Pathway

Back & Neck Service:

  • AHPS currently provides the Back and Neck Service (BaNS) to both the West and East Suffolk CCGs. 
  • We also provide BaNS for Care UK to the local prisons. 
  • The BaNS has been running for 7 years and we have continued to run the service through the course of our contract.
  • The pathway is for patients with persistent back and neck pain and is aimed at making the care journey as effective and efficient as possible. 

Approach to designing the service 

Through consultation with patients, GP’s, Consultants, Commissioners and staff  our Extended Scope Practitioners (ESP’s) designed  the BaNS to :

  • Reduce waiting times to secondary care (for injections or spinal surgery)
  • Ensure timely referral to the most appropriate clinician 
  • Improve  recovery times.
  • Help patients to manage their condition

The BaNS also act an excellent resource for the physiotherapists with their specialist knowledge.

Joint sessions between the physiotherapists  and the ESP’s are encouraged throughout our organisation.

Red Flags:

  • There are a number of red flags that should be sent to secondary care 
  • The most serious of these is cauda equina. This is an autonomic dysfunction of the bladder which can lead to incontinence or retention 
  • Previous history of cancer (particularly breast, lung and thyroid) especially if associated with weight loss, night pain and unremitting pain 
  • Progressive neurological deficit

Standards/ Accreditations/ Regulation

  • All clinical staff are accredited with the Health and Care Professionals Council (HPCP).
  • We provide our service in line with National Institute for Clinical Excellence.
  • Chartered Society of Physiotherapy act an advisory body.
  • All ESP’s must be trained to a Master’s Degree level.

Staff involved 

  • Our lead ESP has been qualified as a Physiotherapist for 22 years and has specialised in spines for the last 11 years. 
  • He has a Master’s Degree in Manipulative Therapy and was instrumental in creating the BaNS. 
  • Our 5 ESP’s across Suffolk are trained to Master’s Degree level and are supported by a team of 3 administrative staff.

Facilities

  • The BaNS currently work out of:
  • Newmarket Hospital
  • Brandon Leisure Centre
  • Haverhill Health Centre
  • Sudbury Hospital
  • Hartismere Hospital, Eye
  • Thetford Healthy Living Centre

All have free on-site parking.  Patients may also choose any of our further 7 clinics in East Suffolk.

Processes

IM&T systems

  • We use SystmOne for keeping our letters and notes on and for diary and reporting purposes.
  • We use Picture Achieving and Communication system (PACs) for viewing scans and x-rays.

Performance

The following data is collated monthly:

  • All patients receive an initial face to face consultation within 25 operational days of referral
  • Where appropriate, patients will be  discussed at the Multi-Disciplinary Team meeting within 25 operational days following initial assessment
  • If further investigation is required the case notes will be discussed at the first MDT 
  • Discharge letters shall be sent within 3 working days

Innovation

  • SystmOne enables sending of text reminders for appointments – reducing DNAs. It also helps patients to cancel and book 24/7 via the internet. 
  • We use PAX which is a computerised system allowing X-rays and scans to be read remotely.

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