Spinal Services
Spinal surgeons carry out a wide variety of spinal surgery, from simple procedures to the complex removal of tumours. Many of the conditions dealt with are not life-threatening but can have a major impact on quality of life. It is estimated that one-third of the population is suffering with lower back pain at any point in time.
This GIRFT national report on spinal surgery focuses on spinal emergency conditions such as cauda equina syndrome, spinal cord injury, spinal infection and spinal trauma, as well as looking at the management of common spinal conditions such as back and radicular pain (sciatica), the biggest cause of disability in the UK. The review also looks at the provision of paediatric spinal surgery.
The recommendations focus on how spinal services can make better use of resources and improve outcomes for patients by supporting earlier discharge from hospital, reducing the number of cancelled operations, increasing the number of available beds and ensuring trusts can deliver the services that best match their skills and competence.
- Spinal Services Clinical Lead
Mike Hutton
Spinal services clinical lead
Mike is a consultant spine surgeon and the national lead for spinal services optimisation and recovery for the NHS England & NHS Improvement BestMSKHealth improvement programme.
He worked at the Royal Devon and Exeter NHS Foundation Trust from 2007 to 2021, undertaking complex spine procedures in all areas of spinal surgery, including paediatric and adult spine deformity.
He currently works at Exeter Medical and Ramsay New Hall Hospital.
Mike held an executive position with the British Association of Spine Surgeons from 2009 to 2019 and led the British Spine Registry from 2012 to 2019. He was an expert advisor to the MHRA from 2012 to 2021 and has developed a National Emergency Referral Tool, which links to the British Spinal Registry.
He is currently the co-chair of the Spinal Orthopaedic Data Evaluation Panel and Beyond Compliance programme, and chair of the national Suspected Cauda Equina Pathway improvement programme.
- Spinal Services Specialist Clinical Advisor
Vinay Jasani
Spinal services specialist clinical advisor
Vinay has been an NHS consultant spine surgeon since 2003, and currently works in the craniospinal service at University Hospital of North Midlands NHS Trust. His NHS practice includes complex reconstructive surgery in adults and children (including deformity) and a busy non-elective practice.
He has held managerial roles at UHNM, as well as being the founding and current lead of the West Midlands Regional Spine Network. He holds a clinical member position on the Spine Surgery CRG and is on the executive of the British Scoliosis Society and the British Association of Spine Surgeons.
As well as his managerial roles, Vinay is a keen teacher and has headed up a fellowship programme at UHNM and written and delivered a modular spine surgery skills course.
- Spinal Services Specialist Clinical Advisor
Mike Grevitt
Spinal services specialist clinical advisor
Mike has been an NHS consultant spinal surgeon for 27 years, currently working at Nottingham University Hospitals NHS Trust, and works as a teacher and mentor.
He has held a number of managerial roles in the NHS at trust, regional and national level, including posts with NICE, NIHR Health Technology assessment, the Royal College Surgeons of England and within the spinal specialist societies. He has also sat on several management and trustee boards for international non-profit organisations.
Useful information
GIRFT’s clinical lead for spinal services Mike Hutton also worked as the lead for spinal services with the Best MSK Health Collaborative, until the programme closed in October 2022. Resources that were jointly produced with Best MSK can be found on FutureNHS, including advice leaflets for patients on interpreting MRI findings and for clinicians to support their decision-making in requesting a scan.
- Summary of National Report Findings
Spinal surgery report may bring benefits for tens of thousands of back pain patients
Replacing short-term pain relief injections with long-term physical and psychological rehabilitation programmes could help tens of thousands more patients cope with debilitating back pain, according to a new Getting It Right First Time (GIRFT) report on spinal surgery.
Lower back or radicular pain (sciatica) is the primary cause of disability in the UK. It affects one-third of the population at any one time, and 84% of people in their lifetime.
The latest GIRFT national report found that, despite NICE guidance, a significant number of patients are still receiving facet joint injections (injections of local anaesthetic and/or steroids to block pain), which have limited clinical value. On average between 2015 and 2018, almost 6% of patients with back pain received three or more facet joint injections in a year, at a cost to the NHS of £10.5m.
Find out more about GIRFT’s data-led approach and best practice resources:
- Case Studies
- Guidance
- Metrics
- Pathways
- Interactive pathway for CES
- GIRFT Spinal Interface Dashboard (SID)
- Webinars
- Studies and Research
- Further Faster handbook for spinal services
- Further Faster handbook for paediatric spinal deformity
- Further Faster handbook for spinal pain services
- NCIP and how to access your data
- Spinal Services National Report
In January 2019, GIRFT published its national speciality report for Spinal Services:
Click above to view the pdf report
- Spinal Services Report Video
Watch the video about the Spinal Surgery report…
Click above to play the Spinal Surgery national report video
- Spinal Services News
Spinal Services Academy Resources
- Guidance
Getting winter ready Maintaining elective spine capacity>
National suspected Cauda Equina Syndrome pathway guide >
National suspected Cauda Equina Syndrome Pathway Guide Appendix 1 Research Priorities >
Further Faster handbook for spinal services >
Further Faster handbook for paediatric spinal deformity >
Further Faster handbook for spinal pain services >
Poster: Examination and management of patients presenting with pain in their spine >
Case Study : Management of Spinal DNAs at Norfolk and Norwich NHSFT >
Case Study : South West London MSK network improve spinal patient waits through MDT triage >
Case Study : Spinal Super-Saturday consultant-led clinic at UHNM NHST sees 94 patients >
Case Study : Virtual triage implementation in Spinal Services at Royal London Hospital >
Case Study : Spinal Assessment Service at Norfolk & Norwich NHSFT >
Case Study : Same Day Emergency Care for low back pain – Nottingham University Hospitals NHST >
- Pathways
Lumbar Medial Branch Block – Facet Joint Injections pathway >
Lumbar Nerve Root Block – Epidural pathway >
National suspected Cauda Equina Syndrome pathway >
Interactive version of national suspected Cauda Equina Syndrome pathway >
One or Two Level Anterior Cervical Discectomy & Fusion – Disc Replacement pathway >
One or Two Level Posterior Fusion Surgery (PLF-TLIF-PLIF) pathway >