Over 20 million people – around a third of the UK population – live with a musculoskeletal (MSK) condition. These conditions encompass a wide range of problems that affect joints, muscles, necks and backs including forms of arthritis. These often lead to severe pain, stiffness, and decreased mobility. Despite the extreme prevalence of MSK conditions and their debilitating effects, access to treatment has fallen victim to wider NHS backlogs: in July there were 342,593 people on MSK community waiting lists in England – this is the largest single condition cohort on the community backlog.
Primarily, for those living with an MSK condition, the lack of sufficient surgical and more personal, localised, community treatment – including effective rehabilitation – is consigning hordes of people to high levels of pain, for far too long. But it is also hampering our social welfare system, industries and economy more widely. Unsurprisingly, being in high levels of pain impacts a person’s ability to work. Only 62.4 per cent of people with a musculoskeletal condition are in work, compared to 82.1 per cent of those without one. Such a status quo can affect one’s financial stability, leading to borrowing or spending savings, or missing out on potential pension contributions. Furthermore, the impact of MSK conditions is not equal: research shows that those who live in the most deprived fifth of society are more likely to report arthritis or a long-term MSK condition compared to those living in the least deprived fifth.
Both prior to the election and since taking office, two of Labour’s key “missions” for government have been to create sustained economic growth and to build an NHS that is fit for the future, unburdened by its record waiting lists. A consensus is growing among economists and health experts alike: you cannot achieve the former without the latter.
“MSK conditions are one of the top two reasons for lost working days for employers, alongside poor mental health; there is a close correlation between the two,” explains Rob Yeldham, director of strategy, policy and engagement at the Chartered Society of Physiotherapy (Arthritis and MSK conditions accounted for 23.4 million days lost in work in 2022.) “We know there are significant productivity efficiencies possible through supporting more people into work, which totals around a £2bn boost to the economy through reduced benefits payments. That is even before we account for increased tax receipts and reduced spending on health and social care,” he added. “We’ve surveyed people with osteoarthritis, and about three in ten said that their condition impacted their ability to do work,” said Tracey Loftis, the head of policy, public affairs and engagement at Versus Arthritis, the UK’s largest and leading arthritis charity.
It seems the message – that economic growth isn’t possible without a healthy population – is getting through. On 9 July, less than a week after taking office, Wes Streeting, the Health Secretary, set out his stall. The Department for Health and Social Care, he announced, will expand its focus to also boost economic growth. This includes harnessing the life sciences sector and bolstering job opportunities with the health service – but perhaps most notably, the government states: “By cutting waiting times and improving public health, the government will support people with their health and speed up their return to work, while maintaining the good health of those in work.” Streeting added: “By cutting waiting lists, we can get Britain back to health and back to work, and by taking bold action on public health we can build the healthy society needed for a healthy economy.”
Experts such as Versus Arthritis and the Chartered Society of Physiotherapy, as well as those experiencing MSK conditions, must be involved in the design of interventions and kept at the heart of decision-making. Streeting and Liz Kendall, the Work and Pensions Secretary, will be instrumental in this.
“We spoke to both of them at our stand at Labour Party conference in September, and we were quite encouraged by what we heard,” said Yeldham. While Labour’s manifesto policies – which included developing better neighbourhood services, including physiotherapy treatment – are hugely encouraging, Yeldham added. A big challenge for the government to fix is the “postcode lottery” of available help to people: “The challenge is to make sure that what is said in Whitehall actually gets translated into action locally,” said Loftis. “That requires, the right policies, but it also requires the right funding and the right data to be collected.”
Arthritis and other MSK conditions need to be taken seriously by the government if it is to achieve its missions on economic growth and the NHS. Due attention must also be paid to people dealing with “multimorbidities”: those suffering from two or more major conditions (such as cancer, respiratory diseases, cardiovascular diseases, dementia and ill mental health), in addition to and including an MSK condition. “A real cross-government, cross-system approach is needed,” said Loftis.
This article first appeared in our print Spotlight report on Healthcare, published on 25 October 2024.
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