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It has been highlighted that there is a greater need for a pain management service in the Hastings and Rother region.
Currently the CCG has not funded the Hastings and Rother region to provide a pain service. It is an area with poor socioeconomic circumstances and it needs a mult-disciplinary service linked to social services and the wider community.
Many referrals for musculoskeletal conditions are complex and require a team to help support patients. As there is no pain clinic a lot of the referrals for people who experience and exacerbation of pain symptoms with often no clear change in pathology or development of other problems means that they are being referred to physiotherapy. This is hiding the need for a comprehensive pain service for the locality. By working on the waiting list during the pandemic it has highlighted the need for this service in my opinion.
What is needed to sustain the change?
A review of service provision by the CCG and for a service to be commissioned.
What is your region?
South East
Thanks Matt
the issues of access to comprehensive pain managment programmes is a big one and features in lots of discussions currently. Definitely not a problem just local to you
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Hi Matt
what might be the next steps to evidence the need and the benefits for the locality and its population with commissioning a Pan Mgt service? What barriers might need to be considered or addressed?
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Hi Matt, I honestly believe that we should use the massive population of experts in pain....i.e. people with pain themselves. I helped set up a support group in my GP practice patch incorporating Tai-chi, yoga and mindfulness. I provided guidance but the majority of the work was done by willing people in the community. Due to the nature of a practice population, there will be willing individuals such as teachers, accountants, yoga teachers who are willing to help. Lets utilise them. Lets also utilise VCS and social prescribing. Sadly, CCGs are becoming increasingly irrelevant in the wider NHS and the 'power' and commissioning will sit with individual primary care networks.
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Thank you all for responding. I suspect that there are many places that need pain services. One of the problems is the changing landscape. CCG, GP Federations, PCN's are in their own state of flux. I don't think that anything can change until contracts are up for renewal. It will be up to future providers/commissioners to offer pain clinics to service their population.
When a provider decides not to have a pain service in an area, they need to be made aware of what the risks are in that situation.
What generally happens is that other services such as ortho, rheum and physiotherapy become a default for people with complex needs hiding the need. The services absorb patients in pain because 'there is no where else for patients to go', they develop new episodes of pain and so are referred back in to the services for further investigations or uni-disciplinary treatment like a merry-go-round. The services also accept cases referred to them because physiotherapy services generally don't have robust service specifications, in my opinion.
Data can be powerful to demonstrate the need to commissioning organisations but the bottom line will be about cost. Case studies can be presented too but deciding on what is best for a local population is tough for everyone involved. I hope to be able to add some of this when the tendering opportunities arise.
Asim, thank you for sharing what you have done. Yes linking people through shared experiences can be hugely beneficial process for sure. That of course can contribute to the pain of the nation but a professional group of clinicians linked into social services is the cornerstone for supporting the public with persistent pain.
I brought this up as a way to keep the need for multi-disciplinary pain services on the agenda but also for physiotherapy services to be clear about what they are offering and what they aren't.
Catch up soon. Thanks for commenting.
Matt
s for your thoughts on this. You seem to be very passionate about how we can help people which is great but what you describe as being on offer is not part of a service specification for physiotherapy I have seen. Individuals who upskill in a department can offer patients treatment options that perhaps their colleagues cannot which I think could lead to
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Status label added: Regional Collaboration
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Moderation status changed: Clear
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The idea has been progressed to the next milestone.
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Status labels added: Implementation, Integration Of Resources, Pathway Redesign, Prim/Sec Integration, Prim/Sec/Com Integration, Reduced Bureaucracy, Referral Pathway Redesign, Horizon 3
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Status labels removed: Implementation, Integration Of Resources, Pathway Redesign, Prim/Sec Integration, Prim/Sec/Com Integration, Reduced Bureaucracy, Referral Pathway Redesign, Regional Collaboration
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