Musculoskeletal problems and work: Challenges and solutions

Dr Richard Graveling has been an ergonomist for 45 years, having worked for the (Institute of Occupational Medicine) IOM throughout. When he first joined the IOM it was part of the NCB and almost all of his work related to coal mining. Once British Coal (and the bulk of the UK coal mining industry) ceased to exist he remained with the now independent IOM and diversified into many other sectors and industries. Throughout these years Musculoskeletal Diseases (MSDs) have been a significant focus and he has engaged in both research and consultancy concerning this major cause of work-related sickness absence and chronic ill-health. Two main topic areas have been back pain and upper limb disorders.

However, MSDs have not been his sole focus and work-related stress has been a constant thread - continuing an interest that started in his pre-IOM years with his PhD research. As with MSDs this work has involved both research and consultancy and he was the primary author of guidance on stress at work prepared for EU-OSHA (the European Agency for Safety and Health at Work) which was translated into all the main EU languages.

These two threads are now coming together, as a growing body of research demonstrates that physical risk factors only provide part of the picture concerning workplace MSDs and that stress at work (psychosocial risk factors) can contribute to their causation.

Although now largely retired Richard remains active with the Chartered Institute of Ergonomics and Human Factors and is currently its Registrar.

Professor Anthony Woolf is a consultant rheumatologist and has worked at the Royal Cornwall Hospital, Truro, UK. He has held honorary chairs in Rheumatology at the University of Exeter Medical School, Plymouth University Peninsula Schools of Medicine and Dentistry, and visiting Professor in Musculoskeletal Science, Faculty of Medicine, Lund University, Sweden. He is past chair of ARMA and co-chair of the Global Alliance for Musculoskeletal Health (G-MUSC).

His work focuses on influencing policy and practice nationally and internationally providing the evidence for gaining priority and the tools to implement change to benefit individuals through prevention and control of musculoskeletal conditions.

He works with NHS England, OHID/Public Health England and Department of Work and Pensions and with WHO and EU to ensure musculoskeletal health is in all policies – health, social and employment. A major focus is on reducing the impact that musculoskeletal conditions have on people’s ability to work, including advising the Joint Work and Health Unit, UK and the European Agency for Safety and Health at Work (EU-OSHA) as well as developing practical solutions for employers such as the ‘MSK Aware’ programme www.mskware.org .

Andrew is a Consultant Musculoskeletal Physiotherapist within Sutton Health and Care hosted by Epsom and St Helier NHS Trust. He provides expert clinical practice and leadership within Community MSK services, transforming the local framework for delivering triage and therapies, integrating first contact practice, digital health technologies, local leisure services, virtual multidisciplinary meetings, and referral pathways to spinal, orthopaedic, rheumatology and pain management services. He has gone on to take a lead expert specialist role within the Southwest London Integrated Care System. He is a non-medical prescriber, a member of the Musculoskeletal Association of Chartered Physiotherapists, and former Co-chair of the Consultant Physiotherapy Special Interest group within the Chartered Society of Physiotherapy.
Andrew became National Clinical Director for MSK within NHSE in November 2019. He led the MSK response to the coronavirus pandemic driving an integrated approach across primary, community and secondary care, working closely with professional and patient facing stakeholders and being recognised for championing co-production. He has gone on to take a lead role in recovery, driving the Best MSK health pathway improvement programme and integrating this work into GIRFT. This also includes championing crowd sourcing strategies such as #Changechallange and #Solvingtogether working with NHS Horizons and integrating associated learning into recovery planning. He continues to take a lead role regarding both Long Term Plan ambitions and driving NHSE priorities related to MSK including First Contact Practice, self-referral, community transformation, outpatients’ transformation, diagnostics recovery, and personalised care. More recently he gone onto collaborate with colleagues across the Department of Health and Social Care regarding the Major Conditions Strategy work and integrating ambitions related to leadership, digital health technologies and employment support.