P259 Helping each other to deliver best practice for our axSpA patients: a special interest groups' ‘top tips’ for colleagues
Authors: Gregory William J , Brazendale Jane S , Longton Clare , Marshall Nina , Martindale Jane 
Published: April 2020

Abstract

Background
The Axial Spondyloarthritis Specialist Interest Group North-west (ASSIGNw) is a regional network of physiotherapists with special interest in axial spondyloarthritis. The group meets to share best practice and provide a forum for professional support. The National Axial Spondyloarthritis Society (NASS) ‘Aspiring to Excellence’ campaign highlights the need for co-production and sharing of expertise as being imperative to the improvement of care for all this group of patients. A consensus sharing exercise was performed within the group to look at addressing this. Following discussions, there was an aim to create a ‘top tips’ for practice guidance for sharing with colleagues both in the group, and nationally.

Methods
During the March 2019 meeting, each member was invited to share their top tips for practice. After this sharing exercise, two members of the group reviewed and themed the suggestions. This thematic analysis was then shared by email to all group members to allow for further contributions. An additional opportunity within our next group meeting was used to ratify the themes and provide group endorsement.

Results
Suggestions for top tips for practice included ‘Do’s and Don’ts’ and fell into 2 main categories: patient care and service delivery. ‘Do’s for patients’ related to ‘Communicate and educate’ focusing on therapists communication, the importance of explaining diagnosis, giving reassurances and signposting patients to appropriate educational materials. The ‘Assessment’ theme included suggestions to acknowledge importance of therapeutic relationship building, using detailed history compilation to learn the patients’ journey, co-morbidities, sleep hygiene and fatigue, and the impacts these have on quality of life. In contrast, ‘Don’t’s for patients’ warned of ‘Being aware’ emphasising the difficulty of arriving at a diagnosis and the pitfalls with con-concomitant chronic widespread pain or Fibromyalgia. ‘Do’s for service’ describes the ‘Communicate with all’ theme highlighting the need to be all inclusive with every member of the service, liaising both with internal and external stakeholders but more importantly focusing upon the needs of patient and the services responsiveness to changes in these. ‘Don’t's for service’ were themed as ‘Silent Gremlins’ warning colleagues to be aware of invisible undercurrents or issues within practice or services and being unafraid to identify weaknesses within the service. Examples included poor booking systems or analysing the ‘one time it went wrong’ when it mainly goes ‘right’ experiences.

Conclusion
We have described a short consensus sharing exercise in which experienced clinicians on a regional basis have been able to contribute their views on what works well and what doesn’t work well for both patients and practice. This work has produced a brief guide or ‘sharing tool’ which can be built upon to help experienced and more importantly less experienced colleagues to develop their practice.

Disclosures
W.J. Gregory: Honoraria; W.G. has received speaker fees from Novartis and received Conference attendance fees from Pfizer. J.S. Brazendale: None. C. Longton: Honoraria; C.L. has received sponsorship support from Novartis, Pfizer and UCB. N. Marshall: None. J. Martindale: Honoraria; JM has received honoraria from Abbvie Ltd, Novartis, Pfizer and UCB. Grants/research support; JM has received a research grant from Pfizer.