NHS North Central London Integrated Care Board (NCL ICB) is leading on a programme of work to improve musculoskeletal, or MSK services across north central London, serving residents in the boroughs of Barnet, Camden, Enfield, Haringey and Islington.
What are musculoskeletal conditions?
Musculoskeletal (MSK) conditions are a group of conditions which can affect your joints, bones and muscles. They can range from minor injuries to long-term conditions and includes ailments such as arthritis or back pain. Symptoms can include pain and discomfort, stiffness, limited movement, and in some cases disability which can affect a person’s quality of life and independence.
We know that poor musculoskeletal health can have a big impact not only for people and their general health and wellbeing, but also for their employers, the NHS and the wider economy.
As people are living longer and as the numbers of people with MSK conditions grows, it is expected that the demand for MSK services will continue to increase in the future.
Current challenges
We know our staff in local services are working hard to deliver safe, high-quality MSK care and there are many examples of excellent care being delivered for our patients. However, as a health system we face challenges that mean we may not always be able to provide care that best meets the needs of our population.
We are seeing a rising number of patients with MSK conditions in north central London. Demand for MSK services has continued to grow in all healthcare settings over the last few years, from GP practices to outpatient appointments and A&E attendances. Care is also sometimes happening in the wrong place and at the wrong time, for example, patients attending busy primary care services or A&E instead of a community-based service where they could be better managed and seen more quickly. An increasing ageing population, together with rising obesity rates and low levels of physical activity, means that demand for MSK services is expected to increase even more in future.
Before NCL ICB was formed, each of our five boroughs were responsible for planning and paying for MSK services separately. This has meant that the type of services available and how they are accessed by patients differs from borough to borough. For example, community pain clinics are not offered in all of our boroughs. This in turn has resulted in differing patient experiences and health outcomes for our residents depending on where they live in north central London. We also know that waiting times to access care for MSK conditions differ greatly by borough.
We need to do more to support prevention and early detection and treatment of MSK conditions. Some of our boroughs offer resources, such as patient leaflets, booklets and information sheets, that can support self-care and help patients to manage their condition themselves; however, these resources can vary greatly. We know that other factors such as obesity, lack of physical activity and smoking can lead to or make MSK conditions worse.
Some of our populations are at greater risk of developing MSK conditions, including people from some ethnic groups and those living in more deprived areas. This is leading to even greater health inequalities amongst some communities. We want all our patients, regardless of their background, to feel supported to access care and treatment – for example, by having digital and non-digital resources available in a range of languages for those whose first language is not English.
Our vision for MSK services
Our vision is to achieve better MSK health outcomes for all and an improved, fairer, more sustainable MSK service that keeps pace with rising demand and cares for patients both now and in the future.
We want to make sure that all residents have equitable access to effective and high quality MSK care, regardless of where they live in north central London. Importantly, we want to simplify the ways that patients can access these services to ensure they receive the right care, in the right place and at the right time.
We have set up a programme of work which is exploring potential solutions to address the challenges currently facing MSK services. Working in partnership with local clinicians, patients and carers, we want to design a model of care that is seamless and more joined up, and simplify the way in which patients can access this care. Our ambition is to offer patients a more proactive and holistic approach to care, and which supports greater prevention and earlier intervention.
We are also looking at how we can improve our digital offer as well as patient information resources to better support and empower residents to self-care and manage their own MSK condition at home.
Given our growing ageing population and the increasing number of residents who will need MSK services in the future, we need to think about how we can provide care in a different way.
There is an opportunity to share the best practice that we already have in north central London across all boroughs so that everyone living in this area has fairer access to effective, high quality MSK care.
Further information
If you would like more information or have any questions about the MSK programme, please contact us via email at nclicb.msk@nhs.net.