Quality statement 1: Risk stratification

Quality statement

Primary care services have an approach to risk stratification for young people and adults presenting with a new episode of low back pain with or without sciatica.

Rationale

Risk stratification can be used to identify a person's risk of poor functional outcome or long-term problems from low back pain with or without sciatica. Risk stratification tools can help to determine the complexity and intensity of support that a person may need.

Quality measures

Structure

Evidence of a locally defined approach to risk stratification and of systems in place to make staff aware of the approach.

Data source: Local data collection, for example, service specifications and written communications to staff.

What the quality statement means for different audiences

Service providers (primary care services) have an approach to risk stratification that they communicate to staff who undertake consultations for young people and adults presenting with a new episode of low back pain with or without sciatica. This can help support decisions about whether risk stratification is used with individual patients and, if so, which risk stratification tool is selected.

Healthcare professionals (such as GPs and nurses) are aware of their service's approach to risk stratification for use at the first consultation with young people and adults presenting with low back pain with or without sciatica. This can determine whether risk stratification is used and, if so, which risk stratification tool is selected.

Commissioners (such as clinical commissioning groups and NHS England) ensure that the services they commission have an approach to risk stratification for people presenting with a new episode of low back pain with or without sciatica and systems in place to make staff aware of their local approach.

Young people and adults presenting with a new episode of low back pain with or without sciatica are assessed in a way that is consistent with a local approach to risk stratification. Their treatment and support is then chosen in line with the results of the assessment.

Source guidance

Low back pain and sciatica in over 16s (2016) NICE guideline NG59, recommendation 1.1.2.

Definition of terms used in this quality statement

Risk stratification

Stratification aims to improve the outcome by selecting treatments that may be more likely to work in certain groups of people. There are several methods of stratification which are all similar in outcome. The STarT Back risk assessment tool is an example of a validated tool for stratification by risk of ongoing functional impairment.

[Adapted from NICE's guideline on low back pain and sciatica in over 16s, recommendation 1.1.2 with expert opinion]