Is co-operation synonymous with integration? If co-operation is the act of working together to the same end, and integration is the process of joining two or more entities together then the answer is surely “yes”.

Since being appointed to the first Patient Engagement & Empowerment Champion role in physical health services, musculoskeletal (MSK) specifically – having been a peer support worker previously –my learning and understanding to bringing the patient perspective and voice to proceedings has grown immeasurably.

Contributing to a number of integration initiatives has been a privilege and witnessing interdisciplinary co-operation has been significant. I can instance two reported scenarios where the patient experience has been extremely positive through clinicians “working together to the same ends”. As the patients put it: “fantastic”, “saved me so much time”.

Picture the scene. A patient has an appointment, after referral, for a singular knee problem. It became evident to the assessing clinician that both knees needed the same attention. During the consultation the clinician was aware the patient’s knuckles were also ‘swollen, enlarged and deviated’. It soon became apparent the patient’s multiple symptoms were related and needed urgent rheumatology input. While the MSK practitioner was the primary clinician, it was known a rheumatologist was in an adjacent consulting room. In immediate conversation with the rheumatologist the patient was further assessed and offered a steroid injection, administered by clinician number three at the same attendance. Short term follow-up appointments have been arranged by the clinicians and the patient has had a “fantastic” experience.

Quite coincidentally, another patient with a troublesome knee had been triaged for physiotherapy. During that appointment the treating physiotherapist became aware the patient had two other appointments some considerable time later; one with an Advanced Physiotherapy Practitioner (APP) and another for an MRI scan, requested by the referring GP. Also being aware that the APP was in attendance at the clinic, the treating physiotherapist took the patient to see the APP who attended to the matters which were scheduled for a later date. The upshot has been the APP will review the patient after the MRI results are received and assess, with the treating physiotherapist, the next phase of the patient’s journey through the service. “An excellent, joined up experience” was the patient’s response.

These are two scenarios where integration and co-operation clearly have the patients’ endorsements.

My current role takes me into areas of huge importance to patients, service users, their carers and the public. As instanced by the two cases above the patient burden can be quite onerous. Imagine each of the scenarios without co-operation. Patients needing multiple appointments and all the on-costs associated – travel time and costs, probably time away from work for carers if not for the patient directly, alongside the potential increase in anxiety, frustration and, almost certainly the continuation of pain and debilitating situations.

I have been working with Prof Sarah Ryan on the matter of patient burden, particularly for patients with rheumatoid arthritis, their medication programmes and the necessity for drug monitoring and such. This is another example of how the medical and clinical world is paying attention to improving the patient experience and reducing the burden of patients, their families, friends and the population as a whole.

While there are inequalities, inequity and scarce resources to manage, people who have touched the service and those who have yet to need the service can all be stewards in helping shape the future.

As an engagement champion I urge anyone interested in being part of the transformation processes to step forward. Patients can and in fact are making a difference, right now!

You can get involved at Getting Involved :: Midlands Partnership Foundation Trust (