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Prevention in the 2020s: what it means for axial SpA (AS)

On 22 July 2019, the government quietly published their green paper Advancing our health: prevention in the 2020s. Read our statement on what this means for AS patients.

On 22 July 2019, the government quietly published their green paper Advancing our health: prevention in the 2020s. There has been a lot of commentary in the media, although it has been hugely overshadowed by activity in Westminster and the appointment of a new Prime Minister. This does not mean however that this paper has any less significance.

What is a green paper?

A green paper is a consultation document. This means that this isn’t the final version and so people both inside and outside parliament are able to comment on policies being proposed.

Relevance to axial SpA (AS)

Many people may read the title of the paper and think to themselves ‘this has nothing to do with AS, you can’t prevent it from happening’, and they would be right about axial SpA (AS) not being preventable, but not that this paper has nothing to do with people living with the condition.

Musculoskeletal (MSK) conditions are problems with bones, joints and muscles, and axial SpA falls into this broad category. MSK conditions are mentioned a significant amount in the paper, particularly when it comes to the amount of disability caused by MSK conditions. Axial SpA (AS) is not specifically mentioned.

There are many areas of the paper which can be directly applied to axial SpA (AS), including a very heavy emphasis on physical activity, mental health, access to work and social prescribing.

The paper is also asking for evidence on musculoskeletal conditions including:

  • raising awareness of MSK conditions among the public
  • the role of physical activity
  • population-level behaviour change programmes
  • action to support staff in the workplace
  • links between mental and MSK health
  • What data should be routinely collected on MSK conditions


Is it slightly disappointing that awareness of MSK conditions amongst health professionals is not a focus, as is the lack of recognition of the role of the voluntary sector, which NASS will include in our response. You can read the open letter from National Voices members, including NASS, which was published in The Guardian a few weeks ago in anticipation of this paper being published.

NASS plan of action

The consultation is running from now until 22 October. During this time, we will ensure that we put together a comprehensive response to the paper, ensuring that we consult people with axial SpA (AS) and the Medical Advisory Board on their views before we submit a final version. Our response will be very specific to our community. We will also work with the Arthritis and Musculoskeletal Alliance (ARMA) on a joint response from the whole MSK community which will be more general.

APPG for Axial SpA

The All-Party Parliamentary Group for Axial Spondyloarthritis will also be working to prepare a response to the consultation, led by NASS and will look to ask parliamentary questions on the paper when parliament reconvenes in the autumn.