How private practice can help support the Government’s Healthy Life Expectancy 2035 plan

Catherine Quinn, President of the British Chiropractic Association (BCA), discusses the Government’s priorities for healthcare patients with Musculoskeletal (MSK) conditions.

The Government’s ambitious goal of gaining five extra years of healthy life expectancy for the UK population by 2035 is highly welcomed by the professional healthcare community. However, there are key components of this plan that should be considered, with a specific focus on how private sector healthcare professionals can support our colleagues in the public sector – through working in local communities, understanding the benefit of Maintenance Care and providing joined up care plans. Specialist health professionals, such as chiropractors, have a wealth of knowledge, skills and expertise. There’s huge opportunity for the public sector and Government to better utilise resources to support our patients and provide expert, patient-centred care for all.

Why private sector healthcare professionals should be seen as a benefit to the public sector

If we are to achieve the ambitious goal of gaining five extra years of healthy life expectancy by 2035, it’s imperative that the Government prioritises MSK conditions. The recent OHID report on the drivers of healthy life expectancy clearly highlights MSK conditions, with their significant impact on health, as the primary contributor to low healthy life expectancy. A recent study from NHS England showed that 30 million working days are lost due to MSK health conditions each year. To successfully address this issue, risk factors associated with MSK conditions, the support for self-management and access to effective diagnosis and care must be prioritised by local systems and the Government.

MSK conditions can be effectively and efficiently managed by private healthcare providers, allowing the patient to have more choice in their own care plan. For many people, such as working professionals, taking sick leave due to an unexpected episode of back pain is a huge drain on their resources and income. By being able to access private health care with little to no waiting time, at a time and place that’s convenient for them, these people often return to work sooner than when faced with waiting times for an appointment with their GP. The NHS must focus, rightly so, on managing these conditions for the wider population, but there is a growing number of people who have the resources and motivation to self-fund their care, allowing them access to a specialist patient-centred approach to MSK Healthcare.

Chiropractors can play a pivotal role in providing another option for local communities to access highly qualified and patient-centred health care in a convenient way. All healthcare professionals in private practice should be seen as a benefit to that community by their NHS colleagues in their ability to provide specialist care, rather than an element of the healthcare system, which is not discussed with patients or, worse still, discouraged.

Maintenance Care and how it can support the public sector

New evidence regarding the natural course of spinal pain has led to a shift in treatment approaches. Previously, lower back pain and neck pain were thought to be self-limiting ailments. Consequently, treatment, if at all required, was aimed at shortening the course of symptoms. We now have a new understanding of spinal pain as a condition which can have exacerbations and remissions throughout life. Therefore, where appropriate, we need to shift the focus of treatment from cure to management.

Condition management, or ‘Maintenance Care’, is a well-understood concept amongst chiropractors and their patients, describing continued care beyond that of reducing symptoms. Both chiropractors and patients believe in the efficacy of Maintenance Care and report high satisfaction levels with this approach in those who responded well to chiropractic care. A study on the effect of Maintenance Care, utilising all the existing evidence, found that Maintenance Care patients experienced fewer days with low back pain compared to patients invited to contact their chiropractor ‘when needed’. It should not be interpreted that all patients with musculoskeletal pain will benefit from this approach, and the literature suggests that 30% of patients continue with Maintenance Care. The evidence supports that there is a strong case for using this approach to care with patients experiencing low back pain .

A key component of Maintenance Care is the patient’s education around self-management, which further goes to reduce their risk factors. By encouraging patients to access this care, we increase the capacity for rapid access to services such as health coaching, social prescribing, and peer support, alongside hands-on-care. Private healthcare providers, including chiropractors, are experienced at integrating with patient organisations which provide condition-specific self-management support – one case would be the SMILE-RA programme from the National Rheumatoid Arthritis Society [1].

Why we need an integrated healthcare approach

It’s crucial that the NHS and private practice healthcare services increase their understanding and awareness of the variety of options available for patients. There is no national policy which states that NHS practitioners can’t inform patients about regulated private practice options. Yet, we know that there are some practitioners who are instructed at a local level that they cannot recommend private practice. As long as a patient is accessing care in a way which is right for them, safe and with a regulated practitioner, it shouldn’t be of any importance where they choose to access this care.

Adopting an integrated, consistent and comprehensive approach to healthcare is crucial at every stage to ensure people with Musculoskeletal (MSK) conditions receive the best treatment possible. It’s essential to provide access to a variety of services and healthcare professionals operating in isolation can lead to delays in diagnosis, prolonged referral times, and difficulties in accessing appropriate services.

The private sector also plays a significant role in person-centred patient care. Private and independent practitioners and clinics serve as a valuable centre for high-quality advice, management, treatment and wider wellbeing and healthcare support. Appropriate acknowledgment of these providers is important, and NHS healthcare providers and community healthcare settings should be encouraged to signpost these services to patients as part of their personalised treatment plans.

In summary, a comprehensive and integrated approach is essential to provide the best care and treatment for individuals with MSK conditions. It requires effective leadership, engagement of stakeholders, utilisation of technology and data, and collaboration with the private and independent sector. By embracing these principles, we can strive to enhance MSK services, deliver improved outcomes for patients and achieve the Government’s 2035 Healthy Life Expectancy plan.