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Original research
Development of a physiotherapy-led atraumatic back pain pathway: a novel initiative to improve the management of complex back pain in the emergency village
  1. Michelle Louise Angus1,
  2. Bruce Martin2,
  3. Victoria Dickens3,
  4. Saeed Mohammad1,
  5. Irfan Siddique1
  1. 1 Department of Spinal Surgery, Salford Royal NHS Foundation Trust, Salford, UK
  2. 2 Emergency Department, Salford Royal NHS Foundation Trust, Salford, UK
  3. 3 MSK CATS, Salford Royal NHS Foundation Trust, Salford, UK
  1. Correspondence to Miss Michelle Louise Angus, Department of Spinal Surgery, Salford Royal NHS Foundation Trust, Salford M6 8HD, UK; michelle.angus{at}


Objectives To see if consultant physiotherapists could effectively manage spinal patients within the emergency village of a tertiary spinal referral centre.

Design A change was made to the traditional medical model for managing patients presenting to the emergency department with low back pain that could not be managed within the national 4-hour standard.

Participants A convenience sample of patients presenting to the emergency department of a tertiary spinal surgical centre who are unable to be managed in a timely manner by the clinicians in the emergency department.

Intervention Consultant physiotherapists took on autonomous ownership of this group of patients, including clinical assessment, management and appropriate follow-up often without the need for medical input.

Outcomes The new model showed a reduction in the number of admissions, a significant reduction in length of stay and an improvement in overall staff and patient satisfaction along with a reduction in patients returning to the emergency department.

Conclusions Consultant physiotherapists are in an ideal position to manage this cohort of patients autonomously in the emergency village allowing medics to be released to manage other patient groups.

  • musculoskeletal
  • orthopaedics
  • advanced practice
  • service improvement
  • spine

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  • Contributors All contributors work within the service and have helped with various aspects of the manuscript. Overall guarantor: MLA. IS: Conception and design: MLA, VD and BM. Collection and assembly of data: MLA and VD. BM: manuscript writing: all authors. Final approval of manuscript: all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was not required as the data was captured retrospectively following the implementation of the new service.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. All requests for data or more information can be made to the lead author