What the NHS Long Term Plan means for people with arthritis
On 7 January 2018, NHS England published their Long Term Plan, which sets out a vision for the health service in England over the next five years.
The Long Term Plan recognised the growing prevalence of arthritis and musculoskeletal conditions in England, their impact on physical and mental health services and their link to obesity. Three key elements of the plan which will impact people with arthritis are:
Ensuring joint replacement surgery within effective timescales
The majority of hip and knee replacements carried out in the NHS are for people with osteoarthritis. Delays in access to hip and knee replacements for those who need them can lead to deterioration in health and worse overall outcomes, ultimately costing the health and care system more.
Targets can play a big part in holding healthcare providers to account for providing care within a reasonable timescale for patients. That’s why it is so important to retain the right for patients to receive elective surgery – including hip and knee replacements - within 18 weeks of referral to treatment.
Whilst the Long Term Plan did not give a commitment to the 18-week target, it did include a measure to re-introduce fines for hospitals and Clinical Commissioning Groups (CCGs) who do not deliver surgery within 52 weeks, which will improve accountability in the short-term.
The Long Term Plan confirmed that greater clarity on existing targets will be provided by a Clinical Standards Review in spring 2019. It is crucial that any changes to the way surgery waiting times and targets are set and measured upholds a clear NHS commitment to deliver treatment within a timeframe that is most likely to deliver the best possible clinical outcomes.
Supporting the mental health of people with arthritis and other long-term conditions
Mental health is a key priority in the Long Term Plan, and we were pleased to see a commitment to expanding Improving Access to Psychological Therapies (IAPT) services for people with long term conditions.
Arthritis and musculoskeletal conditions can have a huge impact on a person’s mental health, with depression and anxiety being more common for those in persistent pain. IAPT services aim to provide better treatment for people with anxiety and depression at an earlier stage.
It is also welcome that the NHS is introducing a target that requires people having a mental health crisis to be treated within four hours. However, additional funding must be provided to ensure that NHS services can meet this target, as well as other standards proposed in the plan for mental health.
We were pleased to see a commitment to expanding the number of physiotherapists working in primary care networks across England. This will help more people with a musculoskeletal condition to access services that are associated with better outcomes like restoring movement and function, without a GP referral.
Besides the areas we have highlighted here, the Long Term Plan includes a commitment to improving research in the NHS, with the aim that a million people will register to participate in health research by 2023/4. It also included commitments to more investment in primary and community care such as GP appointments and continued expansion of personalised care so that people can better manage their own health.
The Long Term Plan provides a starting point for improving health and care services for people with arthritis. The new commitments are important steps towards improving quality of life for people with arthritis and supporting them to live independently for longer. However, much work is needed on the implementation of the Long Term Plan to put its commitments into practice.
Versus Arthritis is committed to working with NHS England and other partners to ensure that real progress is made for the 17.8 million people with arthritis and related conditions over the next ten years.