Abstract
Background
Advanced spinal practitioner physiotherapists (ASPPs) assess and manage spinal referrals, as advocated by the National Low Back Pain Pathway in the United Kingdom. The ASPP pathway relies on multi-disciplinary team (MDT) meetings where potential surgically appropriate or complex cases can be discussed. Meetings were held with two different Consultant Spinal Neurosurgeons (total 2 meetings per month). The aim of this service evaluation was to assess MDT meeting outcomes and surgical listing.
Methods
This retrospective service evaluation used routinely collected MDT meeting documentation between May 2019 and October 2021. Data was extracted by two ASPPs, and 20% checked by a third ASPP. Extracted data included: number of patients discussed, Consultant, reason for discussion, and outcome (surgical listing or other). Data was analysed by two ASPPs using pivot tables in Microsoft Excel and was reported using counts and percentages across month and year.
Results
The majority of MDT discussions were for a surgical opinion (n=293, 25% clinician led, n=351, 30% patient led). Of these, 46% (n=135) of clinician surgical opinions were directly listed compared to 20% (n=70) of patient led discussions. Similar rates of consultant clinic review were seen between the two groups (22% and 32%), suggesting that the majority of patients discussed for surgical consideration were appropriate. 517 (45%) were discussed for management opinion.
Conclusions
This evaluation demonstrates that a majority of cases (68%) identified by ASPPs for surgical opinion were either directly listed or had consultant clinic surgical review. The results and trends identified will guide future patient pathway development and ASPP training.
Conflicts of interest: No conflicts of interest
Sources of funding: No sources of funding
