I thought I'd update everyone with a few developments
The MSI card I have, the temps are fairly steady under mining, about 90 to 98C at most depending on what I'm doing with the card (overclocking etc.) and I've got some more heatsinks coming today and some thin thermal pads so I'm hoping I can put the pads and the heatsinks over where the heatpipes are on the back plate to help with disapating the heat from the RAM. I highly doubt it will do anything much at all but for a few quid of effort and such, it's worth a try
And as for my Strix card, that was put under water and the temps, surprise surprise, are no different under mining, even with gaming as well, they are the same as the air cooler... So long and short, probably don't bother with a block...