Greater Manchester Back Pain Toolkit Outcomes Measures
Purpose
The purpose of this paper is to describe potential outcome measures that can be used by commissioners to monitor the effectiveness of the Greater Manchester Toolkit for the management of Lower Back Pain locally.
Background
The Greater Manchester Toolkit for the management of Lower Back Pain is intended primarily for use for patients presenting with new onset acute lower back pain within three broad categories, nerve root pain with or without radicular pain, lower back pain due to a non-specific cause, and lower back paindue to a specific cause. The aim of the toolkit is to streamline the patient journey for newly diagnosed patients with acute lower back pain to ensure the right treatment and interventions are received in the right place at the right time, and to prevent the development of chronicity in these patients. Commissioners should consider whether it is appropriate to apply this toolkit and the lower back pain pathways for patients with new onset acute lower back pain, to patients with chronic lower back pain who have already entered local services.
Overall Toolkit Usage
Overall usage of the Greater Manchester Toolkit for the management of Lower Back Pain and its constituent tools across Greater Manchester will be monitored by the GM Neurosciences Network through measuring the number of hits and downloads from the neurosciences network website.
Commissioners may wish to print hard copies of the tools for distribution locally e.g. pathways for displaying in local GP practices and, patient information booklet for distribution to patients that are unable to access it online.
Referrals to secondary and community care, and referrals converted to appointments across Greater Manchester can also be monitored via Choose and Book.
Surgical procedure and spinal injection activity and cost data can also be monitored via TIS.
Recommendations to Commissioners
Commissioners should consider measuring the following outcomes:
Referral/activity based outcomes:
- % reduction in referrals to spinal and neurosurgery outpatient services at local spinal services provider/% referrals received appropriate to service
- % reduction in referrals for spinal injections/% referrals received appropriate to service (treatment injections NOT injections for diagnostic purposes)
- % reduction in referrals for spinal surgery/% referrals received appropriate to service
- Monitor changes in referrals to care UK and MSK/physiotherapy/pain service for any adverse effects of introduction of pathways
- % reduction in inappropriate A&E/urgent care attendances for back pain
- % reduction in back pain related non-elective admissions
- Number of referrals to pain management programme
- % completed pain management programme
- Improvement in waiting times to access services
- Monitor if patient journey has become more streamlined
- Measure demand through GP practices e.g. number of people attending with acute back pain, number of people developing chronic back pain etc
Patient reported outcome measures:
- Improvement in pain score
- Improvement in function
- Improvement in psychosocial wellbeing
- Satisfaction with services
General Information:
Commissioners may wish to collect anecdotal information from their GPs and service providers locally on using the Greater Manchester Back Pain Toolkit, and whether it has been supportive to them in managing patients within primary care.
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