Royal Free to pilot self-referral for low back pain

London’s Royal Free NHS Trust is to launch a pilot service for people with low back pain to refer themselves to a clinic run by an advanced physiotherapy practitioner.


Advance practitioner team members Emma Brooks, Sian Bamford, Nicola Akehurst

The pilot service, which is due to start in August, will see an advanced practitioner with spinal expertise working at Fairbrook Medical Centre, a GP practice in Borehamwood, Hertfordshire.

The trust said that if the pilot succeeds the project could be expanded to GP practices across north London and Hertfordshire.

It said the project is specifically for spinal conditions, for which there is significant evidence that early management shortens treatment time and improves outcomes.

Patients attending the clinic will be triaged by an advanced practitioner, who will decide the best course of action. Treatment options could include a follow-up clinic appointment, telephone consultations or advice and support to facilitate their recovery.

The advanced practitioners will also have access to spinal orthopaedic consultants for surgical opinions and be able to book patients in for orthopaedic surgery from the GP clinic.

Improving quality of care

Patients who need physiotherapy will be referred to the specialist physiotherapy spinal team for one-to-one appointments or sessions with a spinal pain rehabilitation group.

One aim is to improve patients’ experience and quality of care by ensuring they receive the treatment from the most appropriate clinician as soon as possible.

Another is to improve efficiency and provide cost savings by freeing up GP time and reducing the number of unnecessary investigations, prescriptions and treatments.

The project team is led by Nicola Akehurst, advanced physiotherapy practitioner and clinical lead at Barnet Hospital, Hertfordshire.

She said: ‘The patient self-referral project is an idea that has developed over many years from our experience of treating patients with back pain.

‘The team of clinicians involved in the project has a wealth of expertise and feels passionate about the benefits that this service will bring to patients.

‘As the advanced practitioners will be working in the GP surgery it will create an opportunity for sharing of ideas, issues and developments.’

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