Benchmarking community/primary care musculoskeletal services: A narrative review and recommendation

Burgess, Roanna; Lewis, Martyn; Hill, Jonathan

Abstract

INTRODUCTION: High quality data on service performance is essential in healthcare to evidence efficacy, efficiency, and value. There remains a paucity of publicly reported data in community and primary care musculoskeletal (MSK) services. There is also a lack of guidance on which metrics MSK services should be collecting and reporting, and how this data could be used to directly improve patient outcomes, experiences, and value. METHOD: A narrative review of the evidence around benchmarking MSK services was undertaken with a focus on how to develop routine data collection within community/primary care settings, and how to develop benchmarking capabilities for the future, looking towards a national MSK audit. This evidence was triangulated with the findings from recent MSK data studies undertaken by the authors and emerging UK policy and guidance in this area. RECOMMENDATIONS: To enable MSK benchmarking services need to collect consistent, standardised outcomes and, therefore, we have developed a recommendation on a minimum MSK 'core outcome set' of Patient Reported Outcome Measures (PROMs) and Patient Reported Experience Measures (PREMs) (PROMs: MSK-HQ, NPRS, WPAI; PREMs: National MSK PREM). In addition, we make recommendations on the use of a standardised evidence-based method for case-mix adjustment and outlier identification (using the following baseline demographics and clinical factors; age, sex, ethnicity, pain site, comorbidities, duration of symptoms, previous surgery, previous pain episodes), alongside considerations on how this data should be integrated and reported within NHS systems. CONCLUSIONS: Capturing high quality MSK data in a standardised, consistent, and sustainable way is a significant challenge. Policy holders, commissioners, managers, and clinicians need to be realistic with expectations, and take time to explore barriers to implementation including, funding, digital infrastructure/intra-operability, data sharing/governance, digital literacy, and local/national leadership. Next steps include developing a national MSK audit programme to provide a benchmarking model to support continuous improvements in care quality for patients living with MSK conditions.

Citation

Burgess, R., Lewis, M., & Hill, J. (2023). Benchmarking community/primary care musculoskeletal services: A narrative review and recommendation. Musculoskeletal Care, 21(1), 148-158. https://doi.org/10.1002/msc.1676

• Journal Article Type: Article
• Acceptance Date: Jul 8, 2022
• Online Publication Date: Aug 11, 2022
• Publication Date: Mar 1, 2023
• Journal: Musculoskeletal Care
• Print ISSN: 1478-2189
• Publisher: Wiley
• Volume: 21
• Issue: 1
• Pages: 148-158
• DOI: https://doi.org/10.1002/msc.1676
• Keywords: Nursing (miscellaneous), Rehabilitation, Physical Therapy, Sports Therapy and Rehabilitation, Orthopedics and Sports Medicine, Chiropractics, Rheumatology