Humber Community Pain Service

HumberNHS Foundation Trust

Humber Community Pain Service

Humber Community Pain Service HumberNHS Foundation Trust

Humber Community Pain Service is a new community based service that treats patients with moderate impact pain including people living with back pain and those experiencing anxiety and depression associated with their pain. Its highly skilled multi-professional core team undertake assessments and deliver individual care management plans with the client.

The service welcomes <referrals> from GPs in Hull and the East Riding and Hull’s community musculoskeletal service PhysioHull.

Specialist physiotherapists,

occupational therapists and

psychologists in pain management

Links with employment

support services

Individual care management

plans

Partnership approach

Community based

Direct referral links to secondary

care

Step down care

Effective self-control

and pain management

http://www.humber.nhs.uk/Documents/Pain_Service_Referral_Form.doc


Our experience

Humber NHS Foundation Trust has continuing experience of piloting and consolidating community pain services within the East Riding.

The Trust provides a community pain service in Bridlington with a multi-professional team consisting of occupational therapists, nurse practitioners, pain management physiotherapists, psychologists and medical specialists. Members of our clinical team there have ongoing clinical input into the Centre for Pain Medicine at Castle Hill Hospital and work closely with secondary care providers. Patient feedback suggests the Bridlington clients are highly satisfied with the group pain programme and that it has led to clinical improvements in self-efficacy.

Pain Management Plan

The pain management plan is a supported, home-based programme based on cognitive behavioural principles for patients unable to access the group programme.

The patient will be supported by their key worker in setting goals, keeping weekly plans and recording progress. The plan contains an easy to use workbook and relaxation CD. This plan is already being used successfully within the Bridlington Community Pain Service.

The Service

Humber Community Pain Service’s highly skilled multi-professional core team undertake assessments and deliver individual care management plans with the client. Each client will have a key worker who stays with them throughout the care pathway, this is usually the team member whose professional remit most closely matches the patient’s needs. The team also run a number of group work programmes.

To support patients fully with a truly holistic service, we will work with internal and external service providers and utilise local and national resources that will help our clients achieve their goals. Our aim is to support clients to manage their own pain through knowledge, empowerment, ownership, change and action.

Contact with local and national resources will be encouraged as part of a client’s agreed package of care and the resource information made available to clients during the course of their initial assessment interview.

Pain rehabilitation group work programme

The pain rehabilitation group work programme is a pivotal part of the service that focuses on the provision of information for self-care. It is is based on cognitive behavioural principles to support and empower patients to self-manage their condition.

The patient joins a group of patients with similar problems who work together in a supportive, empathetic and encouraging environment. This helps them develop appropriate skills in goal setting, pacing, movement and exercise, relaxation skills and challenging negative thinking processes.


Care Pathway

Tier 1 mild impact pain that can be managed in primary care and the support and intervention carried out by other community services such as PhysioHull and East Riding MSK services.

Tier 2 moderate impact pain – these are the patients ideally suited for the Humber Community Pain Service.

Tier 3 severe impact pain – interventions that could be delivered in secondary care specialist services such as rheumatology and neurology.


Tier

3 S

evere

Imp

act

Pain

Tier

2 M

od

era

te

Imp

act

Pain

Tier

1 M

ild

Imp

act

Pain

GP, other clinicians, PT/OT, Physio Direct

Single Point of Access to Community Pain Service admin and

clinical triage

Secondary Care Services Specialist

Pain Service Neurology

Patient with emerging long

term pain condition. pain > 3/12

Patient to complete pre-

assessment paperwork

As Required:1:1 Intervention by appropriate Team

member

Group session intervention offered to all patients led by members of the core

team and a health trainer.5 Sessions of 1 hrs duration

or Pain Management Programme with key

worker

Key Worker Allocation

Community Pain Service. MDT

Assessment by a member of

the team within 4 weeks of

referral.

Review by key worker

• Self reporting Health Needs assessment baseline questionnaire • The Pain Self- Efficacy Questionnaire (Nicholas 2006) • The Hospital Anxiety and Depression Scale • The Pain Disability Questionnaire (Anagnostis et al 2004)

Referral outward bound with review as necessary by key worker at any point in the pathway

Other Services

Other community or MH services: IAPT / Health Trainers / NCT / MSK / Chronic fatigue service

Access to other self care options: gym and leisure centres e.g. exercise on prescription, expert patient programmes, health trainers, smoking cessation, the benefits agency, job centre, social services, library resources, local patient support groups, alternative therapies

Discharge with plan

Maintenance programme review by key worker


Client outcomes:• Quantifiable improvements in patient’s perception of their pain• Taking effective self-control of their condition• A reduction in the use of medication• More use of effective use of medication• Self-reported levels of functional gain

Specialist physiotherapist in pain management

For joint mobilisation, periarticular and intraarticular corticosteroid injection of the peripheral joints (not spinal), TENS, trigger point acupuncture, core stability exercise programme, postural advice and management.

Specialist occupational therapist in pain management

For assessment and provision of aids and adaptations, support and signposting to relevant benefits, employment agencies, training opportunities and introduction of one off relaxation techniques. Support with personal self-care management programme. Facilitation on the group pain management programmes and one to one pain management plan.

Specialist psychologist in pain management

In-depth assessment of issues requiring specialist psychological intervention. Signposting towards services providing intervention and/or support i.e. Single Point of Access, MIND and other support networks. Providing short-term psychological intervention including training in self-hypnosis, cognitive behavioural and mindfulness approaches and individual evidence-based brief therapy approaches including health coaching. Support with personal self-care management programme. Support with personal pain management plan.

Our core team of pain management specialistsPatients can access one to one interventions with members of the whole team that includes:


Other members of our team involved in management and treatment include:

Medical Clinician

Mentor for the core team, review diagnosis, medicine management, trigger point injections and assessment of further specialist intervention as required.

Pharmacist

For review of medicine management and adherence to non-specialist analgesia algorithm in a cost effective way. Recommending and/or prescribing medicines.

Health Trainer

To provide personal support and motivation to clients to help them lead a healthier lifestyle. Put clients in touch with local services, community groups, support and self-help groups.

When and where are patients seen?

Patients are seen at one of our clinics across Hull and the East Riding of Yorkshire and can choose the clinic nearest to them.


Our pain service is available at clinics across Hull and the East Riding of Yorkshire

Refer to Community Pain ServiceHull:

GPs and PhysioHull can refer into the service

East Riding:

GPs can refer into the service

Choose & Book, SystmOne or paper/fax referral. All referrals go through administrative and then clinical triage. Patients invited for an appointment will receive a pain management information pack which includes a number of pre-assessment questionnaires and information on pain and pain management.

Humber Community Pain ServiceCentral Booking OfficeEast Riding Community Hospital Swinemoor LaneBeverleyHU17 0FA

Tel. 01482 478886 or 0800 7314483Fax. 01482 478887

Hull

Humber Community Pain Service

Documents

Transcript of Humber Community Pain Service