NZAMM and Mobility Action Programme
Fellows of NZAMM/ AFMM Jenny Keightley and Iain Bell were involved 2016-2019 in the expert advisory group for the Mobility Action Programme, an initiative to deliver early intervention and community based programmes for people with orthopaedic and musculoskeletal pain conditions using best-practice approaches. The goal was to focus on outcomes for Māori, Pasifika and those within a high deprivation quintile. A final assessment report has been received from the Ministry of Health, written by Allen and Clarke here: https://www.nzamm.org.nz/wp-content/uploads/2021/09/Allen-Clarke_Final-Evaluation_MAP-Report_30-09-2021.pdf
Findings have been summarised by the ministry as:
A summary of the findings:
- The evaluation provides strong evidence that the MAP is an effective early intervention programme for people with MSK conditions. The MAP has resulted in health outcome gains for its participants, with the priority population groups achieving similar or better improvements in health status.
- The evaluation has also demonstrated that the MAP is a prudent investment, with evidence showing it was cost-effective over the short-term, achieving estimated health gains of 155 quality-adjusted life years (QALYs) in the MAP cohort and incremental net monetary benefit (INMB) of $5.4 million. The MAP is projected to be highly cost-effective over a five-year horizon.
- The evaluation concludes that investment in early intervention programmes for MSK conditions represents good value for money. The specific focus of the MAP on priority groups contributes to health equity for Māori, Pacific and those living in areas of higher deprivation.
Six recommendations to MAP implementors:
- The evaluation recommends an expanded roll out of the MAP or similar programmes.
- Models should incorporate the features that have been shown to be effective.
- Focus should be on improving programme completion rates for priority groups.
- Strategies that ensure equity of outcomes for Pacific people should be a core component of the programme.
- Consideration should be given to adapting the programme for participants with comorbidities/complex needs.
- Opportunities should be offered for post-programme support to embed self-management behaviours.
For the second year, funding to DHBs for the delivery of MAP and MAP-like programmes is available under the 21/22 Planned Care Initiative as non-surgical interventions. The Ministry encourages DHBs to collaborate with local providers to deliver MAP for their communities.