12 February 2026
Last month, the Department of Work & Pensions opened a call for evidence on young people and work to understand the key drivers behind the rising numbers of 16-24-year-olds who are Not in Education, Employment or Training (NEET).
We submitted evidence highlighting the specific challenges faced by children and young people living with MSK and rheumatic conditions and the opportunities to ensure they are better supported in education, training and employment.
The rising impact of MSK and rheumatic conditions on young people
This issue is particularly important given the rising prevalence of MSK and rheumatic conditions in children and young people. Pain, fatigue and associated mental health issues can significantly affect their ability to participate in school or work, often leading to prolonged absences.
MSK pain is one of the most prevalent causes of chronic pain in childhood, affecting 25.7% of children and adolescents, and young people with MSK conditions are more likely to self-report mental health concerns than their peers.
Overall, MSK conditions are the second most common cause of sickness absence from work, amounting to more than 28 million days lost working days, emphasising the scale of the impact.
Challenges affecting participation in school and work
Children and young people with MSK and rheumatic conditions face a range of barriers that disrupt their education and future employment.
- Diagnostic delays disrupt school, work and home and negatively affect their long-term health outcomes. Diagnosis is delayed in over a third (33.9%) of young people with Juvenile Idiopathic Arthritis (JIA), with many being bounced between specialties due to inappropriate referrals.
- Prolonged absences from school due to pain and symptom flares can significantly disrupt education, wellbeing and long-term life chances.
- Specialist appointments often require travel to distant specialist centres, and only 1.8% of young people aged 13 years or older are offered clinic times outside school hours.
- Limited work experience opportunities, often due to placements being in small organisations without the knowledge or capacity to provide appropriate reasonable adjustments.
- Transition to adult services is inconsistent with 41.8% of young people not starting the transition process at a developmentally appropriate age.
- Medicine supply issues affect health outcomes and quality of life, leading to reduced school attendance and vocational attainment, and increased psychological stress.
Opportunities to provide better support for education, training and employment
Children and young people need access to specialist health services
It’s clear that children and young people with MSK and rheumatic conditions require more targeted support to participate fully in education and work. This includes access to specialist physiotherapy, occupational therapy and psychology services that are developmentally appropriate and responsive to their needs.
However, many are under referred to these services due to staffing shortages and rising demand. Nearly a third (31.6%) of young people with JIA who should be seen by occupational therapy are not. Within adult rheumatology services, specialist provision for adolescents and young adults is often limited, particularly for vocational readiness and career pathway support.
Collaboration between specialist health professionals and school staff
Occupational therapists play a crucial role in supporting young people. By working alongside school staff, they help raise awareness, reduce stigma, and ensure appropriate support and adaptations are in place. This can directly impact whether a young person feels able to remain in school, opts for alternative education pathways such as home learning or disengages entirely.
Workplace support
Employers also have a responsibility to create flexible, inclusive work environments for young people with health conditions. In our response, we highlighted resources, such as the MSK Health Toolkit for employers and further education institutions, which should be widely promoted to improve understanding and support.
Continuing our advocacy and supporting improvement
We remain committed to raising awareness of the complex needs of children and young people with MSK and rheumatic conditions, as well as the workforce challenges within paediatric, adolescent and adult rheumatology services. With the publication of GIRFT Paediatric Rheumatology Specialty report and the findings of NCEPOD JIA review, we now have robust evidence to strengthen our advocacy and push for meaningful change.
Our Paediatric Quality Improvement Network (PQUIN) is open to BSR members who wish to share best practice, discuss quality improvement initiatives, and connect with colleagues from across the UK. The next meeting will take place on Friday 13 March from 12.30 - 1.30pm via Teams.