Musculoskeletal patients face 'postcode lottery'

Report reveals thirteen-fold variation in PCT spending

Musculoskeletal patients face a ‘postcode lottery’ for NHS treatment, with a thirteen-fold variation in spending existing between Primary Care Trusts, according to the Arthritis and Musculoskeletal Alliance.

A report published by the body this week based on Freedom of Information data revealed that expenditure on treating musculoskeletal patients in 2009-10 ranged from £275 per patient per year in Peterborough, to £764 in Hartlepool.

ARMA said a significant number of PCTs reduced their spending between 2008-09 and 2009-10, with NHS Barnet spending 41% less per patient. However, Hammersmith and Fulham increased spending by 170% per patient.

ARMA said that while some variation between PCTs is to be expected, this level of disparity is concerning as it cannot be justified by differences in health needs alone.

The report said that while overall expenditure on musculoskeletal services has increased at a faster rate than overall NHS expenditure  between 2007-08 and 2009-10 at 16% compared to 11%, it is not clear that this increase ‘has delivered the improvements required by either patients or the taxpayer’.

The paper said that for too long musculoskeletal conditions have been 'under-prioritised' in the NHS, while it also raised concerns that PCTs are failing to communicate with pathfinder commissioning groups on musculoskeletal conditions and that more than half of commissioners do not define them as long-term conditions.

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