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Back pain management audit 2009 – round 1

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This national comparative clinical audit measures how well occupational health doctors and nurses are managing NHS staff in England with back pain, a frequent and a major cause of sickness absence. Occupational health professionals should follow the FOM Guidelines for the management of low back pain. We therefore used the standards contained in these guidelines to develop auditable criteria against which the care provided by occupational health doctors and nurses could be measured.

Key recommendations

  • The audit results show that there is wide variation across England in the levels of implementation of the FOM evidence-based guidance on the management of back pain.
  • OH professionals regularly addressed the interaction between health and work: they asked about the impact on activity and on work and usually encouraged staying at or returning to work. Communication between OH professionals and line managers appeared to be effective when it took place. For example, when appropriate, written advice to managers about temporary work-place adjustments was frequently provided. The findings were largely unaffected by whether or not the back pain was thought to be caused by work, in line with the FOM Guidelines. OH professionals tended not to be so good at screening for red and yellow flags, and enquiring about barriers to recovery and to return to work. They did not routinely give out clear and comprehensive information about back pain. Employee and line manager knowledge about the impact of psychosocial factors on back pain was poor and needs to be improved.