1. STarT Back Screening Tool (SBST) General Presentation

2. STarT Back Screening Tool (SBST) 9 Question screening tool designed for non-specific LBP patients in primary care Developed, researched and validated by Keele University The score identifies the level of risk that patients have of developing chronicity out of low, medium and high risk.

3. Scoring Flow Chart 3 or less4 or more Sub score Q5-9 3 or less4 or more Low riskMedium risk High risk Total Score

4. Outcomes of main study using SBST to target treatment: 1)The ‘low risk’ category had the same outcomes at 12 months whether they were managed with physiotherapy treatment or the Back book and information 2)The ‘medium risk’ group benefited significantly from targeted physiotherapy intervention at both 4 and 12 months after targeted physiotherapy treatment 3)The ‘high risk’ group had statistically significant improvement using targeted treatment compared to current physiotherapy treatment at 4 months, but neither group had an improvement at 12 months

5. The Practical QIPP Opportunities Around SBST Quality: SBST could be used as a shared decision- making tool, to help facilitate the conversation regarding the use of particular treatments or investigations. Innovation: SBST facilitates the development of evidence-based treatment pathways within MSK services –SBST could be used to evaluate the effectiveness of interventions i.e. PROMs –SBST can assist with the development of a true biopsycho-social approach within MSK services

6. The Practical QIPP Opportunities Around SBST Productivity: 26% of low back pain scores in the low risk group. There is an opportunity to realign resources to target the moderate and high risk groups. Prevention: The identification of the high and moderate risk groups, combined with appropriate treatment strategies earlier in the patient pathway should result in the decrease incident of chronic low back pain.

7. Contact details Rachel.Wakefield@southcentral.nhs.uk Hilary.Poole@southcentral.nhs.uk