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Is our healthcare system working for spinal surgery patients? Towards individualised care pathways and person-centered supports

Alison McGregor, Ania Henley, Tim Morris, Caroline Dore


As part of a randomised controlled study into the post-operative management of spinal surgery, this qualitative sub-study sought to explore the patients’ experience of the healthcare system and their perceptions of how the system had worked for them, with a view to establishing more appropriate care pathways and improved support materials for patients undergoing surgery.

Patients taking part in the FASTER study (Function after spinal treatment, exercise and rehabilitation) were invited during their one year post-operative review to provide feedback on their healthcare experience following surgery. This study comprised 245 patients recruited from 7 hospitals, with 20 different spinal surgeons contributing patients.

The majority (82%) of patients were referred through their general practitioner (GP). Forty percent identified a specific event that led to their pain; of these 48% reported a longstanding pain and 33% noted a sudden injury. Thirty percent waited less than a month for surgery and 32% 1-3 months. Eighteen percent experienced surgical cancellations. Many respondents felt that they had not been managed well by their GP pre-operatively, although it appeared that most GPs had followed current guidelines. In terms of their hospital stay the majority felt prepared and content with the care received and expressed faith in their surgical team. Although it appeared that patients were happy with their post-operative care, closer inspection revealed concerns with inadequate information, feelings of abandonment and poor communication from some healthcare professionals. Many reported that taking part in the research itself was a positive experience.

Both negative and positive patient experiences have been identified. Patients express concern at the paucity of information they are given concerning their clinical journey, particularly in relation to discharge from hospital. In this era of social media and the internet there is a clear need to explore new methods of addressing patients’ information needs.


Care pathways, clinical information, communication, FASTER study, patient experience, person-centered care, quality of care, skills, spinal surgery

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