Evaluation of large-scale implementation of self-management NICE guidelines of Osteoarthritis within Primary Care

Large-scale Sustainable Change
Implementation, at scale, of a model to support NICE Guidelines for the management of Osteoarthritis (OA) in primary care

What we know

Osteoarthritis (OA) is one of the leading causes of disability in Scotland which impacts on patients’ quality of life, work and the wider society. Primary care services deal with high-volume demand but there is duplication across primary care, orthopaedic and allied health professional services.  Delay in appropriate advice and treatment for people with OA can result in prolonged pain and disability.

Study Aim

This project will investigate the feasibility of implementing a model of care recommended in national guidelines, as part of the JIGSAW-E (Joint Implementation of osteoarthritis Guidelines Across Western Europe) approach.  JIGSAW-E aims to implement a real-world primary care approach to improve the quality of care and support for the self-management for osteoarthritis. 

It is intended that the JIGSAW-E training model will be used by advanced practice physiotherapists to improve educational and skill levels of health professionals in the care of people with osteoarthritis.  In the future this could impact directly on the health of people with osteoarthritis in the community.

Project Aim

To explore the feasibility of implementing an evidence-based model (JIGSAW-E) to improve self-management for people with osteoarthritis in Scottish primary care.

What this research explored

We recruited 10 practices across Scotland from Lothians, Ayrshire and Arran, the Highlands, Forth Valley and Lanarkshire. 14 participants were interviewed. Following on from the interviews, we organised a knowledge mobilisation / training workshop, which included collaborators from the JIGSAW-E team at Keele University. Discussion focused on key themes arising from the interviews, and issues around engagement support for implementation of the model.

What this study adds

Through networking and collaboration with clinicians working in primary and secondary care; this project has raised awareness of the JIGSAW-E online training resource and has resulted in increased knowledge of the role of the health professional (as stated in the research proposal). We identified staff to train and roll out the training across ESP national networks, which has resulted in 20+ health care practitioners completing a 3-hour training workshop. Knowledge has been disseminated through planned workshops, peer-reviewed publications at EULAR but also through other knowledge exchange activities with the local community and core partners who are already delivering the JIGSAW-E model in England and Europe. This study has resulted in a range of benefits and impact – from the practice change, to future collaboration and opportunities to increase self-management.   

Online JIGSAW training 
The JIGSAW training material is available now on the JIGSAW-E website and free to all NHS health professionals.  Participants are asked to register on the site to monitor impact. 


The project was led by Dr Helen Frost, supported by colleagues from the School of Health and Social Care at Edinburgh Napier University and the JIGSAW-E team at Keele University, in conjunction with primary care colleagues from NHS Lothian and Advanced Practitioners from across NHS Scotland. 

For more information please contact SISCC (siscc@dundee.ac.uk)