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A complex team for complex pain

Read about how the multidisciplinary pain service at UCLH is improving lives for patients who are living in chronic and persistent pain.

The  complex pain team won the
The complex pain team won the "improving" award at the 2017 UCLH Excellence Awards.

At UCLH 50% of patients are in pain and 41% consider that they have long term pain. Pain affects patients physically and emotionally, significantly impacting their quality of life.

If not treated adequately, pain escalates and can cause severe distress for patients. Best practice is to care for both the psychological and physical symptoms. This is why UCLH Charity, in conjunction with Camden Clinical Commissioning Group provided funding for a pilot project which established the first ever integrated and multidisciplinary pain service at UCLH.

Natasha Curran, the lead for the service explains that the complex pain team, which is made up of doctors, nurses, physiotherapists and psychologists, works closely with other medical teams to provide an integrated and holistic model of care which is built around the individual, who is encouraged to take charge in managing their symptoms. This model of care for pain is completely novel in an inpatient setting.

The team works with patients who have complicated medical conditions such as Crohn's disease which causes inflammation of the digestive system and can result in a lot of pain. UCLH pain management addresses the biological, psychological and social aspects of patients’ pain.

Patient Voices has featured patients who are seen by the complex pain team at UCLH. Susan Marsh has Crohn's disease which meant “bits of bowel were removed, burst, stretched, twisted and eaten away by the disease”. Due to this Susan once described her pain as 743 out of ten.

Image shows an outpatient during physiotherapy session. The complex pain team means that this level of individualised pain management is accessible for inpatients
Image shows an outpatient during physiotherapy session. The complex pain team means that this level of individualised pain management is accessible for inpatients

In the video, Susan explains that the complex pain team made her feel validated by acknowledging her pain and she felt like they wanted to help. They helped her to set and progress her own value-based goals and provided follow up support once she had been discharged from the hospital. “As an inpatient it was harder to escape anxiety and mood changes… the complex pain team took the time to listen and offered practical support… once discharged I had months of one-to-one counselling and physio helping me to cope with the pain more often.”

Natasha Curran explains that to support progress towards these individualised goals, the team provides a combination of pain management interventions such as cognitive behavioural therapy (CBT), mindfulness based CBT and clinical hypnosis. These interventions mean that patients can often reduce the need for strong painkillers which are potentially addictive. Family are also encouraged to take an active role in understanding how their loved ones are feeling. In Patient Voices: A Mother’s Story one mother describes how she came to terms with effects of pain on her daughter’s mind and body.

Once the patient has been discharged from the hospital, the team continue their support for the patient and the patient’s other healthcare professionals, such as GPs. They even provide an education programme for community staff and offer telephone advice whenever they need it. In the Staff Stories series of Patient Voices, health professionals discuss the impact that seeing patients who have persistent pain can have on their own wellbeing. “Seeing a patient in lots of pain can be very distressing and this model provides staff with the support they need”, said Natasha. “This is an example of how integrated services can really make an impact on people’s lives – the patient, the patient’s family and the staff who care for them.” The complex pain team has proved successful and has secured permanent NHS funding. Read more patient stories here. Donate to pain services here.