Presentation on theme: "Chronic Pain Services -The East Kent Model"— Presentation transcript:
1Chronic Pain Services -The East Kent Model Hilary BirrellCommunity Chronic Pain and Orthopaedic Services - Service Manager
23 Main Acute Hospitals 15 Community locations DemographicsPopulation 750, GP practices3 Main Acute Hospitals Community locations
3Strategic Background2005- Commissioners asked for review of MSK and pain service in East Kent in response to 18 week RTT and MSK NSFIssues identified long waiting times; low D/C rates; ? outcomes; inequity geographically;Community Pain Service startedVery successful, good outcomes, high patient satisfactionRecognised nationally as an innovative community modelHowever………..
4OPERATIONAL MODEL ISSUES Community service was isolated in the health economy2 separate pain services – hospital and communityDuplicate referrals to both services and occasionally orthopaedics or rheumatology as well42% of referrals to community service came from hospital service (multiple first assessments)Changes in other services – particularly orthopaedics increased need for pain services.Difficult to manage patients’ and referrers’ expectations and educational needs.So a new model that brought the hospital and community services together was successfully piloted and then adopted permanently.
5East Kent Chronic Pain Services SERVICE REMITSThe Hospital Pain service specialises in an interventional approach, and patients whose care is inextricably linked with other hospital services.The Community Chronic Pain Service provides a conservative, long term, self management approach.Support referrers with help and advice / telephone and education.TRIAGEAll new referrals are paper triaged by either senior community clinicians or hospital anaesthetists on a rota basisAgreed referral criteria and service remits inform triage guidelinesCollaboration and excellent communication are essential
6Referral Criteria Pain for 6 months or more Has definitive diagnosis or been fully investigated to rule out untoward pathologyConsideration for interventional pain procedure or previous successful pain interventionNo concurrent planned surgery / other interventionsCompleted active rehabilitationNo untreated / unstable mental health problemsNo current substance misuse
7ONE ACCESS POINT Referral Point Model Completed referral received Chronic Pain Referral Point – EKTriage outcome actionedsent electronically for clinical triageCommunity Chronic PainSecondaryCareOtherservicesReject to referrerChoice48 hrs48 Hrs
8Allocated to Community service Full assessment & management planGPwSI or Consultant NurseSecondary CareInterventionMajority of patients attend ½ daypain education sessionCNS ClinicTens reviewMed reviewHealthy lifestyle managementDischarge planningTai ChiPMP – face to face or on-lineAcupuncturePsychology1 to 1Alexander TechniqueDischargeLong self management plan.Support groups / EPPSecondary care InterventionPatient initiated re-access