Development of a physiotherapy-led atraumatic back pain pathway: a novel initiative to improve the management of complex back pain in the emergency village

Objectives To see if consultant physiotherapists could effectively manage spinal patients within the emergency village of a tertiary spinal referral centre. Design A change was made to the traditional medical model for managing patients presenting to the emergency department with low back pain that could not be managed within the national 4-hour standard. Participants A convenience sample of patients presenting to the emergency department of a tertiary spinal surgical centre who are unable to be managed in a timely manner by the clinicians in the emergency department. Intervention Consultant physiotherapists took on autonomous ownership of this group of patients, including clinical assessment, management and appropriate follow-up often without the need for medical input. Outcomes The new model showed a reduction in the number of admissions, a significant reduction in length of stay and an improvement in overall staff and patient satisfaction along with a reduction in patients returning to the emergency department. Conclusions Consultant physiotherapists are in an ideal position to manage this cohort of patients autonomously in the emergency village allowing medics to be released to manage other patient groups.