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Welcome!

 

The United Kingdom Spine Societies Board (UKSSB) is an organisation composed of 3 national societies that are members of the UKSSB:

  • Society for Back Pain Research (SBPR)
  • British Scoliosis Society (BSS)
  • British Association of Spine Surgeons (BASS)

The Board includes representatives of the British Orthopaedic Association (BOA) and the Society of British Neurological Surgeons (SBNS).

 

Updates

 

The full proposal for a Spinal Training Interface Group (STIG) can be read here .

 

 

 

Please visit this page on our site, to read the latest information.

 

 

 

There are no current vacancies.

 

 

The Board of the UKSSB welcomes applications from its constituent societies for financial support in the delivery of Research, Education and Administartive activities.

Applications must be on the linked form below, and submitted with the supporting information to the Executive Assistant of the Board for consideration. (UKSSB@boa.ac.uk)

Applications can be made at any time, but deadlines for consideration coincide with the Board meetings at which time assessment and decision will be made.

Link to Form:

 

BSS Position Statement on Vertebral Body Tethering for Scoliosis: LINK

 

‘Specialised Commissioning Trauma Programme of Care Briefing 7:
December 2016’ LINK

 

‘SBPR response to Government Green Paper on ‘Work, Health and Disability: Improving Lives’’ LINK

 

National Back & Radicular Pain Pathway (updated)
The National Back and Radicular Pain Pathway has been updated following publication of the NICE Guidelines for Low Back Pain and Sciatica (NG59) in November 2016 and agreement from the Pathway Development Group that all recommendations should be included. Pages 101 and 102 summarise the main changes to the Pathway. This Pathway will be sent to all CCGs and STPs to encourage implementation. NICE has been asked to endorse the Pathway. (Ashley Cole)

LINK

The National Back Pain and Radicular Pain Pathway 2017

Incorporating the NICE Guidance on Low Back Pain NG59 2016


Back pain remains the largest single cause of disability in the UK, with low back pain alone accounting for 11% of the total disability of the UK population. Referrals for spinal surgery are increasing year on year and a growing number of patients are waiting longer than 18 weeks from referral to treatment. Wide variations exist in surgical rates between centres, and there are a significant number of treatments with a poor evidence base.

The National Low Back Pain Pathway was published in 2014, incorporating the latest evidence available at that time in a single end to end care pathway. The objective of this pathway was threefold: firstly to rapidly identify and refer potentially serious pathology; secondly to provide expeditious access to interventions such as nerve root blocks or surgical discectomy where indicated and thirdly, and most importantly, provide effective and timely care for sufferers with acute low back pain to improve outcomes and reduce disability. A number of CCGs have commissioned the Pathway under the auspices of an NHS England implementation project – the Improving Spinal Care Project. Results from two CCGs in the North East have been independently evaluated by the North East Quality Observatory (NEQOS). The Pathway has reduced delays, removed ineffective treatments and helped patients to lead a fuller more active life, reducing disability and chronic pain. Because the treatment pathway is evidence based and more coherent, this management is significantly less expensive than the previous management. Actual savings experienced in the two CCGs with a population of nearly 450,000 have been some £353 K from MRI and nerve root block savings alone. Further savings from reduction in surgery and other injections are predicted to be of an equal value.

In November 2016 NICE published their Guidance “Low back pain and sciatica in over 16s: assessment and management”, NG59. Subsequently the National Clinical Pathway Group have updated the national pathway and the revised version “The National Back Pain and Radicular Pain Pathway 2017” was published in February 2017. All the NICE recommendations have been incorporated and NICE accreditation has been applied for. The National Pathway is therefore the simplest, most effective and best value route for CCGs to implement the latest NICE guidance.

For those CCGs already implementing the National Pathway a few, but not very many, changes in the Specialist Triage Practitioner’s (previously Triage and Treat Practitioners) algorithms, and to the training package. These changes are contained in the new pathway. The new Guidelines include radicular pain which was already contained in the National Pathway.

One important change is that the new NICE guidelines cover chronic pain as well as acute and sub-acute pain, recommending provision of a comprehensive multi-disciplinary CPPP. This expansion commits commissioners to an expanded scope for these programmes, representing a cost pressure. Clearly this aspect presents a challenge, but one that has to be taken seriously. The value impact analysis has shown significant savings overall which will release funding to extend to chronic pain patients, this value impact analysis is being revised for clarity.

Other changes include RF denervation, where it must be noted that the recommendation is to consider for chronic pain; the NICE group noted the evidence was for patients with a two or three year duration.

Fusion for back pain alone must now be done as part of an RCT. This does not have to be against a non-surgical control, but can study any aspect. There is also a strong recommendation in the Pathway and in the Guidance that all surgical procedures must be entered onto the British Spine Registry.

There is an increased focus on return to work and promotion of normal activities.

NICE has made recommendations on the avoidance of paracetamol alone in back pain, as well as some forms of anti-depressants, anticonvulsants, routine use of opioids in acute back pain and use of opioids in chronic back pain. NICE has also clearly recommended that some treatments must not be offered; these include acupuncture, traction, PENS or TENS, ultrasound or interferential, spinal injections for back pain and disc replacement.

This new pathway is a complete end to end pathway for lower back pain and radicular pain which starts at the GP Surgery and moves through primary care and, if indicated, through to secondary care - LINK. All clinicians using this new pathway will be applying right care/right time/right place principles, supported by a Public Health awareness campaign.

Next steps

The 10 regional commissioning centres will have responsibility for working with the transformation team in each CCG commissioning collaborative to take this work forward. We are communicating with the Sustainability and Transformation Plan teams. We will also be inviting provider networks to take part in the peer review and design process on the future pathway of care.

If you are interested in being an early adopter of the Improving Spinal Care Project email: ENGLAND.improvingspinalcare@nhs.net


Ver 1.0 27/02/2017

 

Please note that the UK Spine Societies Board is not responsible for the content of any (linked) external websites.