Versus Arthritis underline the importance of forward planning for improved preventive care for people with arthritis and other musculoskeletal conditions
Last year, Central Government committed to improving the quality of life for people living in England by examining ways to ensure individuals could look forward to five additional years of better health and independence. These commitments can be seen in its industrial strategy in support of healthcare. The green paper published by the Cabinet Office and the Department for Health and Social Care (DHSC) in July this year is the beginning of a consultation period to support the general population in having five additional years of a healthy life.
For several years, it has been thought prevention is the foundation of addressing challenges evident in countries like England with ageing populations and where multimorbidity (including mental health issues) and physical inactivity are ongoing. In 2014, the five-year forward view for the NHS emphasised the essential need for prevention. Last year, the DHSC produced Vision which highlighted a collection of case studies to illustrate and promote the need for prevention. In July this year, we saw the publication of the prevention green paper, Advancing our health: prevention in the 2020s. The green paper recognises musculoskeletal (MSK) and mental health conditions as the leading causes of people living for years with a disability.
Musculoskeletal health is maintained through a preventive (public health) approach
Dr Laura Boothman, Senior Policy Manager at Versus Arthritis, advocates for improved support for people with arthritis and says, “Good general health starts with good maternal health. Studies indicate the health of mothers can have a lasting impact on the health of their children. We look at prevention as being essential at every stage of life.”
Physical activity and maintaining healthy weight support good musculoskeletal health
Adopting healthy lifestyles will likely facilitate a better quality of life later on. The green paper’s reinforcement of the importance of regular physical activity is welcome. The UK Government is working with charities like Versus Arthritis to encourage people of all ages to include some form of activity in their everyday lives.
Dr Benjamin Ellis, Senior Clinical Policy Adviser to Versus Arthritis and consultant rheumatologist, says, “If someone has been diagnosed with a condition that affects their joints, the most important thing they can do is to maintain and increase the amount of physical activity they do.”
People with arthritis should be supported not only to stretch but also undertake activity that builds core strength. Everyone should be active daily; this can mean something other than an exercise routine such as regular walking, cycling, or doing housework or gardening.
Regular physical activity supports maintaining a healthy weight. As well as being good for the body, exercise also supports improved feelings of wellbeing.
Healthier workplaces can allow people to stay in work for longer
According to the Office for National Statistics (ONS) the average person in the UK is employed for 37.5 hours each week, but this can be as much as 48 hours weekly dependent on their type of employment. Not all jobs are office-based and some people have different working patterns; for example, freelance or shift workers. As people of working age can spend the majority of their time at work, the workplace is a vital setting to apply best practice advice to encourage people to look after their musculoskeletal health.
Through his clinical work providing care for people with arthritis, Dr Ellis sees the importance of supportive conversations that allow people to be honest and open about their needs.
“People should feel free to talk – whether that’s with their healthcare provider or in the workplace – so they are able to discuss what they need to maintain their independence at work and home.”
Individual healthcare concerns can present obstacles to remaining in work and for those new to the job market, these concerns can cause apprehension about employability. Musculoskeletal conditions can reduce mobility and can compound other long-term conditions like mental health. Research indicates people with musculoskeletal pain are twice as likely to experience signs and symptoms of mental health challenges such as anxiety.
Yet, for some people who are just joining, or perhaps trying to rejoin, the workforce health problems can be a barrier to gaining and retaining employment. This is particularly the case for those living with long-term musculoskeletal conditions such as arthritis, fibromyalgia or mental health conditions such as depression. It is reassuring Government are exploring offering support to enable workplaces to become more flexible and accessible for those people who can benefit from this the most.
“The law requires employers to make ‘reasonable adjustments’ for people living with a disability, which includes many people with arthritis,” says Dr Ellis.
“Depending on the person and their job, this could include reducing the physical requirements of their role, being flexible about working hours and location, or providing specialist equipment.”
Getting prevention wrong isn’t an option for the health service
While the prevention green paper has indicated regular health checks being an objective in improved patient care, ideally, these health checks would do more for people with arthritis.
Treating symptoms in isolation doesn’t offer a solution to deeper issues. Knowledge, resource and awareness will inevitably be the foundations for a shift in the model of how patients access support to prevent further damage resulting from musculoskeletal conditions.
The Government’s target is fifteen years to achieve the goals set out in this year’s official green paper. Poor musculoskeletal health and arthritis can stop individuals from living their lives. To allow people to continue living as independently as possible, working and enjoying their lives, they require access to appropriate services that support, acknowledge and address individual needs.