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In March 2024, ARMA sent Freedom of Information (FOI) requests to the 42 Integrated Care Boards (ICBs) in England to assess their leadership and strategic priorities for MSK services. The resulting report underscores the need for immediate action.
Key Findings:
- Nearly one in four ICBs reported having no designated MSK lead.
- Almost one in four ICBs were unable to outline their priorities for MSK services.
Given that MSK conditions are a leading cause of years lived with disability and one of the primary reasons for long-term work absence, these gaps in leadership and prioritisation are concerning. MSK services cut across multiple areas of care—primary, community, and several secondary care specialties—and represent a significant portion of NHS spending. Despite this, the report reveals that many ICBs are not giving MSK the attention it requires to comply with their statutory duties.
Recommendation:
The report recommends that any ICB that has not explicitly discussed MSK services at a Board meeting in the past year should do so immediately. Such discussions are essential for understanding the effectiveness of current MSK services, ensuring equitable access, and improving outcomes for all populations, including children and young people with MSK conditions.
This report serves as a crucial reminder of the importance of integrating MSK health into the strategic planning of every ICB. With the right focus and leadership, ICBs can significantly improve the quality and accessibility of MSK services, ultimately benefiting the millions of people across England living with an MSK condition.
Analysis of ICB Joint Forward Plans report
In 2025, ARMA has carried out analysis of all Integrated Care Boards’ (ICBs) Joint Forward Plans and published the findings in a new report which highlights critical gaps and opportunities to improve MSK and chronic pain services within ICBs.
MSK conditions are a major driver of long-term disability, one of the two leading causes of people being unable to work due to ill health and the impact on individuals, the NHS and the economy is significant. Yet key findings of the report show that too many ICBs are still giving insufficient attention to MSK and chronic pain.
Key findings:
- One in three ICBs make no meaningful reference to MSK, rheumatology or orthopaedics in their plans.
- Only one in five ICBs is taking a strategic system wide approach to delivery of MSK.
- Only one in five have any stated outcomes for the services they commission and only one in six have a target.
- Two thirds of ICBs make no meaningful reference to chronic pain services in their Joint Forward Plan and only one in six have any indication of the outcomes they expect those services to deliver.
Recommendations:
The report recommends that all ICBs should ensure that a strategic, cross system approach is taken to delivering and improving MSK services, with clear outcomes for the services they commission. By investing in well-integrated, outcome-driven MSK and pain management services, ICBs can improve individual health, enhance system efficiency, and support economic productivity.