On the precipice

We all look forward to 2022 with some trepidation. We don’t know how much impact Omicron will have on the NHS, the population, and our own families. 2021 was a year of challenge and also of incredible achievements. A vaccination programme which has now provided all adults with the opportunity for three doses, four in some cases; which has delivered boosters to three quarters of the eligible population; which delivered 1.6 million boosters in the final week of the year. None of this just happened. It was a success because of people who worked on Christmas day to deliver vaccinations, who volunteered in vaccination centres on top of their day jobs, who dropped everything to rapidly scale up the programme at a moment’s notice.

The pandemic has taken an appalling toll on everyone, especially healthcare practitioners and all those working in the NHS. Yet we have also learned from it. The delivery of vaccinations and the development of treatments have shown what we can achieve through concerted and collective effort. One of the things we have learned from the vaccination programme is about health inequalities. Take up remains lower in some communities, but not as low as it might have been without some extraordinary efforts to work in a different way. COVID-19 drove much needed learning about how to tackle inequalities. That learning can be used to address other health inequalities, including in MSK.

ARMA recently published a report of our roundtable on MSK and health inequalities. This will be a priority for us in 2022. We know that there are many inequalities in MSK health. In deprived areas, for instance, incidence of MSK conditions is higher, waiting times longer, the elective care catch up slower and outcomes for treatment of conditions such as rheumatoid arthritis poorer. This is something we have tolerated for too long.

Both MSK and health inequalities are beginning to get the attention they deserve. Since April the BestMSK Health programme has driven up the status and the focus on MSK and the 2022/23 NHS priorities and operational planning guidance mentions MSK as a priority area. We can deliver this programme in a way that focusses on the easy to implement, targeted at an already engaged and health literate population in “leafy Surrey”. Or we can take on the challenge of addressing the needs of communities that have been marginalised, which is where the need is greater. I am seeing signs that people are choosing the latter. It will be harder, but if we want to tackle health inequalities then we have to do things differently.

I know that many of our readers will now be making extraordinary efforts to deal with the current wave of COVID-19. You will continue to do this for a long time as the backlog of elective care is cleared and you deliver much needed support for those waiting. Whenever you get a chance, please take a look at the roundtable report. It’s the beginning of a conversation about how we can change the entrenched inequalities in MSK health. Please think about what this might mean to your work, including work on the elective care catch up.

A quote from the roundtable discussion: “We are on the precipice of doing something differently.” That is true in MSK and in health equalities. Let’s come together in 2022, do something differently, and make extraordinary things happen.