MSK and Proactive Care Planning From Rhetoric to Reality Dr David Paynton National Clinical Lead RCGP Centre for Commissioning david.Paynton@nhs.net Holly opens the day

Changing the Conversation What is the Problem Correcting biomedical Traditional medical approach History Examination Investigations Diagnosis Treatment Context Review Preparation Discussion Agree/record Make it happen CC&SP Supported by nurses/advocate The hardest bit! What is important to you

Medical or Social Model of Care Medical model Reactive Social model Proactive Crisis plan, focus on bio-medical solutions – passive involvement Support planning focus on biosocial solution – active involvement

So why is this important?

So where does MSK fit?

RCGP commission principles (Oct 15)

Changing the way we work is not easy! Proactive processes to enable monthly MDT’s Redefine the primary care team Working with people, third sector and social services Sharing the information Perverse system levers Cultural ways of working But This is our chance to take back the professional agenda

Developing a network of champions Learning by Doing Support those implementing despite the system Encourage them to cascade locally Inform us and share the learning in real time Four types of champions Regional Specialty Process Local influencers We are all on a journey