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Referral
Pain Management General Clinic
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
- 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
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
- Understand the pain management approach: Top Tips
- 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
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
- Please refer to the Top Tips for Pain Management
If the patient has previously been seen in pain management, please consider whether a referral is likely to change the outcome.
Referral Instructions
e-Referral Service Selection:
- Specialty: Pain Management
- Clinic Type: Pain Management
- Service: DRSS-Northern-Pain Management- Devon ICB- 15N
Referral Form
Patient Information
Pathway Group
This guideline has been signed off by the North Devon Pain Team on behalf of NHS Devon
Publication date: September 2019
