A staggering surge in the community musculoskeletal (MSK) services waiting list at Sussex Community NHS Foundation Trust, a single trust in the South East of England, has put it in charge of nearly one in ten people waiting for this care nationwide. The waiting list for MSK services at this trust quadrupled in just one year, a rate far exceeding the national average.
This dramatic increase, resulting in roughly 10 per cent of England’s entire MSK waiting list concentrated in one trust’s catchment area, highlights the escalating pressures on community health services. These services are vital for treating widespread and often debilitating conditions like back pain, joint problems, and arthritis.
The localised pressure in Sussex, likely exacerbated by workforce shortages, demographic shifts, and referral bottlenecks, mirrors a wider national crisis. National community services waiting lists now exceed 1 million patients waiting for assessment and treatment, with data indicating the total soared past 1.10 million by mid-2024. Unlike hospital elective care, community services waiting lists have traditionally been less visible and less of a political priority. MSK conditions are a leading cause of GP visits and a major driver of workforce absence and diminished quality of life, affecting around 17.9 per cent of adults in England. Delays in care can lead to prolonged suffering, worsening symptoms, and ultimately necessitate more invasive treatments like injections or surgery.
The Chartered Society of Physiotherapy (CSP) has identified a lack of physiotherapy posts as a key contributor to the soaring wait times, advocating for sustained workforce growth, potentially at least 7 per cent new roles annually, to meet the spiralling demand. Analysts suggest that the disproportionate waiting list in the South East trust reflects regional variations in referral rates, service capacity, clinician retention, and commissioning approaches.
Patients stuck in these long queues often report frustration due to inadequate communication and unclear eligibility criteria, leading to the perception of an “invisible backlog.”
To alleviate this crisis, there is growing interest in digital and technology-enabled solutions, such as remote assessment platforms and app-based triage, which have shown promise in reducing wait times. However, the finding that a single trust holds 10 per cent of the national MSK waiting list underscores the urgent need for prioritising community health resources at a national and regional level.
Stakeholders argue that addressing MSK waits early and at scale could reduce upstream demand on A&E and surgical services. While NHS England has acknowledged the need for better data and transformation efforts in community services, without targeted investment—including workforce expansion, digital triage systems, and streamlined referral pathways—patients will continue to face increasingly long waits, impacting both individual wellbeing and overall system efficiency.
