Joint effects 2011 - An update of the involvement - 18 Weeks

Joint effects 2011
Low Back Pain Physiotherapy Pathway
Christine McCallum
christine.mccallum@lanarkshire.scot.nhs.uk
01698 242615
The lower back pain pathway was introduced in July 2010. All patients with LBP are either self
referred or GP referred, they are assessed and treated according to an evidence-based, managed
clinical pathway. There is a clear escalation policy for patients identified requiring further
investigation or have complex needs. An orthopaedic spinal clinic run jointly by an ESP and an
orthopaedic surgeon reviews all patients with more complex outcomes or who have had an MRI
in order to provide a single point of exit from NHSL for surgical opinion if required. Exit routes
to other services such as WHSS, pain clinic, and exercise classes are available with outcome
measures assigned to each in order to evaluate the pathway and inform future service provision.
Improvements measured: measurable reduction in inappropriate referrals to ESP ortho vetting
system and reduction in waits. Resources were shifted to support the service through savings
made.
Outcomes measured: at present VAS, and clinical subjective and objective markers. STarT Back
tool in use. Will shortly be using the EQ5D, Roland and Morris and HADS.
Physiotherapy Assessment Line
Ruth Currie
ruth.currie@lanarkshire.scot.nhs.uk
01698 723246
The Physiotherapy Assessment Line (PAL) is a single-access telephone triage service for all
adults living within NHS Lanarkshire with an MSK condition for which Physiotherapy advice or
intervention may be of benefit. More than 60 experienced MSK clinicians have been trained and
handle calls, with the service manned by up to 10 physiotherapists each morning. Calls last on
average 15 minutes with the patient being thoroughly questioned and then managed in line
with evidence-based treatment and local service pathways such as routine appointment, urgent
appointment and emergency referral.
Improvements measured: call data outcomes available from our database and telephone system.
Outcomes measured: numerous outcomes are recorded including the call outcomes as
mentioned above, the percentage of back pain referrals made, the percentage of patients asked
to self manage, presenting conditions and demographics. A 22% increase in demand has been
addressed with the same resource.
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