Background Rheumatic and musculoskeletal diseases (RMD) are high prevalent, disabling conditions. As a major cause of lost productivity and social and healthcare resources consumption, incur great social costs. About 23% of the population over 20 in Spain refers having been diagnosed with a RMD. To reduce this large and growing burden as a priority, and in alignment with the principles of the the Spanish Law 16/2003 on Cohesion and Quality, the Spanish Ministry of Health, Social Services, and Equality (MHSSE) launched the Strategy for RMD on April 2011
Objectives To describe the methodology used in the elaboration of the strategy and its main strategic lines
Methods The Strategy was designed by the MHSSE Department on Quality and Cohesion as the other nation-wide Health Plans. Procedures to develop the final document aimed to achieve maximum consensus among the scientific community, patients, and healthcare providers. The process can be summarised as follows:
1) Schedule and planning of the document; 2) Selection of the scientific coordinator – a peer of national recognition appointed to lead the scientific aspects of the strategy – and stakeholders, by the MHSSE; 3) Constitution of the Technical Committee – scientific societies and patients' associations representatives plus independent experts–and the Institutional Committee – regional authorities who discuss the feasibility of implementing the actions at the local level, plus a team from different departments from the MHSSE, plus representatives from the Ministry of Employment and Social Security; 4) Development of the document with the concourse of both Committees and the technical team of the MHSSE Department on Quality and Cohesion, according to subsequent steps:
4.1) Epidemiological analysis and evidence report.
4.2) Identification of critical points/needs on RMD in the context of Spain and its 17 autonomic regions.
4.3) Definition of the main strategic lines, objectives, and recommendations.
4.4) Design of the evaluation, definition of quantitative and qualitative indicators.
4.5) Identification of best practices.
5) The final document was submitted to the Interterritorial Council (IC) of the NHS, the highest level health policy board, for its approval by consensus of all 17 regional health authorities
Results Spain's Strategy on RMD was approved on December 20th 2012 by the IC-NHS. Five strategic lines were proposed: 1. Equity and health across all policies: health promotion and disease prevention. 2. Patient empowerment and autonomy. 3. Social and health care provision: 3.1. Early diagnosis and access to care; 3.2. Coordination and continuity of care; 3.3.Clinical practice harmonization. 4. Information systems. 5. Knowledge: 5.1.Professional training and continual education; 5.2. Research.
Conclusions Spain's RMD strategy is a reference tool for consensus at the national level. It addresses prevention and management of RMD through evidence-based interventions. Its ultimate goal is to improve health and quality of life of patients and of the entire population. Consensus and participation of all stakeholders are essential elements for a meaningful health plan that ensures a high quality of care in terms of equality and uniformity
Estrategia en enfermedades reumáticas y musculoesqueléticas del Sistema Nacional de Salud. Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad; 2013.
Disclosure of Interest None declared