Complex pain clinic for palliative care patients

Week 1: MDT. Pain, Radiology and Palliative Care senior medics review patients who are referred into the MDT. Cases are presented by people who know the patient, scans reviewed and options are discussed. If suitable to consider an intervention, patients are seen virtually in Week 2

Week 2: preassessment clinic. A pain and palliative care specialist will see the patient and discuss the options. If they decide to proceed with the offered intervention it is usually undertaken in Week 3

Week 3: injection list

Week 4: patients are reviewed jointly by pain and palliative care to assess effect of intervention.

How does it work?

Patients are discharged from the complex pain clinic but can be re-referred if further interventions may help.

Who might benefit?

Interventions like nerve blocks are useful to treat nerve pain. This might be directly related to a cancer, or, for example, from a back issue unrelated to a life limiting illness. Patients must have a life limiting illness to be eligible for the service.

When should we refer?

Early referral is always beneficial. Patients will need to travel and attend Musgrove for a procedure. We can often reduce the analgesia they are on, so earlier referrals are better. Don’t wait until the medications aren’t helping before considering this option.

How do I refer?

We need to know

• Name
• MRN/ NHS number
• Diagnosis
• Likely prognosis
• AKPS
• Likely cause of pain/ reason for referral
• Pain score
• Current medications:
• Anticoagulation
• Allergies
• Referrer and/or Presenter

Email the details to palliativecaresecretaries@somersetft.nhs.uk and they will be added to the next pain MDT

The MDT counts as CPD so please do join if you would like to learn more. Everyone is welcome to come and learn.