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Clinical efficacy and risk profile of NHS routine spinal operations

Overview

One in three people have a musculoskeletal condition affecting their muscles, bones or joints. This can cause pain, difficulty moving, time off work, and increased chance of conditions like heart disease. The NHS spends £6.3 billion on these conditions each year.

Physiotherapy is standard care which helps, but wait lists are long and there are not many other options. Also, it often focuses on the referral reason and not other health and social care needs which these people have.

To solve this problem, Community Appointment Days or ‘CADs’ offer an appointment to help people with their musculoskeletal condition, and other health and social care needs. People can access an assessment, rehabilitation and advice, health promotion, and support from social care, local council and the voluntary sector. This takes place in a non-medical setting like a leisure centre.

Why this study matters

When CADs have been run, people were happy with their care and waiting lists were shorter. However, we do not know if CADs should be made available everywhere because we do not know for certain if they really help people with musculoskeletal conditions or if they support the NHS in the best way.

Our study aims to find out if CADs should be a part of musculoskeletal care or not. If the study finds that CADs are helpful, it will also tell us how to make sure as many people can benefit from CAD as possible.

What we’re doing

We will set up 8 locations where people with musculoskeletal conditions go to a CAD and 8 locations where they have standard care. The set up will be decided at random. This study will focus on quality of life and healthcare costs.

We will find out what worked well (or not) at each of the CADs during interviews with people who went to them, those who organised and paid for them, and group discussions with staff who worked at them.

We will see if people are more likely to come to their first appointment if it is at a CAD, whether they are more likely to come back if their care was first at a CAD, and the time people with musculoskeletal conditions are waiting for care.

We will also see if we can measure the environmental impact of CAD compared to standard care.

Who is involved

  • Lead investigator: Prof Katie Sheehan  
  • Co-Lead investigator: Prof Beth Stuart 
  • Public and patient representatives 
    • Ms Vicky Grandon 
    • Mr Kamil Sterniczuk 
  • Key partners NHS: 
    • Ms Laura Finucane: Here, Sussex 
    • Mr John Jeffords: Barts Health NHS Trust 
    • Dr Benjamin Ellis: Imperial College Healthcare NHS Trust 
  • Key partners Academic: 
    • Dr John Ford: Queen Mary, University of London 
    • Ms Jamila Kassam: Queen Mary, University of London 
    • Dr Lisa Newington: Queen Mary, University of London 
    • Ms Jessical Pawson: Queen Mary, University of London 
    • Dr Veronica Toffolutti: Queen Mary, University of London 
    • Dr Alice Berry: University of West of England, Bristol 
    • Dr Stephanie Hemmings: University of Brighton 
    • Dr Philip Kinghorn: University of Birmingham 
    • Prof Christian Mallen, University of Keele 
    • Prof Nicola Walsh: University of West of England, Bristol

Current status

Contact email: cad-bjh@qmul.ac.uk

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