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Healthcare at breaking point

Healthcare at breaking point

Musculoskeletal conditions – the term for more than 200 illnesses affecting the bones and joints, such as arthritis, lower back pain and osteoporosis – threaten to stretch the NHS to breaking point, writes Lilian Anekwe

Healthcare at breaking point

With healthcare budgets already under severe pressure, experts warn that only significant investment can prevent the serious state of bone and joint health in the UK from further deterioration.

Statistics compiled by the Medical Research Council’s UK Centre for Integrated Research into Musculoskeletal Ageing show that more than 30 per cent of people aged over 65 are affected by conditions of the bones, joints and muscles.

Millions of people of working age have lower back pain, which can affect their ability to be productive at work, earn a living and enjoy a normal life.

Sickness Costs, a 2010 report by the Chartered Society of Physiotherapists, estimated that around ten million working days are lost to musculoskeletal conditions every year. This means that, on average, each person with a musculoskeletal complaint misses around 17 days’ work a year.

One in five people in receipt of Incapacity Benefit or Employment Support Allowance report musculoskeletal disorders.

There is a clear business case for employers to help staff protect their bones and joints

Research, sponsored by the pharmaceutical company Abbott and conducted by The Work Foundation, an independent think-tank based at Lancaster University, estimates that work missed due to musculoskeletal conditions costs the UK around £7.4 billion a year. So there is a clear business case for employers to help staff protect their bones and joints.

The Royal Mail, for example, has struggled with long-term absence related to musculoskeletal health. In 2003, their sickness absence levels were 7 per cent – an average of 16 days per employee a year – costing £1 million every day.

The organisation offered employees a package of measures, including health screening at work, access to occupational health services, and physiotherapy focusing on improving back, neck and shoulder injuries. After four years, absence levels due to sickness had fallen to 4 per cent – ten days per employee – saving the business almost £230 million, and up to 3,600 more staff were available for work each day.

Research by the insurance company Aviva on work-based health initiatives, like the Royal Mail scheme, found that up to 30 per cent of visits to GPs are due to musculoskeletal complaints. The Arthritis and Musculoskeletal Alliance estimates the annual cost of treating musculoskeletal conditions is £4.8 billion.

The Government believes that, by reorganising musculoskeletal services as part of health reforms set out in its Health and Social Care Bill, some of these costs could be recouped. It has forecast potential savings of £235 million by 2015 through tackling hospital waiting lists and reducing unnecessary hospital stays. This could save more than two million days spent in hospital.

The Department of Health is now encouraging people to take more personal responsibility for their bone and joint health by promoting exercise and healthier living through its Change4Life programme.

Ministers have also asked the National Institute for Health and Clinical Excellence (NICE) to develop quality standards for major musculoskeletal conditions with the aim of improving standards of care.

Demographic changes are leading to an increase in many types of long-term illness, including musculoskeletal conditions. The UK will need a clear vision if services are to meet such mounting pressures.

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Written by Lilian Anekwe

Consumer health editor at the BMJ Group, she is an award-winning medical journalist who has also written for New Scientist and New Statesman. Read more articles from Lilian.