Delivery of the Comprehensive Multi-Disciplinary Combined Physical and Psychological Programme of the National Low Back and Radicular Pain Pathway in England and Wales: where do we stand?

Objectives This survey study aimed to map the current provision of the Comprehensive Multi-Disciplinary Combined Physical and Psychological Programme of the National Low Back and Radicular Pain Pathway in England and Wales.

Design Online Survey.

Setting England and Wales.

Participants In total there were 66 respondents; 18 Trusts provided a full data set for their programmes - one delivered in Wales and 17 in England.

Results All programmes met the core criteria for CPPP laid out in the Pathway but there was great variation in many key areas of content, outcome data collected, structure and delivery mode and staffing.

Discussion The variation seen reflects a non-standard quality and nature of care across England and Wales. This likely reflects the absence of detail to inform NHS Commissioning in the corresponding NICE Guidelines, which in turn arises from the paucity of robust, pragmatic, evidence of efficacy and effectiveness of different models of CPPP.

Conclusions Robust, pragmatic, evaluation of CPPP service provision is required to inform NHS Commissioning and bring best care to all. A standard ‘data dictionary’ of outcomes would facilitate cross-site comparison and enable ongoing monitoring of provision across sites.