Your voices heard: community shapes optimal system of care for low back pain

Low back pain (LBP) is a com­plex health prob­lem that is often not well sup­port­ed by tra­di­tion­al mod­els of health­care. The Chron­ic Pain Statewide Clin­i­cal Net­work (SCN) has been lead­ing a project to sup­port more appro­pri­ate and con­sis­tent care for peo­ple with LBP to bet­ter meet patient needs and more effec­tive­ly sup­port the busy hos­pi­tal system. 

The Chron­ic Pain SCN’s LBP work­ing group devel­oped a pro­posed opti­mal sys­tem of care for LBP that was released for broad com­mu­ni­ty con­sul­ta­tion via the Your­SAy plat­form in late 2023. Con­sul­ta­tion is now con­clud­ed but you can still vis­it the Your­SAy web­site to read about the con­sul­ta­tion process and view the sum­ma­ry of feed­back responses. 

Over 60 con­sul­ta­tion respons­es were received from a range of stake­hold­ers includ­ing con­sumers, clin­i­cians, health pro­fes­sion­als, researchers, and peak body organ­i­sa­tions. The con­sul­ta­tion feed­back was used to refine and finalise the opti­mal sys­tem of care pro­pos­al. Next steps involve secur­ing resources and estab­lish­ing part­ner­ships to tri­al the fea­si­bil­i­ty of the mod­el with a view to it being com­mis­sioned broad­ly across South Australia.

Watch the video below to see mem­bers of the Chron­ic Pain Statewide Clin­i­cal Net­work Steer­ing Com­mit­tee, Prof. Anne Burke, Clin­i­cal Lead and Mary Wing, Con­sumer Rep­re­sen­ta­tive, dis­cuss the pur­pose of this work.

Many peo­ple with LBP cur­rent­ly rely on the hos­pi­tal sys­tem for treat­ment, yet evi­dence sug­gests com­­mu­ni­­ty-based ser­vices which fol­low best-prac­tice guide­lines are appro­pri­ate for most pre­sen­ta­tions. Treat­ment also varies across set­tings, rang­ing from phys­i­cal and psy­cho­log­i­cal inter­ven­tions through to strong med­ica­tions (e.g., opi­oids) and surgery. Con­tem­po­rary approach­es to pain man­age­ment should reflect the cur­rent under­stand­ing of pain sci­ence and evi­­dence-informed care through inno­v­a­tive and flex­i­ble design. We must​‘reimag­ine’ the way we deliv­er care for LBP to improve out­comes for peo­ple liv­ing with this condition. 

The opti­mal sys­tem of care pro­pos­es a shift away from tra­di­tion­al health­care struc­tures by cre­at­ing ver­sa­tile com­­mu­ni­­ty-based options for LBP that bet­ter sup­port ser­vice nav­i­ga­tion and facil­i­tate access to ear­ly assess­ment, man­age­ment, and review. Key com­po­nents of the sys­tem include: 

• A cen­tral triage hotline 
• Mul­ti­dis­ci­pli­nary care teams with­in com­mu­ni­ty care hubs 
• Ded­i­cat­ed pain coach roles 
• Sup­port­ed self-man­age­­ment to empow­er indi­vid­u­als in their care journey.