Outstanding Patient Feedback

Since 2012 Pathway through Pain has been part of the NHS Somerset Community Pain Management Service and enjoys outstanding levels of patient satisfaction with the self-management programme. Here is the patient feedback.

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NHS Somerset: Taking high quality self management support for people with pain to scale

Alf Collins writes:  I have been a consultant in pain management for 17 years. Over that time, very few new, effective treatments for chronic pain have come on the market. The fact is, for most people with chronic pain, they have to live with it. Indeed you might say that the word ‘chronic’ says it all - chronic pain doesn’t go away.

Because of this, we decided in our clinic many years ago that we would focus on: (a) Ensuring that people at risk of developing chronic pain were offered effective treatments as quickly as possible in the course of their condition and, (b) Ensuring that those who developed chronic pain were also offered effective, high quality self management support strategies as quickly as possible

As we began to orientate ourselves towards being primarily a self management support (SMS) service, what struck me were 2 things:

• There’s a lot of pain about.
• Most services offer SMS via an intensive pain management programme or a functional restoration programme. These are effective but costly interventions. 

This made me think…how could we deliver high quality SMS at scale for an entire health economy (population base 500,000) - and do it without the CCG laughing me out of the room? In other words, and to use current buzz words, how could we improve quality at a population level by focussing on value?

Well, we have done a lot. We have trained everyone in our service in motivational interviewing. We are also commissioned to train GPs and physios in the principles of pain management. We have put lots of accessible information on the internet for patients and GPs. And we have invested in technology: patients hold their own ‘virtual health record’ and have access to an on-line pain management programme; Pathway through Pain.

There are 3 important things about Pathway through Pain. Firstly, it has been designed by experts and is absolutely aligned with our entire service ethos - it fits with what we are saying. Secondly, it tells patients more about their condition and about how to manage their condition than we ever could: other than if they went through a formal face to face group Pain Management Program (PMP). Lastly, we couldn’t offer a face to face PMP to everyone we see. The cost would be far too high. We do offer Pathway through Pain to everyone with back pain and a significant number take up this option. We still do run face to face PMPs - but only for the most distressed and/or disabled patients we see.

So, Pathway through Pain is a core element of our service. Patients don’t have to wait for treatments to fail before they are offered the programme - very often they go on the programme after just 1 or 2 sessions of seeing us. Importantly as well, we see them after the programme; to find out if there is anything further we should offer to reinforce some of the techniques and strategies they learned whilst they were using Pathway through Pain.

Pathway through Pain is now integral to our pain service. It improves the quality of life of the patients we serve- and its improved my quality of life no end; I don’t tell patient after patient the same thing time and again in my clinic - the course does it for me!

Dr. Alf Collins
Consultant in Pain Medicine, Somerset NHS Foundation Trust.