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Between June 2014 and June 2017, a feedback loop had formed around the Musculoskeletal (MSK) Physiotherapy interview show The Physio Matters Podcast and its surrounding social media. Having a podcast in common often helped the 20,000+ clinicians, patients, educators and policy-makers to involve themselves in discussions, even around topics infamous for causing conversation breakdown.

Chews Health, the Manchester-based healthcare company responsible for the podcast, partnered with Newcastle-based healthcare company Connect Health to host an event that they hoped would channel this energy. Fifty invitees discussed a variety of topics central to contemporary MSK practice at the inaugural event ‘Reasoning, Responsibility and Reform’. The event was a huge success and interest beyond the room was clear from the immediately trending hashtag #TheBigRs, which the resultant movement was known as.

A further invitational event in May 2018 saw 100 innovators in the field look to identify mechanisms for change as they explored the question of whether a reformative agenda was emerging from the discussions on and offline. Following this event and a further 150-strong conference in November 2018, it was clear that there was momentum behind the movement. The collective was also privileged to have the involvement of many great leaders, five of which were selected to head up individual Working Groups made up of volunteers for a bold new project.

The Working Groups consisting of clinicians, patients, students, educators and policy-makers sought to identify what reforms would best facilitate improvements in MSK patient outcomes. They did so across the topics of

Evidence, Governance, Education, Excellence and Influence


A previously unused hashtag was seen by 34.1 million social media users in one week in 2018, turning the heads of senior civil servants, Members of Parliament, major company CEOs and, most importantly, many hopeful MSK patients. #TheBigRs has come to represent Reform by way of discussion, persuasion and consensus rather than legislative force.

It is a truly inclusive grass-roots movement involving a diverse group of people with the common goal of reforming MSK practice for the betterment of patient care.

You can now download the MSKR Manifesto for Reform; the first document from the think-tank to emerge from #TheBigRs – MSKReform

download now

You can now download the MSKR Manifesto for Reform; the first document from the think-tank to emerge from #TheBigRs – MSKReform


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Get in touch with us using the contact form, email us at info@mskreform.org.uk or connect with us on social below