Pain Management General Clinic

  • This is a two part referral process: patients will also be required to fill out the patient questionnaire as part of the process to be considered by the Specialist Team. This process is managed by DRSS
  • Please direct the patient to MyHealth-Devon: Pain for information & self-management resources

Scope

  • Patients 18 years and over (local services may have arrangements for 16 and 17 year olds)
  • Suffering with pain greater than 3 months duration
  • Complex Regional Pain Syndrome, cancer and trigeminal neuralgia may be referred more urgently

Out of scope

  • If out of scope consider local advice and guidance services
  • Patients with predominantly recreational drug dependency problems (if complex problem, Pain team will liaise with drug dependency service)
  • Patients with severe mental illness (i.e. significant depression, psychosis, anxiety, Post-traumatic stress disorder (PTSD)) who need to be reviewed and supported by mental health services prior to referral
  • Ongoing investigations for same condition with another service

Assessment

  • Details of the pain problem including longevity
  • Treatment trialled including pharmacological and non-pharmacological. It would be helpful to know what the outcome of previous trials of pain medication has been along with maximum doses reached.
  • Current medication
  • Past medical history
  • Psychosocial history including history of anxiety and depression and any treatments previously undergone for this
  • Evaluation of suicide risk assessment where appropriate

Red flags

Please rule out red flags prior to referral:

  • Severe mental illness
  • Unmanaged suicide risk
  • Substantial unexplained weight loss
  • Symptoms or signs of inflammatory joint disease or connective tissue disease
  • Symptoms or signs of cardio-respiratory disease
  • Clinical significant lymphadenopathy
  • Widespread or progressive neurological symptoms
  • Acute medical trauma
  • Signs of cauda equina syndrome
  • Unremitting night pain

Management

  • Understand the pain management approach
  • Try reasonable simple analgesia and if neuropathic pain, anti-neuropathic as per local guidelines (insert link to formulary)
  • Consider appropriate self-management, community and primary care (e.g. MSK physiotherapy, Improving Access to Psychological Therapies, occupational therapy)
  • Please refer patients to the website MyHealth-Devon: Pain
  • Consider local advice and guidance as an option

Referral

Please rule out red flags prior to referral.

Please include the following information in your referral:
  • Details of the pain problem
  • Treatment trialled including pharmacological and non-pharmacological.
  • Current medication
  • Past medical history
  • Recent blood tests or investigations
  • Details of other services involved in patients care
  • Psychosocial history including previous interventions
  • Evaluation of suicide risk assessment where appropriate
  • What you hope to achieve by the referral
  • What the patient hopes to achieve by the referral

Referral criteria

  • This is a two part referral process: patients will also be required to fill out the patient questionnaire as part of the process to be considered by the Specialist Team. This process is managed by DRSS
  • The DRSS patient letter will direct patient to MyHealth-Devon: Pain for the online questionnaire, information & self-management resources. DRSS will also provide a telephone contact to support patients to complete the questionnaire

If the patient has previously been seen in pain management, please consider whether a referral is likely to change outcome.

Referral Instructions

e-Referral Service Selection:

  • Specialty: Pain Management
  • Clinic Type: Pain Management
  • Service: DRSS-Northern-Pain Management- Devon CCG- 15N

Referral Forms

DRSS referral form

Supporting Information

Patient Information

MyHealth-Devon: Pain

Pathway Group

This guideline has been signed off by the North Devon Pain Team on behalf of Devon STP

Publication date: September 2019

 

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