The benefits and effectiveness of chiropractic and osteopathic treatments can be overlooked by GPs and NHS services. It’s fair to say that some health professionals don’t truly understand how our services can help their patients, which can make collaboration difficult.
In my region of North Hampshire it’s a different story. Chiropractic and osteopathic services are viewed as a useful contribution to an integrated care network.
As a result, Back Active is able to provide a fully integrated NHS service. We have had chiropractors working as first contact practitioners in GP surgeries and we have operated within the NHS integrated musculoskeletal pathway for a number of years. Our involvement in the pathway leads to over 40 referrals a week. In fact, in the North Hampshire CCG area, over half of all spinal community care has been delivered by clinicians at Back Active. Our reputation for providing high quality patient care means we have gained the trust and confidence of healthcare professionals across the region.
This hasn’t happened overnight. It has taken many years to reach this position. I had to argue about the importance of including chiropractic services as part of the locally commissioned services for spinal care. Being able to show the outcome measures for patients during and after care was critical to demonstrating the effectiveness of chiropractic treatment. For example, our measurements show that 85% of patients were better or much better after receiving care at Back Active.
Integration of patient care
The musculoskeletal pathway is a great example of how coordinating healthcare services and collaboration between disciplines can enhance patient care.
Patient referrals first go via a GP practice (or patients can self-refer) to a central hub called Circle Hub. These referrals are read by specialist clinicians whose role is to put patients in front of the clinician most likely to help them. When we receive a patient through the pathway we undertake an initial assessment and write a Care Plan, outlining their diagnosis and treatment. This is shared with the GP and the Circle Hub so all health professionals are aware of the patient’s condition and care plan. This means that if a patient gets a flare-up and contacts their GP there’s continuity and integration of care.
A proactive approach
Some GPs still aren’t able to distinguish between chiropractors and osteopaths. This is often because they care about the specific treatment that an individual clinician can provide for their patients rather than focusing on the profession that delivers the treatment.
It’s therefore in the best interests of the patient as well as chiropractors and osteopaths to build personal relationships with GPs and other healthcare networks. A proactive approach is needed and communication has to be the starting point.
There are lots of ways to build relationships. For example, running a training event in a chiropractic practice and asking local GPs to come and give a talk. Writing letters that give advice about a patient can be helpful to a GP. My experience shows that GPs will refer to a health professional they know and trust.
Finding the best fit for the patient
We are a multi-disciplinary practice with chiropractors, osteopaths and physiotherapists. When we receive a referral we always ask the patient who they want to see in order to find the best fit between patient and practice.
Ultimately, we need to make sure the patient receives the right treatment. There are transfers within clinic between our clinicians. If a patient isn’t doing well after four treatments we will stop and reassess. For example, if a patient is not responding to the exercise given by one clinician, we might start a trial with spinal manipulation. If a patient isn’t doing well early in care, it probably isn’t the right treatment.
As a clinic we will always work together as a team, combining our specific expertise and specialisms, to find the right treatment for a patient that puts them on the path to recovery.