10:39am Saturday 20th March 2010
By Richard Catton
THE controversial decision to scrap routine pain relief injections for sufferers of chronic back complaints in York has been defended by city health chiefs.
NHS North Yorkshire and York had been accused by the group representing hundreds of back pain sufferers of misinterpreting guidelines issued by the National Institute for Clinical Excellence (NICE).
The trust chose not to routinely fund spinal injections for back pain last November, saying it must focus on buying services which give the best possible clinical outcomes to ensure value for money.
Now The Press has been handed a copy of an email sent from NICE to Gordon Hart, of the York and District Pain Management Support Group, which says its guidelines recommend seeking alternative treatment for those who have suffered undiagnosed back pain for no longer than 12 months.
The email said: “I am writing to confirm that the NICE guideline on low back pain only covers the treatment of patients who have persistent non-specific low back pain that has lasted for longer than six weeks but less than a year.
“Patients who have known cause for their back pain or have had back pain for longer than a year were explicitly excluded from the scope of the guideline.”
The support group said people who fell into the latter group were now being denied treatment. Mr Hart accused the trust of a misunderstanding of the intention of the guidelines and at worst “a deliberate distortion of the intents of the document”.
Dr David Geddes, medical director at NHS North Yorkshire and York, said: “While NICE guidelines are an important factor in our decision-making, they are not the only source of evidence.
“Our commissioning policy has been based on a comprehensive body of both national and international evidence that has become available over recent years.”
Dr Geddes said: “While spinal injections for patients with long-term back pain have to some extent become custom and practice, studies have consistently failed to demonstrate any evidence to support the use of epidurals or facet joint injections for patients with back pain lasting up to, or over 12 months.
“My clinical colleagues and I are in agreement that these injections are not an appropriate long-term solution and we continue to support the use of other therapies and surgery where appropriate.”
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