Introduction
Chiropractors in Wales are already delivering timely, evidence-based treatment for MSK conditions, often seeing patients within 1–2 weeks, compared to much longer waits in NHS community services. By better integrating chiropractic care into Welsh MSK pathways, there is an opportunity to support the Welsh Government’s goals for early intervention, prevention, and care closer to home.
The BCA represents a highly trained workforce equipped to enhance community MSK services, reduce future healthcare demand, and promote physical activity across Wales. Chiropractors across Wales are regulated to a high standard through the General Chiropractic Council (GCC) who are an independent statutory body established by, and accountable to, Parliament to regulate the chiropractic profession. They are in place to protect the health and safety of the public by ensuring high standards of practice in the chiropractic profession. Additionally, the Royal College of Chiropractors (RCC) is an apolitical professional membership body who promotes and supports high standards of education, practice and research, enabling chiropractors to provide, and to be recognised for providing, high quality care for patients.
Chiropractors are recommended by the WHO and NICE for back pain treatment and therefore, if formally included in national and regional MSK strategies, Wales could strengthen its capacity to deliver responsive, localised, and sustainable MSK care for its population.
The All-Wales Primary and Community Care Integrated Musculoskeletal (MSK) Service Specification does not adequately address certain areas in the specification’s aims and must do more if MSK conditions are to be effectively tackled across Wales. Below is a further breakdown of the key areas in which the specification should be amended.
Making People Healthier and Reducing Inactivity
The British Chiropractic Association (BCA) represents a highly trained, community-based workforce that supports people to live healthier, more active lives through early access‑ to musculoskeletal (MSK) care. BCA members hold a minimum of a four-year Master’s level training in musculoskeletal diagnosis and management and operate at scale across the country. Chiropractors provide outcomes comparable to other Healthcare Professionals, such as physiotherapy and osteopathy, and can complement existing local physiotherapy and osteopathy services to increase capacity and patient choice. Chiropractors provide care equivalent in outcomes to AHPs status professions such as physiotherapists[1] and can complement existing physiotherapy services to broaden local capacity and choice for patients.
To promote better health across Wales and reduce inactivity, it is vital that both osteopaths and chiropractors are integrated into MSK pathways to maximise workforce capabilities, and to ensure more patients are supported to return to work.
Independent expert analysis by the York Health Economics Consortium, a subsidiary body of York University, used current community NHS waiting lists to find a conservative average of 11 weeks for MSK patients waiting to be treated, however, this can often rise to 24 weeks in parts of the country. This is far higher than chiropractic [2] times which average 2 weeks. The report used the reduction in wait times of 11 weeks to 2 weeks to conclude that if those people were treated and returned to work quicker, this would boost productivity by an estimated £400 million per year. By offering early, evidence-based interventions such as manual therapy, rehabilitation exercise, and self-management advice, chiropractors play a vital role in preventing avoidable inactivity and promoting sustained physical wellbeing.
Reducing Future Need for Healthcare
Integrating chiropractic care into NHS and community MSK pathways offers the potential to reduce future demand on healthcare services. Early intervention and prevention are central to chiropractic practice, addressing minor problems before they develop into chronic pain or complex conditions that require hospital treatment.
YHEC’s analysis also suggests that integrating chiropractors into NHS pathways could reduce waiting lists by up to 100,000 appointments annually and contribute around £400 million to the UK economy through faster recovery and reduced sickness absence.[3] This community-based, proactive approach aligns with the UK Government’s objective‑ of shifting from reactive treatment to preventative, sustainable models of care.
If chiropractors were integrated into the Welsh MSK model, patient interactions with chiropractors would be recorded within NHS systems. Improved data sharing and retention between chiropractic providers and NHS records would strengthen planning, monitoring and evaluation and support the aims of the Welsh MSK model.
Creating Localised, Community-Based Care
Chiropractors already operate at scale within local communities across Wales, with the South Wales University recently opening a new clinic in the University where they will be able to treat additional patients every day at just £16, with 26 treatment rooms available. Chiropractors are supporting Welsh people every single day across Wales, and BCA members actively collaborate with local healthcare providers and universities to deliver treatment, rehabilitation, and education in community clinics.
This localised model of care ensures that patients can access timely support without the need for hospital visits, helping to ease pressure on NHS outpatient services. Chiropractors are well placed to participate in or co-locate within MSK hubs, enhancing local capacity and broadening patient choice.
Chiropractors can play a pivotal role in private sector integration and signposting within primary care networks and Integrated Care Systems (ICSs). By formally recognising chiropractors as part of the community health ecosystem, GPs and other healthcare professionals can confidently refer or signpost patients to chiropractic clinics for rapid assessment and treatment.
Formal inclusion of chiropractors within referral pathways would provide a more coordinated system of care, ensuring patients receive the right support at the right time and helping to reduce the burden on NHS services.
The All-Wales Primary and Community Care Integrated Musculoskeletal (MSK) Service Specification fails to adequately consider the role the private sector can play in the national MSK Strategy.
Currently physiotherapists hold Allied Healthcare Professional Status (AHP), however both chiropractors and osteopaths do not. This disparity between status only hinders current MSK pathway and reduces the ability for MSK pathways to be localised, and community-based. It is therefore vital that the government reevaluate the current Allied Healthcare Professional Status list and update it to include chiropractors if they wish to meet the aims set out in the specification.
Delivering flexible, responsive services and support that respond quickly to the fluctuating and unpredictable nature of MSK conditions
Chiropractic care is inherently flexible and responsive, enabling rapid assessment and personalised treatment plans that meet the diverse needs of local populations. Chiropractors can adapt quickly to fluctuating service demands, offering early intervention, rehabilitation, and long-term management for MSK conditions, that can be in more localised settings away from hospital.
This responsiveness supports the NHS in tackling long wait times and meeting Government waiting time targets. Chiropractic care complements physiotherapy services, which has already been granted AHP Status, expanding local treatment capacity without requiring new training.
Supporting the Physical Health of Patients
Chiropractors provide comprehensive support for patients’ physical health through a holistic approach to MSK care. Treatment often includes education on posture, ergonomics, physical activity, and injury prevention, ensuring patients are empowered to manage their health beyond the clinic setting.
By improving physical function, mobility, and self-management, chiropractic care enhances patients’ quality of life while reducing reliance on pain medication and hospital-based interventions.
Policy Recommendations
To maximise the potential of chiropractic care in supporting public health and community-based MSK services, the BCA recommends:
Recognition and Integration - Formally recognise chiropractors as Allied Health Professionals (AHPs) to enable structured referral pathways from primary care and occupational health. We therefore urge the Welsh Government to engage with the British Chiropractic Association and representatives of the sector to outline a clear pathway for attaining AHP status and work with the sector to ensure existing community resources are utilised to clear the backlog of community MSK NHS waiting times. By also embedding chiropractic care into the Government’s preventative health agenda, focusing on early intervention, physical activity promotion, and community wellbeing this continues to address the key aims of the specifications set out in the integrated primary and community care musculoskeletal health services in Wales.
Include chiropractors within local MSK strategies and ICS planning frameworks - through Community Partnerships and expand university–community clinic partnerships within NHS settings to increase supervised treatment capacity and provide low-cost access to preventative MSK care within the NHS.
Conclusion
The chiropractic profession stands ready to play a larger role in improving population health, reducing inactivity, and strengthening the UK’s MSK care model.
The British Chiropractic Association calls on the Welsh Government to formally integrate chiropractors into the national Musculoskeletal (MSK) strategy by granting them Allied Health Professional (AHP) status. Doing so would utilise an already established, highly trained, and community-based workforce capable of delivering timely MSK care that aligns directly with the Government’s ambitions for early intervention, prevention, and care closer to home.
Chiropractors in Wales are already contributing to healthier, more active communities through rapid access to care, typically within one to two weeks. Recognition of chiropractors as AHPs would strengthen collaboration within local MSK hubs, ensuring that patients receive the right care locally.
Granting chiropractors AHP status would address the current disparity between MSK professions, enhance patient choice, and expand local treatment capacity without requiring additional training or infrastructure. In doing so, Wales would position itself as a leader in integrated, community-based MSK care, capable of reducing inactivity, improving physical health, and alleviating long-term demand on NHS services.
The Welsh Government now has a clear opportunity to recognise the value of chiropractic care and to embed it within its national MSK strategy. By working in partnership with the British Chiropractic Association and the wider chiropractic sector, Wales can deliver a more responsive, sustainable, and preventative model of care.
References:
[1][2][3] The Impact of Chiropractors on Workplace Productivity in NHS MSK Pathways, York Health Economics Consortium (YHEC), Nick Hex, 2025