Spinal Triage by Extended Scope Physiotherapists in a diagnostic interface clinic: Spinal unit conversion rates from a 12-month service evaluation.
The Back and Neck Service (BaNS) was established in Suffolk (2003) as an interface clinic with the aim of reducing unnecessary referrals into the secondary care Spinal unit for surgical opinion. Since this time the service has expanded and now consists of six Extended Scope Physiotherapists (ESP) across the East (BaNS-East) and West (BaNS-West) localities. Importantly, the BaNS is embedded within a wider spinal pathway spanning both primary and secondary care which allows timely self-referral to musculoskeletal physiotherapy via a Single Point of Access (SPOA) portal. Patients with radiating symptoms failing to improve at 6-weeks, or those with axial symptoms that have failed appropriate management can be referred into the BaNS by their treating physiotherapist or via their General Practitioner. Following assessment and, where indicated, investigation(s), suitable cases are reviewed with a spinal consultant at a weekly meeting where appropriate patients can be directly referred into the secondary care spinal unit. The purpose of this service evaluation was to establish the effectiveness of the BaNS in triaging patients with axial and/or radiating symptoms into secondary care and to report the conversion rate to surgically led interventions (nerve root block injections & surgery). A secondary aim was to establish patient satisfaction with the service.