For example, some patients were given manual therapy alone and back classes still encompassed a large core stability element. It was acknowledged that this was not financially sustainable and patients were not being given the adequate support they needed to self-manage their pain.Įxisting specialised spinal services and musculoskeletal (MSK) physiotherapy were found to have inconsistencies in the type of care provided between clinicians and some treatments on offer were found to be outdated and / or absent. An analysis of the top 20 highest attenders within this group of patients revealed that they received 1035 attendances at a cost of £540,000 in a 5 year period. Within a 5 year period the cost associated with patients attending multiple services totalled £2.1m. These concerns indicated an increased number of patients with chronic pain of which 50% were thought to arise from back pain, increased waiting times for specialist pain services and increased associated costs.Ī review of patients with chronic pain conditions undertaken by West Berkshire CCG highlighted that a significant number make multiple attendances within secondary care. Key concerns were raised informally on the back of the original spinal service and then formally via workshops attended by the stakeholders of Berkshire West. To release capacity to secondary care in order for ‘red flag’ patients and those requiring invasive procedures to be seen more quickly.To reduce the number of attendances in secondary care, therefore making a cost efficient service.To offer a range of strategies including back and pain management classes to engage patients in exercise activities and promote self-management strategies. To provide access to specialist spine and pain services in the community closer to patients home.To provide appropriate assessment and treatment earlier on in the patient journey, avoiding duplication, delay and inappropriate referrals.To offer better support for patient self-management.To improve communication between primary, community and secondary care to enable more co-ordinated care.To establish a multidisciplinary community pain service for rapid MDT assessment and treatment of patients with back and chronic pain.
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