Pain Clinic Services - For Clinicians

Referral information
The purpose of the information we require is to triage patients to the most relevant specialist to provide the quickest access to the most appropriate treatment and to avoid long delays when referring between services.

Email: painclinicclinical@nbt.nhs.uk

Exclusion
Pain Management Services are not always successful in relieving the patient’s pain. This may be for a variety of reasons. Whilst it may be helpful to review a previous patient after a period of time to ensure that no new treatments have been developed, multiple repeated referrals are not necessarily in the patient’s best interest. In these difficult and complex pain problems, discussion between the GP and the Consultant in Pain is indicated.

Whilst a therapeutic intervention may help some individuals this will often only have a limited effect and should be part of a multidisciplinary management programme. A decision on an intervention will only be made after a full discussion with the patient if it is considered appropriate. We do not perform procedures at the request of a referring individual unless it is part of a combined management approach with an associated team.

We aim to improve the quality of lives of our patients by controlling, reducing and where possible, curing their pain.

Download: 

Map of Medicine - guidelines for:

• Pathway for management of chronic widespread pain - Diagnosis of fibromyalgia.pdf117.45 KB
• Back pain
• Sciatic
• Pelvic pain

The following criteria should be filled for new referrals:

• The patient has not attended a Pain Clinic for the same condition before (see below)
• Any underlying cause for the pain has been eliminated
• The patient does not want or is not fit for a definitive procedure
• The referral has been discussed with the patient and the patient has agreed that this is the most appropriate management pathway
• Drug therapy has been tried (see flow diagrams) but has been ineffective
• Advice has been given about exercise and a healthy lifestyle. Rest can cause increased disability and patients should be encouraged to maintain as much mobility as possible
• An explanation about the aims of the Pain Service has been given to the patient so they can make an informed decision about whether they want to engage with our approach to management
• The patient has not been referred to a different specialty for the same condition at the same time
• The patient is not being referred for a specific intervention

Urgent referrals
We often have requests to bring forward appointments. In the interests of equity this is not possible unless there is a cancellation when we will endeavour to fill the slot with another patient. We are doing our best to keep the waiting times as short as possible.

Tertiary referrals
Patients already seen in another Pain Clinic and those referred from out of area for management of specific problems will be considered as tertiary referrals.

Rejections
We will not accept a referral for any specific intervention e.g. injections or acupuncture.