Exploring impact of early pain information within NHS Greater Glasgow and Clyde (NHSGGC) Pain Management Service; a service development opportunity.

Purpose

NHSGGC Pain Management clinicians have for many years observed that people who access the service, typically lack a full understanding of the therapeutic approaches the service provides, both medical and non-medical. This can result in discrepancies between clinician and patient expectations of therapeutic outcomes and management options (Realistic Medicine 2019) and dissatisfaction. Recently NHSGGC Pain Management Service has experienced sustained increases in referral demand alongside universal staffing pressure, resulting in waiting times rising significantly on a monthly basis. There was a strong view amongst clinicians that a more sustainable and responsive model of care was required to address and meet the complex needs of the patient demographic and improve their initial experience, thereafter prevent lengthy waiting times for our patients. Provision of early information has been shown to increase people’s ability to better manage their long term pain (National Clinical Strategy for Scotland, 2019).

93% of people
said they would be extremely likely or likely to recommend the sessions to friends or family
96% of people
said they found it useful to share “what matters to you” with staff

Approach

From September 2019 people referred to the service were triaged (by multidisciplinary teams) for suitability to attend two introductory sessions delivered over a two week period by AHP and Nursing staff. The sessions were delivered prior to initial consultation, across three sites in NHSGGC. The content of sessions included; information about the service, pain neurophysiology education, and introduction of management strategies. There was also an opportunity for individual conversations to discuss “what matters to you”, patient concerns, their expectations of the service and provide signposting information. Outcome data was collected over an initial 5 month pilot phase including patient satisfaction and wait times over 12 weeks.

Outcomes

Results: Outcome data was collated from 216 responses (276 attendances). 93% of people said they would be extremely likely or likely to recommend the sessions to friends or family, 96% said they found it useful to share “what matters to you” with staff and 89% rated that they were positively satisfied with the information provided. Wait times over 12 weeks reduced by almost 50% over the 5 month period. Patient feedback has included themes of; feeling understood, gaining information/support and improved expectations of what the service provides.

Conclusion(s): From initial pilot data, the provision of a new model of care has improved the experience of people who access the service and they have been satisfied with the model explored. The significant reduction in waiting times allows people timely access to information. People feel more prepared for their individual clinical appointments; it is hoped this translates into better engagement with the self-management approaches we offer and a more seemless journey through the service. We hope to explore this further with ongoing patient and staff feedback.

Cost and savings

Costs unknown at this stage

Implications

Given this evaluation, the clinical leads in the service have agreed this new model provides a sustainable pathway and it is an appropriate entry to therapeutic intervention. This will allow our service to disseminate findings to other pain services that may have the resources to consider this model/approach. To support sustainability of this model, it needs to become integrated into staff job plans which may impact on the skill mix required within the service.

Top three learning points

No further information. 

Funding acknowledgements

The work was not funded.