Back pain is a very common health problem and affects people across the world. This study applies an Inclusive Design approach to a community-based back pain service to understand the challenges, in relation to patients' capabilities, that can affect their access to the service. It consisted of three steps: i) online surveys and interviews with physiotherapists and collected patients' personal online care stories to gather insight into their experiences within the back pain care journeys; ii) estimated services' demands made on patients when they access the service and identified the related challenges and iii) proposed recommendations that could address the challenges for patients to access the service. The study suggests an Inclusive Design approach could help identify capability-related challenges such as vision and memory which could affect people's access to back pain treatment. In addition, the application of the approach also uncovered some non-capability-related challenges.@en

Inclusive Design is usually applied to consumer products and services; here we investigate if it can be applied to healthcare delivery services. Methods: A case study approach was used by applying Inclusive Design methods to a telephone 'Physio-Direct' service for patients with back pain. Online surveys and interviews with healthcare professionals were used to gather insight into the delivery of back pain care and to construct a task analysis of the patient care journey. The task analysis was used to estimate the service demand made on patients' capabilities. Finally, an exclusion calculator was used to estimate the proportion of a population excluded from the service. Results: The surveys (n = 30) and interviews (n = 4) showed that communication difficulties, patients' reduced capability, service misconceptions and difficulties in obtaining information were the main barriers, which prevented patients from accessing the service. Some tasks placed a high demand on the patients' capabilities. These included telephone assessment, waiting for a telephone response, memorising the verbal advice, understanding the posted exercise leaflets and doing the exercises. It was estimated that at least 15% of the British population are excluded from the 'Physio-Direct' service. Conclusion: Inclusive Design methods were applied to the 'Physio-Direct' service and demand on its users identified ways in which the service could be improved. This suggests that Inclusive Design may be a useful tool in improving healthcare service delivery.

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