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Objectives The aim of this evaluation was to review service outcomes for a spinal advanced practitioner physiotherapy (APP) triage service during COVID‐19. The evaluation compares outcomes gathered against pre‐pandemic data and evaluates the impact of the pandemic on service delivery. Design Service‐level data were extracted between 2019 and 2021 including: total referrals, new and follow‐up appointments, telehealth consultation rates, discharges at first appointment, magnetic resonance imaging and injection request rates. Multidisciplinary‐team (MDT) meeting notes with Spinal Surgeons were reviewed and surgical conversion calculated. Patient satisfaction data were collated using: Friends and Family test, specific questionnaires, individual and formal complaints and compliments, and telephone surveys. Analysis was performed by the lead author and results were compared between years using analysis of variance, as well as with previously reported data. Setting ‘Nottingham University Hospitals’ National Health Services Trust is a secondary care spinal unit, using APPs to triage, assess and manage spinal conditions. Results In 2020, 407 (22%; p = 0.02) less patients were referred to the service, however, there was a significant increase in the number of telehealth attendances (mean = 50% in 2020 from 2019, p = 0.005). Only 13% (n = 1342) patients were discussed at MDT, of which 8% (n = 808) were discussed for surgical consideration, and 36% (n = 268) were directly listed. High levels of patient satisfaction were reported by 89% (n = 1028 of 1160) patients. Conclusion This service evaluation demonstrates a statistically significant change in numbers of patients referred and telehealth attendances in the year of the pandemic (2020). Surgical conversion declined during the pandemic, and did not recover post‐pandemic.