Lived experience, equality and prevention

Whatever anyone may claim, the NHS has been, and still is, completely overwhelmed by the impact of Covid-19. Across the board MSK services are struggling. Meeting the targets of 90% elective procedures and 100% of outpatient appointments by October is not easy. Lots of things will be required – efficient pathways, appropriate use of digital, increases in support for self-management. Three things I feel must be included are lived experience, a focus on equality and prevention.

I’ve been privileged to be part of the Lived Experience Group which informs all aspects of NHS England work on MSK services post-Covid. Please read Power to the People, the fantastic blog about their work, and join our tweet chat at 7pm on 21 September, #MSKCoPro.

Like many organisations, ARMA has been discussing our work in relation to equalities. There are many ways in which this is relevant to MSK. We can’t think about what good pain services look like unless we acknowledge that there are geographical as well as educational differences in the incidence of chronic pain. I’m pleased that our conference on 30 November will hear from Dr Asim Suleman, a GP in Bradford on BAME communities and Equity of Pain Care. Our next webinar looks at the different ways Axial Spondyloarthritis manifests in women and the implications for diagnosis and management.

Finally, the best way to reduce pressure on services is prevention. Much of the pain of MSK is preventable. The announcements about the future of Public Health England (PHE) last month focused on the response to Covid-19 and future epidemics/pandemics. There was little about the rest of the very important functions of PHE, including MSK. The framework for MSK prevention published by PHE last year is of vital importance. Whatever the final future shape of public health in England, it is vital that this focus on MSK is not lost. 

ARMA understands the enormous challenge faced by MSK services trying to clear the record waiting lists. We also understand the experience of people waiting in pain. Lives have been put on hold – lives which also need restarting. So we will continue to support improvements in MSK services, but we are also here to challenge where systems are not giving the pain of MSK conditions the priority it deserves, and where they are not putting enough focus on lived experience, equalities and prevention.