Annual Newsletter 2009

by Iain Gilchrist
on 1st January 2009

Dear Member

Welcome to the latest PCR Newsletter. I hope the recent snow storms, high winds and floods haven’t affected you too much. Looking back on Adam’s Newsletter last year, he wrote much the same. Perhaps we should change the time of year the Newsletter comes out! Still, I shall attempt to warm the cockles of your heart by informing you of some of the activities of the Society and some individual members.

We must acknowledge the achievement of Graham Davenport, one of our illustrious former Presidents, in being appointed the RCGP Clinical Champion for Musculoskeletal Disease. As part of his remit Graham has organised a “Training the Trainers Workshop” in osteoporosis in April. Details are enclosed with this mailing. It is hoped that the Trainers will then disseminate this osteoporosis programme throughout each PCT area, raising awareness of the condition, and best practice for dealing with it. Graham’s appointment is an excellent boost to the awareness of the Society in the wider world of general practice, and congratulations once again to Graham.

John Dickson, whom some of you may know, has been very busy again in the past year. No surprise there, then. Among his achievements have been co-operating with Prof. Michael Doherty in writing a chapter on gout and pseudogout for Map of Medicine, and referral guidelines for the Royal College of Surgeons on hip OA. He has also been involved in NICE Technology Appraisal on hip replacement prostheses and metal on metal hip resurfacing, due for publication later this year. John has also co-authored a chapter on back pain for ABC of Rheumatology, to be published later this year by Oxford Publishers. Somehow or another, John also was a co-author of the Sapphire Trial, on shoulder pain (Watson J et al., Rheumatology, 2008, 47, 1795-1802.

John has also been heavily involved with Elspeth Wise in setting up the Bradford/PCR Diploma in Musculoskeletal Medicine which will hopefully more than adequately fill the gap left by the demise of the Bath/PCR Diploma in Primary Care Rheumatology. The first intake goes live at the end of March, and there will be two intakes each year. We hope that they have great success with this new venture.

John and Elspeth are also collaborating with Phil Helliwell in organising the Primary Care Day on Feet at the BSR in Glasgow on 28th April.

One of our newer members on the Steering Committee, Alan Nye, sits on the Rheumatology Futures Group, which commissioned a King’s Fund Report “Perceptions of patients and professionals on rheumatoid arthritis care”. I was pleased to represent the Society at the launch of the report recently, and would recommend it to you. The report can be accessed through the King’s Fund website. As a result of this, Alan has been asked to develop a commissioning pathway for inflammatory arthritis on behalf of the DH and the Futures Group, The draft pathway will be sent out next week, with a consensus event in April, where the pathway will be agreed. As if that were not enough, Alan has also attended a meeting on behalf of PCR and DH looking at ways of influencing NICE to adopt some MSK measures to be included in QOF. It has been decided to use ARMA as an umbrella organisation to take this project forward, looking in particular at osteoporosis and inflammatory arthritis.

With all this activity going on, it looks like 2009 will be the “Year of Inflammatory Arthritis”, as NICE is also due to issue their Guidelines on Management of Rheumatoid Arthritis next month.

However, Primary Care Rheumatology is not only about inflammatory arthritis. It was good, therefore, to see the recent publication of a double blind trial on localised or systemic steroid injection for rotator cuff disease (BMJ 2009;338:a3112). While the results may be welcome to those who don’t know their arse from their elbow (or indeed shoulder), is it going to change our practice? In their discussion, even the authors note several problems with their study, including the fact that most of their patients had symptoms of over 6 months duration. How many of the patients that we see have their first injection at 6 months? Further research is still needed so that we can find the optimum treatment for this common disorder.

It is good to see that in its third decade, the Society is as active as ever, if not more so. It is your society, so please make whatever contribution you can, by using the website, by attending meetings, and by promoting the PCR Society to your colleagues. I look forward to meeting you at the osteoporosis meeting, BSR, and our own Conference in November. Details of these meetings are being enclosed with this newsletter.

Iain Gilchrist


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