News story: New return on investment tool on musculoskeletal conditions

Public Health England (PHE) today (11 October 2017) launched its latest return on investment (RoI) tool, this time helping local commissioners decide the best approach to preventing musculoskeletal conditions (MSK) within their populations.

RoI assessments can be made at local authority, clinical commissioning group, or sustainability and transformation partnerships level, helping commissioners make the economic case for prevention.

PHE commissioned the York Health Economics consortium to develop the tool. The different approaches to addressing MSK were chosen following a literature review and in consultation with an expert steering group.

Among the approaches are:

• ESCAPE-pain, an exercise-based rehabilitation program for knee pain, which would return £5.20 in healthcare savings for every £1 spent
• cognitive behavioural therapy including exercise for back pain, which would see £7.52 in both healthcare savings and quality of life year gains returned for every £1 spent
• vocational advice from physiotherapists in primary care for all MSK conditions, which would return £11.14 in healthcare savings, quality of life year and productivity gains for every £1 spent

Duncan Selbie, PHE’s chief executive, said:

The main way in which the NHS operates – you get ill, it fixes you – is unsustainable. People will have to take more responsibility for their own health and the NHS should intervene much earlier to help people avoid the need for expensive care. Bad backs and joints cause the most sick leave at work and using this resource will both help to get people back into work, reduce pressure on the NHS and boost the local economy.

Low back and neck pain is the leading cause of morbidity, as laid out in our Health Profile for England. Its impact is 3 times bigger than the second place condition, skin diseases. In 2014 to 2015, 9.5 million sick days were claimed because of MSK conditions. This represents 40% of all days lost due to work-related ill health and 33% of long-term sickness absence in England is due to MSK conditions.

Reducing the burden of MSK on local populations is an important step to getting people back to work, boosting the local economy and also lowering the future demand on health and social care budgets.

It is the latest tool from PHE’s health economists underlining why investment in prevention is important to long term health of the population and long term sustainability of the NHS. At the end of August, PHE published an ROI tool for mental health interventions, including a school anti-bullying programme and social and emotional learning for children.

A suite of tools have already been published, with ones on falls prevention and Best Start in Life in the pipeline.