Mobility Action Programme - questions and answers

The aim of the Mobility Action Programme (MAP) is for people with musculoskeletal health conditions to fulfil their health potential and increase independence.  This will be achieved by improved access to high quality advice, assessment, diagnosis and treatment including education and rehabilitation.

These outcomes would include improved management of pain and other symptoms of their musculoskeletal conditions. People will be able to better carry on activities and functions that are important to them. Providing the right support for people to manage musculoskeletal conditions early means quality of life is improved and the need for surgery may be reduced.

A fundamental principle of the MAP is that the right care is provided in the right place at the right time by practitioners with the right resources.

The wider aim of the MAP is to evaluate programmes so that we can identify models of care that provide the greatest benefits for people with musculoskeletal conditions while providing good value on the investment in health resources.

It is the expectation that the MAP models of care, and the lessons learned from them, will translate into larger scale and sustainable publicly-funded services provided by local funders.

It’s recognised that more can be done to improve the health and quality of life of individuals with musculoskeletal health conditions. The MAP will look to find ways to address this issue.

It’s positive that people are living longer, but an aging population also means musculoskeletal conditions are increasing. We want the extra years of life enjoyed by our people to be as full and independent as possible.

Musculoskeletal conditions can be a major contributor to people requiring time away from work and impact on other parts of their life.

Data from the New Zealand Health Survey 2014/15 shows:

• The prevalence of chronic pain and arthritis (a cause of chronic pain) is increasing.
• The prevalence of chronic pain has increased from 17% in 2006/07 to 20% in 2014/15. Similarly, the prevalence of arthritis has increased from 15% to 17% over the same period.
• The prevalence of arthritis increased steeply with age, with more than half of adults aged 75 years and over (54%) affected.
• The most common form of arthritis was osteoarthritis, which affected 11% of adults. The prevalence of osteoarthritis increased from 9% in 2011/12 to 11% in 2014/15.

In Budget 2015 the Government allocated $6 million of new funding over three years to help improve care for people with musculoskeletal conditions.

This includes improving access to early community-based care, education to encourage self-management, and rehabilitation programmes to improve function, and participation in activities.

In late 2015 the Ministry sought initial applications for funding a range of projects to demonstrate improvements that can occur to the quality, quantity and timeliness of care for people with musculoskeletal conditions. We expect the projects to be underway in the first half of 2016.

While the projects will take a variety of approaches, we are referring to them collectively as Mobility Action Teams (MATs).

There will be a further opportunity in early 2016 for future applications to be part of MAP.

The target population for the MAP includes adults with musculoskeletal conditions that are present for three months or longer and who are not covered by ACC.

The MAP aims to assist people at all stages of their condition.  However the main focus is on people who need advice and support to manage their symptoms before they have deteriorated to the extent that they may need hospital level care / surgery, for example a hip or knee replacement.

A fundamental principle is that the programme will contribute to a reduction in disparities in access to musculoskeletal health services and health outcomes, between non-Maori and Maori and Pacific Island communities.

The programme will enable people with musculoskeletal health conditions, including osteoarthritis (OA), rheumatoid arthritis (RA), and osteoporosis (OP) to access publicly funded services that reduce pain and other consequences of the conditions, and enable participation in everyday activities.

Services include early and appropriate assessment, diagnosis, treatment and care, including education to support self-management, and rehabilitation to improve quality of life.

An individual with a musculoskeletal health condition e.g. Osteoarthritis, would be referred to a service where they will receive an assessment, diagnosis and have a plan of care developed with them.  The plan will be tailored to meet their individual needs based on their diagnosis and musculoskeletal assessment.

Depending on the needs of the individual, care may include exercise and weight loss programmes, education on how to manage their pain and symptoms that are impacting on their lifestyle and ability to participate in activities important to them.  The individualised programme will include education and rehabilitation components so that people can better understand their condition and improve their self management or know when to seek appropriate professional help.  Programmes will be individualised based on a person's specific needs, and may include group exercise and education sessions.

A range of health care providers could be involved in delivering the care, including GPs, physiotherapists, dieticians, nurses, and wellness experts, depending on the specific needs of the individual. This team of health providers make up the Mobility Action Team.

However we would stress that MAP is looking for a variety of approaches.

No, this programme is about developing and putting into practice a range of different projects so they can be evaluated.

We want to understand the strengths and benefits of all of the different approaches.   

By necessity some of the projects will involve relatively small groups of people.

The long-term aim however is that the lessons from the MAP will be able to be applied eventually to many individuals where the benefits can be clearly shown.

The Ministry of Health oversaw selection and contracting with individual projects.

The Ministry was assisted by a multi-disciplinary Expert Advisory Group (EAG) that has been established by the Ministry to advise on the programme. The experts include specialists in rehabilitation, rheumatology, exercise, nutrition, orthopaedics, physiotherapy, pharmacology, primary care, nursing, and representatives from ACC and consumers.  The group covers a breadth of academic expertise and current clinical practice.

Two tender processes will be undertaken to select providers who can deliver evidence-informed, innovative and collaborative models of care developed by practitioners, consumers and their families where appropriate, to  meet the needs of people with musculoskeletal health conditions.

Three years. It is for the 2015/2016, 2016/17 and 2017/18 financial years.

You can contact the MAP team by emailing Edith Bennett: Edith.Bennett@health.govt.nz.