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NHS publishes its Long-Term Plan

On 7 January 2019 NHS England published its long-term plan for the NHS

On 7 January 2019 NHS England published its long-term plan for the NHS. It sets ambitious targets to reduce deaths from illnesses such as heart disease and dementia and makes commitments to improve care in areas including cancer and mental health.

It is disappointing that musculoskeletal health doesn’t feature very much in the plan, particularly as early diagnosis and effective treatment can improve the quality of life of millions of people. However, one encouraging area is the proposed national roll out of the First Contact MSK Practitioners pilots, which embed physiotherapists in GP surgeries. Patients with undifferentiated back pain see a physiotherapist who can then make a direct referral to rheumatology. For people with suspected axial SpA this could make a significant difference to reducing the delay to diagnosis.

More generally the Long-Term Plan addresses some issues for people living with long-term conditions:

  • NASS is concerned that the emotional health needs of people with axial SpA are not being well-supported by the NHS so it is encouraging to see NHS England’s proposal to expand the Improving Access to Psychological Therapies programme to people with long-term conditions.
  • Self-management is important to people living with long-term conditions, so we are pleased to see the plan to roll out the ESCAPE-pain online programme. This is a rehabilitation programme for people with chronic pain, integrating self-management and exercise.
  • The document also highlights the increased role of personalised care plans to support people to manage their condition in work and to help people stay in employment.
  • There is a strong focus on the digital aspect of health care, with plans to develop a number of condition-specific apps, and ensure that every patient is granted access to their health record.
  • Care Plans will become an integrated part of all patient records, and all of secondary care will become fully digitalised. However, this is not due to happen fully until 2024.


We will have to work hard to ensure that the healthcare needs of people living with axial SpA are understood and met. That’s why our campaign Every Patient Every Time and our new programme Aspiring to Excellence are going to be so important.

View the full plan here: