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Community back pain clinics 'can manage vast majority of patients'

By Nigel Praities

A GP-led clinic can manage as many as 84% of patients with low back pain without the need for hospital referral, an audit reveals.

The community service – which also involves physiotherapists and osteopaths - is now being considered by the Department of Health as a model for back pain care.

Low back pain accounts for as many as 4% of GP consultations, with many patients ending up being referred to a surgeon.

But the audit, of a service based at three surgeries in Plymouth, found a multidisciplinary team in the community could manage a high proportion of cases.

Some 70% of patients service were seen within 14 days of GP referral and only 16% were then referred onto other services, such as neurosurgery or specialist pain clinics.

Almost 80% of patients visiting the clinic had better than 70% improvement on discharge, with an average cost of £122 per patient.

The Department of Health is now looking at developing the model in national guidance for commissioners, with lower back pain costing the NHS £480m a year.

Dr Mike Hopkins, a GP involved with the service and a trained osteopath, said: ‘Although the majority of back pain settles in four to six weeks, diminishing numbers would recover on their own after this and the very presence of these clinics keeps these from hospital referral.'

Dr Hopkins said his PCT had now decided to direct all GP referrals for low back pain to the clinics, rather than have direct referral to hospital, and that clinics in Dorset and Exeter were already implementing their model.

Dr Peter Stott, a GP in Tadworth, Surrey, who has set up a back pain clinic, said: ‘There just aren't enough surgeons to manage the current epidemic of back pain - the vast majority can be managed in the community.'

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