A new study shows it's feasible to benchmark musculoskeletal (MSK) care quality across English primary care networks — but wide variation in opioid prescribing and patient outcomes persists. Researchers found that socioeconomic deprivation plays a significant role, with the most deprived patients faring worse on nearly every measure. Only 3 of 13 networks hit the top-performance benchmark for MSK health improvement.
A prospective cohort study published in BMJ Open found that case-mix-adjusted benchmarking of musculoskeletal (MSK) care across English primary care networks (PCNs) is feasible — and reveals meaningful variation in both patient outcomes and opioid prescribing practices. Researchers tracked nearly 1,900 adults with non-inflammatory MSK pain across 30 general practices in 13 networks, measuring health scores and prescribing patterns over three months.
While patients' average MSK health scores improved modestly overall, only 3 of 13 networks cleared the top-performance benchmark. Opioid prescribing varied dramatically across networks, and two networks exceeded the upper control limit for high prescribing — a red flag for potential overuse.
Socioeconomic deprivation emerged as a consistent driver of worse outcomes, with the most deprived patients reporting lower health scores, more negative consultation experiences, and higher rates of opioid prescriptions.
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Why it matters: This study offers a proof-of-concept for systematically comparing MSK care quality across primary care networks — a tool that could help health systems identify underperforming areas, reduce opioid overprescribing, and address health inequities tied to socioeconomic deprivation.
