Experiences of Musculoskeletal (MSK) treatment

Background

Musculoskeletal (MSK) conditions affect many people and can affect your joints, bones and muscles and sometimes associated tissues such as your nerves. They can range from minor injuries to long-term conditions.

Over 20 million people in the UK, almost one third of the population, have a musculoskeletal condition such as arthritis or back pain. Symptoms can include pain, stiffness, limited movement, and disability which can affect quality of life and independence.

Treatment for musculoskeletal conditions in the NHS is delivered in various settings such as primary care (i.e. your GP) and in community settings like physiotherapy clinics. Some specialised and more complex services are also provided in hospitals, for example through outpatient clinics.

The survey intended to help us understand your experience of seeking and receiving care from one or more of these musculoskeletal services. This will help us make sure future services meet the needs of all Greater Manchester patients.

The insights captured through the survey help us better understand what is working well and where improvements are needed across the MSK pathway. By listening directly to service users, we aim to support more timely, coordinated, and person-centred care, shaped by real experiences and priorities.

The full report is available at the bottom of this page

a person in a clinical space having their muscles checked in their neck

The Key themes

Access and navigation: Most people enter MSK care through their GP due to limited awareness of alternative routes, while direct access to physiotherapy is highly valued where available for faster, specialist support.

Waiting times: Although average waits are around 3–4 weeks, experiences vary widely, with a significant minority waiting 8 weeks or longer, particularly for onward referrals or hospital services; long waits are a key driver of dissatisfaction.

Incomplete resolution and long‑term management: MSK conditions are rarely fully resolved across primary, community, and hospital settings; people more often receive partial improvement, a diagnosis, or a management plan, reflecting the chronic nature of many MSK conditions.

Value of self‑management support: Services are most positively received when they provide clear advice, reassurance, and support to help people manage their condition over time.

Mixed care experiences: Positive experiences are associated with being listened to, clear explanations, empathetic and professional staff, and shared decision‑making, while negative experiences involve feeling rushed or dismissed, poor communication, limited appointment choice, and lack of continuity.

Communication and coordination gaps: Poor handovers between services, unclear or delayed information, and a lack of joined‑up care lead many people to chase appointments or repeat their history multiple times.

Inequalities: Older adults emphasise continuity, proximity to home, and clear information but often experience longer waits; younger adults prioritise speed of access and being taken seriously, with some turning to private care; women highlight the importance of clear communication, tailored support, and shared decision‑making, while evidence of ethnic differences is limited by small sample sizes.

Key points for commissioners to consider

Increase awareness and availability of direct access MSK services, reducing default reliance on GP appointments
Improve public navigation and signposting so people know where and how to access the right care first time
Reduce variation in waiting times across localities and providers, particularly long waits for onward referral
Focus investment on pathway flow and bottlenecks, not just individual services
Recognise MSK conditions as often long‑term, commissioning services that support ongoing management rather than one‑off resolution
Strengthen self‑management support, education, and personalised care planning
Improve communication and coordination between primary, community, and hospital services
Reduce the need for people to repeat their story or chase appointments themselves
Embed patient experience measures (listening, explanations, shared decision‑making) alongside clinical outcomes
Commission services that are flexible and inclusive, reflecting different needs by age and life stage
Monitor impacts on health inequalities, especially for under‑represented groups
Use the survey results as a baseline, repeating engagement to track improvement over time