Table 2 Summary of key themes: Provides a summary of the findings in relation to each of the key themes identified from the data

Acceptability of the ‘fast-track’ care pathway

Both patients and clinicians found it acceptable for patients identified as needing spinal specialist assessment and consideration for more invasive treatments to be seen by those specialists sooner. Patients were pleased with the speed of their ‘fast-track’ referral; however, some clinicians expressed concern that patients with short symptom duration may be ‘fast-tracked’ too soon and that their symptoms could still resolve naturally. All clinicians expressed reluctance to consider invasive treatment options too early for these ‘acute’ patients.

Perceived benefits of the ‘fast-track’ care pathway

Patients and clinicians perceived benefits from the ‘fast-track’ pathway in providing early patient reassurance based on MRI scan findings, particularly in enabling patients to understand the cause of their pain and assuring them that there was no serious underlying pathology. However, clinician views were mixed about the potential longer-term clinical benefits of the ‘fast-track’ care pathway.

Waiting times for onward treatment following being ‘fast-tracked’

Although patient management following ‘fast-track’ was not altered as part of the trial, patients highlighted the significant difference between the short timeframe for the initial ‘fast-track’ to MRI scan and spinal specialist opinion and the usual NHS waiting times after onward referral for more invasive treatments. This led to uncertainty about how long they would be waiting to receive further treatments, resulting in dissatisfaction. Clinicians similarly felt that not being able to influence the timing of the receipt of further treatments once patients joined the waiting lists was a limitation of the ‘fast-track’ pathway.