Description
In this presentation, David Cumming, a spinal surgeon and the National Clinical Director for NHS England, addresses the significant challenges faced in spinal surgery, particularly regarding waiting times and the implications of MRI scans. He highlights a recurring issue: many patients who receive MRI scans are often found to have non-normal results, such as disk protrusions or degeneration, leading them to seek consultations from spinal surgeons unnecessarily. This influx can hinder the timely treatment of patients with serious conditions.
To mitigate these challenges, Cumming proposes a streamlined approach where patients are directed to the appropriate healthcare providers earliest in their treatment pathway. By implementing effective triage systems, the initiative aims to reduce unnecessary referrals to surgeons and focus resources on patients who genuinely require surgical intervention. This involves collaborating closely with allied health professionals, particularly physiotherapists, who play a crucial role in the initial assessment and treatment of back pain cases.
Cumming describes a successful triage system implemented in Ipswich and Suffolk, which emphasizes evidence-based practices to expedite efficient treatment for patients. The process includes careful patient assessments, where red flags are identified and prioritized. This systemic approach, involving a multidisciplinary team (MDT) for weekly discussions on cases, ensures patients receive the right care at the right time, enhancing overall patient outcomes and reducing waiting periods for those needing specialist intervention.
He further critiques the common rush to MRI scans, advocating for reserved use. By managing patient expectations and systematically determining who truly needs imaging, Cumming's approach safeguards against the misinterpretation of MRI results, which often leads to patient anxiety and unnecessary chronic pain conditions. Instead of inundating surgeons with cases, this model promotes the use of physiotherapy and conservative therapies as initial interventions for non-acute back pain, reserving surgeries for patients with confirmed pathology. Ultimately, his emphasis is on creating a cohesive, integrated care pathway that benefits both patients and healthcare providers by minimizing redundancy and promoting effective treatment pathways.