This year, BackCare will be shining a light on the subject and promoting good back health for everyone involved in the sport.
KEY TOPICS
l Injury factors l Warm-ups and stretches l Treating the pain l Rehab and exercise l Supports and accessories
TALKBACK l SPRING 2019
Charity No. 256751
Image: chevanon/Freepik
WE WANT TO HEAR FROM YOU! Tell us how you’d like to get involved. Contact info@backcare.org.uk
