Government warned that millions with arthritis left behind as NHS begins recovery plans

NATIONAL charity Versus Arthritis warned of the urgent need to prioritise NHS recovery plans to support millions of people with arthritis who have borne the brunt of disruption to treatment and surgery caused by Covid-19. Many now face waiting in pain for years for life-changing treatments such as joint replacement surgery.

The charity surveyed over 6,000 people with arthritis and musculoskeletal conditions across the UK and found that lockdown, and the impact of the pandemic on the NHS, has had devastating consequences for many managing their conditions:

· Over 40% reported that appointments for their arthritis had been cancelled; for those experiencing chronic pain that number was 44%.
· A third (33%) said they had been advised to self-isolate – and shielders bore the brunt of cancellations with 46% experiencing cancelled appointments, far higher than cancellations experienced by non-shielders.

When asked about their health, care and quality of life during the pandemic:

· 2 in 5 people (40%) have not had access to the care and treatment they needed to manage their pain.
· 1 in 2 people (50%) reported being unable to manage their pain to do what they wanted around their homes and to undertake basic tasks.
· 1 in 2 (50%) said they are not able to be physically active due to their pain.
· 40% reported feeling more lonely or isolated.
· Almost half (44%) reported difficulties accessing shopping or deliveries.

Almost 19 million people in the UK have a musculoskeletal condition such as rheumatoid arthritis, osteoarthritis and back pain. Even before Covid-19, many faced long waits to access health services including physiotherapy, rheumatology and crucial joint replacement surgery.

Versus Arthritis has launched a campaign warning the Government that if people continue to be unable to access appropriate health care then millions across the UK are at risk of significant health deterioration and the NHS will pay a higher price in the long term.

The Versus Arthritis survey follows the release of NHS data on waiting times for elective surgery in England, and the stark news that approximately 456,108 people in England were on a waiting list for trauma and orthopaedics in May 2020.

The number of people waiting over 18 weeks from referral to treatment (RTT) has also risen sharply due to reduced access to surgery during March and April, having already reached record levels in the preceding months.

In May 2020, the number of patients waiting over 18 weeks for treatment (214,294) was more than double the number waiting this long in May 2019 (81,240). Even before the outbreak of Covid-19, the growing number of people waiting for hip and knee replacement surgery was reaching crisis point, with an estimated 35-42,000 people being added to the T&O waiting list every week.[i]

This situation is reflected in Scotland, Wales and Northern Ireland. Patients across the country face the longest waits on record for surgery, with trauma and orthopaedics (which includes joint replacements) having the largest overall waiting list of any individual specialty.

Chief Executive of Versus Arthritis Liam O’Toole said:

“The NHS has just about survived Covid-19 so far, but at the expense of services that many relied upon to sustain their quality of life. The Government must take urgent steps to ensure people with arthritis are not forgotten or ignored. We can’t go back to ‘normal’ – we must demand better.

“It’s imperative that recovery plans include arthritis treatments, including joint replacement surgery, so this crisis does not accelerate further.

“Governments must prioritise bringing down waiting lists, restarting planned joint replacement surgery and ensuring people are given clear information on what to expect as well as support to manage their pain.”

Richard Holmes from Kent, who has osteoarthritis in both hips due to an accident in 2008, has had multiple operations to repair his knees, hips, ligaments, and back. He has been waiting for a hip replacement since October 2019; he had his first operation in December, and his second-stage surgery was scheduled for March this year, was postponed till June, and was then cancelled again due to Covid-19. He said;

“I’ve not spoken to my consultant since my operation was cancelled. All I had was a brief phone call from my consultant’s department saying I’ll be seen this October – but that’s just another meeting. That’s almost up to a year of waiting since being first told I needed the replacement.

“I’m in constant pain, and can already feel the pain creeping up in my other joints. On a day-to-day basis it’s grinding. Like a hot knife slicing through you. My shoulders are under stress due to crutches I have to use to get around, and sometimes I’m in agony with my right shoulder – which I suspect is more arthritis developing.

“This has affected my whole life and I have no independence; I can barely walk beyond the garden path. I’ve been signed off work another 2 months and have no operation in sight. My employer wants to know, which is fair. They might need to give the job to someone else.

“I feel like we’ve been pushed to the side during Covid. I need to get my hip fixed before more damage is done and just want to understand when I can get treated.”

Terri Mosley, 23, is from West Yorkshire. She was diagnosed with inflammatory spondyloarthritis in December 2019. As she was unable to tolerate NSAID treatment, Terri was referred in March 2020 to have a CT-guided intra articular steroid injection into an inflamed joint. She also discussed with her nurse the possibility of trying biologics if the steroid injection did not work. But the week after, the referral for the treatment had to be postponed due to Covid. Now Terri isn’t getting treatment for her arthritis. She said:

“Now I am in limbo, just waiting. My nurse, who is fantastic, said to get back in touch when it seemed that everything was getting back to normal, in case my referral got lost in the system with all the waiting lists. Instead, I was prescribed a different, newer NSAID to try, but again I couldn’t tolerate it.

“I waited so much time for a diagnosis and finally felt like I was getting somewhere, but all of it has been taken away by Covid-19. I need to get my condition sorted because it’s not getting any easier or better.

“The pain is really getting to me. It’s unrelenting – sometimes sharp and sudden, but mostly a constant dull ache that never seems to stop. It also means that I’m unable to do stuff easily, which is very frustrating – I shouldn’t be dealing with this in my twenties.

“I have done my best to hold on throughout the pandemic, but my symptoms and pain are worsening. Right now, it feels like it will go on like this forever!”