Training gaps drive up cost of musculoskeletal services

Opportunities to slash repeat consultations and improve outcomes for patients with musculoskeletal conditions are being missed because of gaps in education for GPs and patients, a GP specialist has warned.

Rheumatoid arthritis: high cost (Photograph: SPL)
Rheumatoid arthritis: high cost (Photograph: SPL)

Around a fifth of all adults in the UK consult their GP with musculoskeletal problems and chronic pain each year, accounting for an estimated 10.1 million visits to surgeries. With an ageing population, these figures are likely to rise.

Musculoskeletal problems are also the second most common reason after mental health for incapacity benefit claims.

East London GPSI Dr Tom Margham said GP training should do more to help clinicians diagnose ailments and empower patients to self care. He said this would cut repeat visits, work absenteeism and benefit claims caused by common conditions, such as rheumatoid arthritis, gout and back pain, and boost outcomes.

'We need to challenge the notion that nothing can be done for these patients,' he said.

His comments came at the 25th Primary Care Rheumatology Society annual conference in York last week, where experts warned that musculoskeletal care risks worsening unless it is prioritised by the DoH, the profession and royal colleges.

Dr Margham told GP the conditions were a 'key reason' for repeat visits to GPs but had been sidelined in practices. Diseases, such as arthritis and gout, are the 'poor relative' of other conditions in core training, said Dr Margham.

Moving such conditions into the QOF may be a starting point, Dr Margham suggested, but GPs should also keep registers of affected patients so they can treat pain and help them to self manage.

Speaking at the event, Professor Mike Doherty of Nottingham University warned about the lack of priority given to conditions, such as gout, in the education of medical students. 'The musculoskeletal system has even less emphasis now than 30 years ago,' he said.

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