MSK and the Major Conditions Strategy

by Sue Brown, CEO ARMA

Everyone working in or living with MSK conditions will have been delighted to read the interim report of the Major Conditions Strategy. MSK is recognised as a “major condition”. It has its own section alongside cancer, dementia, mental health and others. The same size, the same structure, the same status. It finally puts MSK where it belongs. Or should do.

There is so much to welcome in the document. The focus on prevention and personalisation. On treatments in the community and alignment of physical and mental health. The recognition that so many people living with these conditions live with more than one.

The report draws out the similarities between the conditions. They all need long term management. They are impacted by factors earlier. They are all more common in people experiencing socioeconomic deprivation.

So how can we maximise the benefits of this for people with MSK conditions? This is where I think MSK still faces a challenge compared with the other five. Given the commonalities between the conditions, I hear a lot about the need to get away from a condition-specific focus and look at these commonalities. The challenge we face is that if MSK is not mentioned then MSK is not there. Until everyone, from people living with MSK conditions to the leadership in ICSs, shares the government’s understanding that MSK should be treated just as seriously, then we will continue to be the poor relation.

The paper calls for ICS leadership to incorporate the aims into joint forward plans and integrated care strategies. I will be looking for these plans and strategies to demonstrate that they deliver for all six of the manor conditions. Otherwise, there is a risk that early diagnosis will be all about cancer and not about identification of inflammatory MSK conditions. Or that managing multiple conditions will mean talking to people about how their heart failure is impacting their mental health while ignoring the fact they are waiting in pain for a hip replacement.

So there is a huge amount to celebrate in this report. But there is still a lot to do if we are to see change for people living with MSK conditions. Between now and the final report there are opportunities to influence government. For real impact we need to influence the NHS, especially ICBs. So that they make the shift to realist that MSK is more than an elective waiting list. It is a fundamental driver of healthy life expectancy.

The Major Conditions Strategy is a huge asset for us in doing this. It now needs all of us to champion the cross-cutting multi-condition approach of the strategy, whilst also ensuring that MSK maintains its rightful status as a major condition.