Professional Practice Committee
BOA Guidance Development Process
Professional practice does not lend itself to easy definition and our strategy in this area is multifaceted. It comprises:
- Liaison with the Department of Health to influence and inform the healthcare reform programmes across the UK, the NHS productivity challenge, and the quality agenda. We seek to effect this through constructive engagement with:
- Health Ministers – both in our own right and through our membership of Arthritis and Musculo-skeletal Alliance – ARMA (http://www.arma.uk.net/)
- Senior Department of health officials, including the Medical director for NHS England and the relevant National Clinical Directors
- The Right Care, Centre for Workforce Intelligence, Payment by Results, Patient Reported Outcome Measures and Enhanced Recovery Programmes, as well as Procurement
- Engagement with the chief medical officers for the devolved administrations in Scotland, Wales and Northern Ireland
- NHS liaison through:
- Orthopaedic clinical directors at the front line via the British Orthopaedics Directors Society.
- Our Regional Advisers, who twin hatted as Royal College of Surgeons of England Regional Specialty professional Advisers.
- Our linkmen in each hospital across the UK
- ARMA to engage with commissioners in conjunction with clinical colleagues in the British Society of Rheumatologists and the Chartered Society of Physiotherapists
- Private practice – where we work closely with the British Medical Association and the Federation of Independent Practitioner Organisations
- Engagement with NHS Trusts – in particular the Specialist Orthopaedic Alliance
- International engagement – through our membership of the European Federation of Orthopaedics and Traumatology, the Carousel (the National Orthopaedic Associations of the United States, Canada, Australia, New Zealand and South Africa), the Bone and Joint Decades, and increasing interaction with the Indian and Chinese Orthopaedic Associations
- The dissemination of good trauma and orthopaedic practice through our Blue Book and trauma guides
- The dissemination of information for orthopaedic patients
- Issues of clinical surgical practice, where we engage with:
- The National Institute for Health and Clinical Excellence (NICE) on Quality Standards and clinical guidance
- The Medicines and Healthcare products Regulatory Agency (MHRA) on implants and other devices, as well as the NHS Supply Chain Orthopaedic Device Evaluation Panel (ODEP)
- The Healthcare Quality Improvement Partnership (HQIP) for issues related to the National Joint Registry and the National Hip Fracture Database
- The National Confidential Enquiry into Patient Outcomes and Death (NCEPOD)
- Medico Legal issues in a rapidly evolving area of surgical advisory practice
- Extensive liaison with industry through engagement via the Association of the British Healthcare Industry (ABHI) orthopaedics Special Interest Section and our own British Orthopaedic Industry Liaison committee (BOIL)
Restoring Your Mobility: Doing more and better for less
The BOA has recently launched a new Practice Strategy Document, an extract from which is below. The full document can be found in the 'Related Content' at the bottom of the page.
The aim of orthopaedic surgery is to restore pain free mobility.
The burden of long term musculoskeletal conditions, which impair mobility and therefore independence, is increasing due to an aging but healthier population.
Although the science and practice of orthopaedic surgery has developed the demand has stretched the capacity of current NHS surgical resources and infrastructure, manifested by steadily rising waiting lists. The current financial situation constrains the ability of the NHS to increase sustainable capacity.
The NHS Operating Framework for 2012/13 highlights the current problem with waiting lists and emphasises the patients’ right to a maximum wait of 18 weeks between referral and treatment. It indicates that pilots, focused especially on orthopaedic surgery, will be carried out in 2012/13 to identify the best way(s) in which NHS Trusts can meet their responsibility in the best interests of patients – and that the lessons will be available for full roll out from April 2013.
This is a critically important initiative.
Conventional solutions to the mismatch between demand and capacity of withholding access to care or increasing short term capacity – for example the use of the independent sector treatment centres, risk the safety and quality of care and neither are sustainable.
Innovative approaches are required that optimise existing structures, resources and programmes in ways not previously considered, harness the opportunities in the emerging healthcare landscape, and focus on many of the benefits available through the QIPP. In this way we can safely improve quality, decrease unexpected variation optimise expenditure and release resource.
The British Orthopaedic Association stands ready to assist in this work.
This short strategy paper sets out the problem, based on six interconnected elements, including the challenge to clinicians. It sets out a five part solution encompassing quality, integration (across primary and secondary care), effective provider partnerships, radically improved implant surveillance and culture change. Click here to read the full document.
The Practice Strategy MindMap (see right) describes the six guiding principles for Trauma & Orthopaedic Surgery - click on the image to expand.
We progress detailed elements of our practice strategy here through our Professional Practice Committee, Trauma Group and Medico Legal Committee:
The Professional Practice Committee (PPC)
Developing and sustaining excellence in professional practice is a core objective of the BOA’s overall strategy. The PPC is charged by the BOA Council with maintaining a clear focus on all aspects of professional practice, including essential linkages with Association’s other core objectives related to training, education and research.
The PPC supports both surgeon and patient needs. To do this it covers:
Professional Standards of Patient Care – objectives:
- Create a structure for Blue Books that:
- Highlights gaps in coverage that need to be filled
- Clearly shows when guidance needs to be reviewed/updated
- Create a similar structure for BOASTs
- Develop a framework of standards with other members of the broader musculo-skeletal clinical and allied health professional multi-disciplinary team
- Building on the ACPA national transferable role documentation
- Focusing in particular on extended scope practitioners (physiotherapists, podiatrists and orthopaedic nurses)
- Professional Behaviours – objectives:
- Review existing GMC, BMA, AAOS and ABHI guidance covering:
- Consider the need to fill any gaps in this coverage
- Publish the Code of Ethics for Interaction with Industry
- Employment, Trusts and Private Practice:
- Review existing (Blue Book) guidance
- Compile a list of issues where BOA positions would be important to support the membership
- Develop the BOA’s shopping list for the BMA and FIPO
The BOA Guidance Development Process
The Professional Practice Committee is currently implementing a new process by which future BOA Publications can receive NHS accreditation. As such, the BOA's Guidance Development Process has recently been drawn up and will soon be tested on some new and existing documents. This Guidance closely follows the NHS Evidence model with it's 6 domains and 25 criteria, and can be viewed via the mind
map (see right).
For more information about the PPC, please go to the PPC page
The Trauma Group
The Trauma Group is responsible for covering all aspects of trauma care within the BOA's remit. These include:
Developing the BOA professional guidance on Major Trauma Centres
Producing BOA Standards for Trauma (BOAST) guidelines
Contributing to the trauma component of the emergent BOA research strategy
Developing policies and standards of care for fragility fractures
For more information about the Trauma Group, please go to the Trauma Group page
Co-ordination of unit reviews triggered by National Hip Fracture Database reports
The MedicoLegal Committee
The aim of the Committee is to focus on the BOA role in providing medicolegal assistance in all aspects of trauma and orthopaedic practice. Its role is to maintain an oversight of legal matters in relation to the safe practice of orthopaedic and trauma surgery and the preparation of reports for the Courts.
The medicolegal committee also has a responsibility to inform members of the Association of the changes in law relating to the practice of trauma and orthopaedic surgery, report writing and giving evidence.
It co-ordinates the position of the BOA in response to Government and legal profession changes in policy in relation to medicolegal expert and professional witness practice. The Medicolegal Committee also gives advice to external agencies regarding appropriate expertise to deal with medicolegal questions, both nationally and internationally.