Table 4 Changes to practice and recording in patient records

Imaging:

“I know for a fact I haven’t ordered a single back x-ray.” (Participant 2)

Psychosocial assessment:

“I suspect, this is what I think, that a lot of the GPs are doing psychosocial assessments, but we don’t have a way of recording it automatically. I think people just talk about it, you know?” (Participant 4)

“..we start screening that psychological assessment. So that’s changed. The last time we usually don’t do that because that’s sometimes never even come into your mind, just go for medical model, maybe physical, psychological assessment lacking”. (Participant 1)

“..discussing mental health issues, and what is the barrier for them, like not going for physio, like what are their thoughts or beliefs, like about the pain and the progress of the disability” (Participant 3)

Self-management information:

“we started discussing more about how to take care of back pain, and how - what are the strategies which can help them, they started - things have changed, really” (Participant 3)

“Give them pamphlets; give them that educational material which you very kindly gave us on back ache” (Participant 4)

Recording in patient records

“..typing into the case note is not a priority because we’ve got a time of 20 min and then under the pressure of the workflow. So we - because not everyone is good at typing as well. So they probably have to type into the more significant medically related things. But it’s come into the last, right, sometimes you didn’t even type it at all.” (Participant 1)