Pain Management at Luton and Dunstable

Services

The Pain Management Service at the Luton and Dunstable Hospital sees patients in both inpatient and outpatient setting.

Outpatient Clinics:

  • Chronic Pain
  • Pain Management Programme
  • Community Musculoskeletal Service (CMS) Pain Management Service


Chronic Pain Clinics - outpatient service at The Luton & Dunstable Hospital NHS Foundation Trust

Referrals by GP or Consultant
Dr Yogasakaran Consultant Anaesthetist and Lead for Chronic Pain
Dr Nesaratnam Associate Specialist in Anaesthetics
Lynn Grigg, Senior Lead Nurse

Role of the outpatient service

To manage intractable, difficult to manage pain in patients where GPs have tried medicines as recommended by the Chronic Pain Guidelines for Primary Care. This may take the form of invasive or non-invasive treatment.

Pain Management Programme (Psychology led) usually held at The Luton & Dunstable Hospital NHS Foundation Trust

Referrals are by consultants at the L&D only, as this helps ensure that patients have had their condition medically assessed and assurance given that further surgical or medical procedures are not pending. GPs can refer to an appropriate consultant in the Rheumatology, PRC, Orthopaedic departments. Patients can also be referred via the Chronic Pain Clinic.

This service also differs from the CMS (Community Musculoskeletal Service) in that it takes appropriate pain management referrals from patients in the South Bedfordshire area, including Leighton Buzzard and Dunstable. This includes less complex / functionally challenged patients. Once referrals have been received, if patients live within Luton PCT area, they can be referred to the CMS programme if deemed appropriate.

Dr Greg Wood, Consultant Psychologist
Lynn Grigg, Senior Lead Nurse
Ruth Jenkins, Senior physiotherapist
Debbie Clough, Senior Occupational Therapist

The role of the Pain Management Programme

Clinical Psychology provides the lead in a multidisciplinary service, which includes an occupational therapist, senior physiotherapist and nurse specialist. This team provides multidisciplinary assessment of patients with chronic pain referred from the Pain Clinic, Orthopaedics and Rheumatology in the main, as well as specific pain-related problems from other departments.

Three pain management groups are completed each year, which include eight half-day outpatient sessions and a three-month follow-up for groups of eight to 16 patients. Individual CBT interventions and an eight-session individual guided bibliotherapy (guided self-help) programme are also provided.

The PMP provides for referrals of patients with suitable complexity to warrant secondary care provision (such as myofascial pain, fibromyalgia, CRPS, severe and unresponsive back pain, etc.) or pain management interventions for those referred from the South Bedfordshire area of NHS Bedfordshire commissioning. The PMP liaises and coordinates with the community.  Patients  who are pending further investigations or treatment are not  accepted for inclusion on this programme

Community Musculoskeletal Service (CMS) Pain Management Service

Referrals are accepted directly from GPs, using the Choose and Book form. Please indicate 'pain management' in your letter. Only GPs in Luton PCT can use this service. Referrals are also relayed from within the CMS and from the Luton and Dunstable Hospital PMP and Physiotherapy Department.

Dr Caroline Tovey and Dr. Sheena Kapur (Clinical Psychologists)

Kesha Dutta and Chris Whybrow (Physiotherapists)

Sue Bell (Clinical Nurse Specialist)

Role of the CMS

This community-based service includes input from pheumatologists, orthopaedic surgeons, physiotherapists and the Pain Management Service. Patients are initially referred by the GP and then triaged to the appropriate service. According to the referral information, they may then be referred to (a) secondary care services, or (b) the CMS for orthopaedic assessment, rheumatology assessment, physiotherapy or pain management. The CMS pain management service is based at the Chaul End Centre, where a range of treatments are provided. These include the pain management programme (also Urdu and Bengali Women's groups), guided self-help, individual/group psychological interventions and medication review.

Please note: The CMS Pain Management Programme differs from The Luton and Dunstable Hospital NHS Foundation Trust PMP in that CMS is CBT focused (for higher functioning patients) - it also accepts patients who are pending further medical investigation and treatment.

An inpatient service is also provided

08.00 - 16.00 weekdays (anaesthetists cover out of hours)

Patients are seen on a daily basis if they have a patient controlled analgesia system or an epidural in place. The specialist nurses can also be contacted to see any patient in pain. As this could potentially be any patient in the Trust, the main aim of the service is to educate nurses and doctors looking after patients, in the skills of excellent pain management. Developing partnerships with all concerned in the care of patients is central to the role - this includes anaesthetists, doctors, nurses, patients' relatives and carers and pain nurses from other Trusts.

Any healthcare professional can refer patients to the service
Nurses:    
Lynn Grigg, Senior Lead Nurse (full time)
Sue Bell, Clinical Nurse Specialist (full time)
Adrianne Randall, Pain Sister (part time)
Consultant:
Dr Indra Srikantharajah Da, Consultant Anaesthetist

Who to Refer

For the pain clinics

Patients with difficult to manage intractable pain who do not respond to analgesia as recommended by the Chronic Pain Guidelines for Primary Care

Who not to Refer

For the pain clinics

Patients who have not been tried on analgesia recommended by the JPC Chronic Pain Guidelines for Primary Care

Resources

British Pain Society: www.britishpainsociety.org/
Bandolier: www.medicine.ox.ac.uk/bandolier/  NICE Guidelines for neuropathic pain and lower back pain



Last updated: 11/10/2012

Update due: 11/10/2013