Nova Scotia Health's new Spine Assessment Clinic (SAC) offers assessments and support for patients with neck and back pain.
Funding for the clinic was made available under Nova Scotia Health’s Surgical Access and Quality Improvement Strategy.
What is the Spine Assessment Clinic?
The Spine Assessment Clinic is comparable to Nova Scotia’s Orthopedic Assessment Clinics (OAC) which support a single-entry intake and wellness model for patients with hip and knee arthritis, as well as Ontario’s Rapid Access Clinics For Low Back Pain.
Patients referred to the Spine Assessment Clinic receive initial assessments by physiotherapists who support patients to better manage their condition or refer onto a surgeon as needed.
What was the Spine Assessment Clinic needed?
Nova Scotia has seen increased demand for spine consultations, assessments, and spine surgeries, with about 4000 patients waiting for spine assessments, and more than 300 patients added to the waitlist each month. Under the previous model, all patients would wait to see a surgeon for an assessment; however, only about 10 per cent of referred patients have conditions that require surgery. This situation contributed to long waits for patients.
When should a patient be referred to the Spine Assessment Clinic?
Patients should be referred when they are experiencing neck or low back pain and/or related symptoms (e.g., sciatica, neurogenic claudication) that have not improved after six weeks to 12 months and have pursued conservative management strategies (e.g., pain management, physiotherapy).
Other patients that are appropriate for referral are those experiencing unmanageable recurrent episodic pain and/or related symptoms of less than 12 months duration since last onset.
It is also important that a clinical assessment be completed before sending a referral. This video, shared with permission from Ontario's Rapid Assessment Clinic for Low Back Pain, highlights a quick physical assessment that may be helpful.
****It is recommended to consider referral to the Spine Assessment Clinic prior to:
- the initiation of an opioid prescription,
- specialist referral,
- or imaging referral.
An MRI, or other imaging, will be requested through the Spine Assessment Clinic as required, which may be a change in current practice.
How can I refer my patient to the clinic?
eReferrals Users
The Spine Assessment Clinic is part of Nova Scotia’s electronic referral tool (Ocean eReferrals). To submit a referral, simply select the Spine Assessment Clinic from the eReferrals directory, complete and submit our standardized referral form.
Please encourage patients to provide an email address that can be added to the eReferral. This allows patients to receive automatic notifications and follow-up communications. This can also save primary care providers time following up.
Providers not set up to use eReferrals
Please use the standardized referral form that has been developed to support these referrals.
NOTE: The deadline for mandatory use of eReferrals by primary care providers and surgeons is April 1. Please request onboarding and training support ASAP at: www.referralsns.ca/contact-us.
What can patients expect once they are referred to the Spine Assessment Clinic?
Patients awaiting assessments can expect improved access to care through the clinic. This includes:
- Spine surgeons review all referrals to triage needs and prioritize access where appropriate.
- Both newly referred patients, and those referred to surgeons previously, will be triaged as appropriate and booked for an assessment with the clinic.
- Initial assessments involve a comprehensive evaluation by a physiotherapist. Following the assessment, a personalized action plan is created with each patient. This might include strategies to manage pain, improve mobility and connect patients with appropriate community supports.
- The initial assessment will help the team decide if the patient needs to see a surgeon, or if other non-surgical therapies and supports are more appropriate.
- For those appropriate for surgery, a spine nurse case manager will be involved in their care to help prepare them for surgery.
- The spine team will provide ongoing support and care, which includes offering access to a new digital education tool (Maela) that provides patients with the information they need to prepare for a spine assessment, as well as resources to support their care. Patients who go on to have surgery, will receive resources to support them through the pre-surgical, surgical, and post-operative phases.
Assessments are provided at the new Bayers Lake Community Outpatient Centre and Cobequid Community Health Centre. Follow-up care for those requiring surgery, continues to be provided at Halifax Infirmary site of the QEII Health Sciences Centre. Some patients may receive the initial assessment through a virtual visit.
Please refer to our Frequently Asked Questions for more information or feel free to reach out to:
