No person should be left unsupported on an MSK waiting list

Musculoskeletal (MSK) injuries and conditions affect millions of people across the United Kingdom, impacting their daily lives and overall well-being. A growing number of people now find themselves on MSK waiting lists. In this article, we delve into the challenge of growing MSK waiting lists, the need to provide self-management support and the lessons we have learnt from deploying ICS wide digital self-management support

Understanding the MSK waiting list problem in the UK

The prevalence of MSK conditions is rising due to an ageing population and lifestyle factors.  At the same time NHS waiting lists are growing. 12% of the adult population are currently on a waiting list, with an average 10,000 people waiting for an orthopaedic operation across an ICS and more waiting for investigations or other treatments like physiotherapy.  There are often multiple stages of waiting when a person has an MSK condition including

• Waiting for a GP review
• Waiting for physiotherapy
• Waiting for referral to orthopaedics
• Waiting for investigations or different treatment
• Waiting for trauma and orthopaedic appointment
• Waiting for additional investigations or second review
• Waiting for an operation – patient has a date.

Impact of Growing MSK Waiting Lists on Physical and Mental Health of Patients

Extended waiting times for MSK treatments take a toll on patients’ physical and mental health. They lead to deconditioning, increased pain, decreased quality of life, and, in some cases, irreversible deterioration. Chronic pain and limited mobility can also lead to a cascade of other issues, including anxiety and depression.

Growing backlogs and escalating healthcare costs

Rising waiting times lead to delayed treatment which not only affects patients but also contributes to rising healthcare costs. As conditions worsen over time, the complexity of required interventions increases. By supporting MSK patients on waiting lists promptly, we can help mitigate these risks.

Workforce Productivity and Economic Implications

The economic repercussions of prolonged waiting times extend beyond healthcare.  Many people with MSK conditions are of working age, and their ability to contribute to the workforce is hindered by pain and reduced mobility. MSK injuries and conditions account for 50% of all days taken off work. Back pain alone costs our economy over £12bn a year. By implementing early, evidence-based intervention, we can support individuals to regain their productivity, minimise absenteeism, and foster a healthier, more economically active population.

Implementing digital self-management support for patients on MSK waiting lists.

There is now an absolute need to provide patients with evidence-based digital self-management support while they are waiting.  Our focus groups and interviews found that patients didn’t feel engaged while they were waiting, and this often led to feelings of uncertainty and a lack of trust in the management of their condition.  Both patients and clinicians also reported a lack of consistent messaging and advice across ICSs further adding to the lack of trust and concerns were raised about the long-term impact waiting has on an individuals mental and physical health.

getUBetter now has experience of deploying ICS wide digital self-management support across 16 ICSs including to patients on waiting lists.  Below are the lessons we have learnt around supporting patients on waiting lists.

1. It is important to provide standardised and evidence-based support for all common MSK injuries and conditions, so the system has a consistent approach.
2. Support can be made available at all stages of waiting and made available 24 hours a day 365 days a year.
3. Safety netting is incredibly important. It is not just about an initial single triage but ongoing symptom monitoring and safety netting.
4. Support needs to be locally configured to the needs of each ICS depending on how waiting lists are managed and what local services are available.
5. Waiting list support can be provided as a whole pathway approach to digital self-management support.
6. Significant numbers of patients will no longer require physiotherapy if they have access to digital self-management support.

Conclusion

getUBetter has been designed to take a whole pathway approach to digital self-management support including all stages of waiting.

getUBetter safely promotes self-management whilst using outcome measures and stratification tools to navigate patients back into the system if needed. With waiting times lengthening, the chances of deconditioning increase, meaning patients might experience more and intensified symptoms.  getUBetter works closely with ICSs to make sure patients with worsening symptoms get directed to the appropriate part of the healthcare system.

The importance of supporting MSK patients on waiting lists in the UK cannot be overstated. Timely access to care is not only vital for improving the quality of life for individuals with MSK conditions but also for reducing overall costs.  Providing patients on waiting lists with standardised evidence based digital self-management support is essential in helping mitigate the risks of long waits for MSK treatments.

Find out in detail how we support patients on waiting list as part of our whole pathway approach to MSK self-management support in our next webinar.

More information on how we support people on waiting lists and their elective recovery can be found here.