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Brett Hill, head of health and protection at Broadstone, expects continued innovation across occupational health, private healthcare and workplace health strategies to tackle MSK.
For people living with a musculoskeletal (MSK) condition, waiting for treatment can have a huge impact on their quality of life. Pain can worsen, mobility can deteriorate, and a condition that was once manageable can slowly start to make everyday living a challenge.
Sadly, the NHS backlog is making this a painful reality for more and more people.
In July, the number of people waiting for treatment in England rose to 7.33 million – its highest level in nine months – suggesting that hard-won progress on reducing the waiting list from its post-pandemic peak has essentially stalled.
MSK conditions are among those hardest hit by delays in treatment. Many issues, such as osteoarthritis, are chronic and progressive, while others, including back and neck pain, which often respond well to quick intervention, can deteriorate and lead to secondary pain in other parts of the body if left untreated.
This matters even more against the backdrop of a worsening MSK landscape. The disruption to treatment during the pandemic, increasingly sedentary lifestyles, and rising obesity levels have all contributed to growing pressure on MSK health. The shift towards home working has brought major new challenges, with often poor workstation set-ups and less movement during the working day aggravating existing risk factors.
Far-reaching consequences
The consequences of this are considerable, both for patients and the wider economy.
Recent ONS research on MSK waiting times and labour market outcomes puts some stark numbers around the cost of delayed care. The median waiting time for elective inpatient treatment for MSK conditions – from decision to admit to admittance – was more than two months (69 days), rising to almost three months at 83 days for osteoarthritis, which saw the highest median waiting time across all the MSK conditions.
More strikingly, longer waits were associated with reductions in gross employee pay that persisted for years after treatment. By the fourth year after first treatment, every additional four weeks of waiting was associated with annual earnings falling by up to £487 for people with joint disorders, £301 for osteoarthritis, £234 for back, neck and MSK pain, and £365 for other MSK conditions.
That is a sobering reminder that the cost of delayed care isn’t just the clinical impact on patients, it’s often also the financial impact as they find themselves less able to work, and it can have a long tail.
For the wider economy, MSK conditions are one of the main causes of workplace absence, and stand as one of the top drivers behind rising levels of sickness-related economic inactivity in recent years.
When someone is unable to access treatment quickly, there is a greater risk that their condition begins to affect their mobility, working hours, productivity and ability to remain in work altogether. For businesses already grappling with the productivity impact of long-term sickness, this is becoming increasingly difficult to ignore.
There is some progress in recognising the scale of the challenge. The government’s investment in NHS England’s Musculoskeletal Community Delivery Programme is intended to improve access to MSK support and reduce waiting times, helping more people receive treatment before their conditions become more debilitating.
But while efforts to tackle the NHS backlog continue, employers are also tackling the issue head-on to support people with MSK problems before they become long-term health issues.
We are increasingly seeing businesses engage with workplace wellbeing providers, occupational health providers and group health and protection insurers on prevention, early intervention and vocational rehabilitation. This can include ergonomic assessments and home workstation visits, employee education programmes focused on movement and activity, and fast-track physiotherapy pathways – all designed to address problems before they develop into more serious conditions.
Speed is critical
Once symptoms have developed, speed of access to MSK care is critical. Prompt and appropriate treatment can help prevent an acute problem developing into chronic pain, which is why employers are making greater use of private healthcare benefits in the workplace, such as private medical insurance and health cash plans. These provide fast routes into physiotherapy, diagnostics, pain management and specialist treatment, while early-intervention services through Group Income Protection can provide crucial rehabilitation support for employees whose conditions result in long-term sickness absence.
The priority should be to keep people moving, working and well – intervening as early as possible rather than waiting for an MSK problem to become a debilitating, chronic issue. For employers, healthcare professionals and the wider health system, that means making preventative care and early intervention the cornerstones of an effective MSK risk reduction strategy. A combination of NHS care, occupational health expertise and employer-funded healthcare can help people access the right support at different points in their journey.
Ultimately, with progress in reducing the waiting list backlog stalling, MSK looks set to remain one of the biggest health challenges facing the UK workforce. With the consequences of delayed treatment now increasingly clear, we can expect to see continued innovation across occupational health, private healthcare and workplace health strategies to tackle this problem, and meet the growing needs of an ageing workforce.
