Section 1: Responding to the Three Shifts - Community, Prevention, and Digital
The British Chiropractic Association (BCA) represents an experienced, clinically trained workforce equipped to expand community-based and preventative MSK care. BCA members hold a minimum of four years of Master’s-level training in musculoskeletal diagnosis and management and operate at scale across the country. Chiropractors provide care equivalent in outcomes to AHP status professions, such as osteopaths and physiotherapists, and can complement existing physiotherapy and osteopathy services to broaden local capacity and choice for patients.
Across the UK the chiropractic profession has already been contributing to a shift away from hospital-centred pathways toward more accessible, and community-based musculoskeletal care. Something the BCA have been doing for 100 years. Chiropractors are delivering community-based treatment for Musculoskeletal (MSK) conditions – one of the NHS longest waiting times – via timely assessment, manual therapies, self-management education and targeted exercise programmes in local clinics. Chiropractors are also creating new partnerships with universities across the UK and with public sector healthcare providers.
The average wait time for treatment at a chiropractic clinic is 1-2 weeks, contrasting sharply with the conservative average estimate of 11 weeks for NHS community MSK treatment. Where formal collaborations exist between chiropractors and primary care networks or integrated care systems, patients experience shorter referral-to-treatment times and clearer pathways for ongoing rehabilitation. However, these are siloed initiatives as chiropractors are unable to support public healthcare providers at scale, as the sector is not able to attain Allied Health Profession (AHP) status.
Chiropractors can deliver faster access to treatment, a reduced burden on hospital outpatient services, and improved patient satisfaction because care is provided closer to home and tailored to daily function. Chiropractic services are already absorbing a significant proportion of routine MSK patients who would otherwise flow into hospitals, further increasing the backlog—which currently stands at 388,076.
If chiropractors are supported by the Department of Health and Social Care to integrate services with NHS community care settings, the NHS will not only be better able to is shifting care out of hospitals, utilising existing resources in communities at pace, but this will also support a preventative approach that allows patients to access timely treatment in their community before conditions require hospital intervention. If granted Allied Health Professional (AHP) status, chiropractic care could continue to support MSK patients across the country in a more streamlined and scalable manner.
Independent expert analysis by York Health Economics Consortium, a subsidiary body of York University, found that when using current community NHS waiting lists to find the 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 wait 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.
Chiropractors have already begun delivering preventative care services across the country, helping patients avoid unnecessary escalation of MSK conditions due to wait times, whilst also providing localised treatment. These contributions speak directly to the capabilities of chiropractors to support both early intervention and long-term rehabilitation.
We therefore urge the Department of Health and Social Care (DHSC) 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.
The is currently no clear criteria for how to gain AHP Status in either England or Wales. Additionally, there is no clear timeline for the expected length of time that healthcare professionals must wait before being considered for AHP status.
The lack of AHP status for chiropractors restricts strengthening MSK pathways. This prevents chiropractors from being formally recognised within strategic MSK plans, despite their clinical training and proven outcomes.
To overcome these barriers, the BCA recommend two immediate actions:
Integrate chiropractors into strategic local MSK plans as recognised Allied Health Professionals, enabling referral pathways from primary care and occupational health.
Expand university-community clinic partnerships to occur in the NHS and increase supervised capacity, provide low-cost access, and generate practice-based evidence.
These measures would relieve pressure on the NHS and hospital demand, widen preventative service delivery, and make more efficient use of the skilled chiropractic workforce.
Existing health economics analysis from the YHEC report indicates 100,000 NHS appointments could be freed up every year if chiropractors were integrated into the NHS. Integration would also accelerate return to work timelines, relieve pressure on outpatient and diagnostic services, and reduce the current MSK NHS wait times which have already hit a record high of over 380,000. Economically, these effects translate into reduced sickness absence costs and potential net gains in workforce productivity, which could save the Government £400 million through lost productivity every year.
As such, we urge the Department of Health and Social Care (DHSC) 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.
Section 2: Workforce Modelling Assumptions - Utilising Existing Capacity
Established community-based chiropractors are well positioned to support community services such as MSK hubs. The success of these initiatives will require utilising the expertise of the independent sector to meet existing demand within the Governments waiting time targets. By amending the current workforce model to include chiropractors in a national MSK strategy there is potential to free up 100,000 NHS appointments every year, reducing the burden on the existing public sector workforce and ensuring the NHS is better supported with patient access to a wider range of localised treatment choices.
The integration of chiropractors to support the NHS in the treatment of MSK conditions aligns with the government’s goal to streamline the workforce model into communities rather than hospitals.
Preventative services also make up a key pillar of how the Government want to shift the current care model from reactive to preventative care. MSK services such as postural education, ergonomic advice, and early intervention for minor injuries are assumed to reduce long-term demand for complex rehabilitation and diagnostics.
Ensuring a clear pathway for chiropractors, and other healthcare professions with MSK expertise, to attain Allied Health Professional status will unlock MSK pathways that allow for flexible deployment across primary care networks, integrated care systems, and across the NHS. This would enable the NHS to adjust workforce numbers based on local need, rather than relying solely on hospital-based physiotherapy or orthopaedic services.
These assumptions reflect a future facing MSK strategy that leverages chiropractic care to decentralise services, reduce hospital dependency, and rebalance the workforce toward early intervention and community-based management. This change in strategy to include chiropractors would also align with existing health economics findings that suggest chiropractic integration could reduce NHS waiting lists by 100,000 annually and deliver £400 million in economic gains through improved productivity and reduced sickness absence.
Section 3: Productivity Gains - Economic Benefits
Chiropractors can also reduce demand on the NHS through their ready to action MSK expertise. The Government have recommended improved training in GP surgeries, however if chiropractic care was effectively utilised by the NHS this could help deliver immediately actional MSK care, that would not require additional training.
The positives of integrating chiropractors into the National MSK Strategy are clear as detailed in the YHEC report. By amending the current workforce model to include chiropractors in a national MSK strategy there is potential to free up 100,000 NHS appointments every year, reducing the burden on the existing public sector workforce and ensuring the NHS is better supported with patient access to a wider range of localised treatment choices.
References:
- The Impact of Chiropractors on Workplace Productivity in NHS MSK Pathways, York Health Economics Consortium (YHEC), Nick Hex, 2025
Community Health Services Waiting Times, ONS waiting times, August 2025