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Statement regarding the commissioning of spinal/facet joint injections for chronic low back pain

Blackburn with Darwen and East Lancashire CCGs commission (buy) a pain management service for patients in the Pennine Lancashire area, which is provided by a number of hospitals. As commissioners we have a responsibility to ensure that services such as the pain management service are delivered in line with the latest National Institute for Clinical Excellence (NICE) guidance on good practice.

The CCGs identified that in comparison with providers elsewhere, the pain management service provided by one hospital had unexpectedly high numbers of patients in receipt of back injections.

Following an investigation into this unexpectedly high number of back injections, the CCGs, introduced a policy for back injections to ensure it is in line with the latest national guidance and best practice. In particular, this recommends that spinal/facet joint injections for chronic low back pain, should not be offered to patients, as this type of treatment is not considered to be clinically effective. New NICE Guidance has recently been issued and has reinforced our position. We shall be reviewing our policy in the light of this guidance.

It would not be in the best interest of the patients for the CCG to continue to buy treatments where there is no evidence of their benefit or effectiveness. Our sole aim is to ensure that patients are offered treatments that are effective, and that they are supported with the right treatments. For chronic low back pain, there is a range of treatments and services that are available, and we are working with providers to ensure that patients are offered this range of treatments.