A PHYSIOTHERAPY-LED SPINAL SERVICE WITHIN THE EMERGENCY VILLAGE: A NEW MODEL OF CARE

Background Low back pain (LBP) with or without leg pain, is one of the most common causes of pain and disability and a frequent cause of attendance to emergency departments (ED). Increasing numbers of patients create a difficult challenge for clinicians to effectively and appropriately manage patients with LBP in an urgent care setting. Purpose To improve the management of atraumatic spinal pain patients admitted onto the emergency assessment unit (EAU) thus improving quality of care, reducing bed stay and facilitating appropriate discharge and follow-up within an interdisciplinary model. Method From January 2014, consultant physiotherapists, led a 7-day service to assess and manage patients admitted to the EAU with atraumatic back pain. Patients are referred for appropriately and timely investigations. Non-medical prescribing skills allow physiotherapists to offer pharmacological review and prescribing in line with best practice guidelines. All care is delivered within a framework of inter-professional care with involvement of emergency medicine, spinal orthopaedic, neurosurgical, pain management and pharmacy teams. Results Length of stay has reduced by 25% in two years (potential saving £411,726 per annum). Official patient complaints have reduced to zero. Readmission within 30 days has fallen from 1.2% of the total number of admissions with atraumatic back pain to 0.8% despite earlier discharge. Cost of bed stay has fallen from Conclusion Highly skilled physiotherapists are ideally placed to lead and deliver safe and effective care for patients presenting with atraumatic back pain within an urgent care setting. This has resulted in improved care at lower cost. No conflicts of interest No funding obtained