Pain Service BHSCT

Sr Liz Matthews MSc

Advanced Nurse Practitioner Pain Management

The importance of pain• Acute/chronic/palliative pain all associated

with physical, psychological, emotional & social components.

• Important economically as requires medical/ surgical and pharmacological costs.

• NHS needs to ensure availability & accessibility for relief of pain against financial constraints.

Context• 2010 – acute & chronic pain service brought

under one umbrella • Specialist nurses supported to develop

practice• 6 nurses independent prescribers. 2

complete in May• Cross site working, reflective learning and

working in partnership to develop roles.

Episodes of care per annum– Acute Pain

4 acute pain services – RVH, MPH, BCH, MIH

Total no pts assessed = 6152

Total no assessments = 12,921

Emergency pain calls = 254

Non-surgical pain patients = 146

Access to services – Acute Pain Service

•Average length of pain care days = 2.9• Average number of interventions = 2.8/pt

Episodes of care – Chronic Pain

Nurse led clinics – Knockbreda Health and Wellbeing Centre

Total no New pts = 524

Total no Review pts = 1143

Total no Telephone review pts = 766

Ad hoc telephone contact = 800

Access to services – Chronic Pain Service

•Average time in clinic New patients = 35.5mins/pt•Average time in clinic review patients = 25.5mins/pt•Average time for telephone review = 15mins/pt

Improved patient experience•Nurses provide:•Timely access to pain services•Source of expert knowledge for all who experience acute/chronic pain•Education on pain conditions, daily management and treatments•Direct route for advice, management & reassurance•Timely admission for treatments•TENs & acupuncture clinics

Achievement of service objectives

• Six monthly audit APS (Epi, PCA, LA, TAP, intra opioids).• Ad hoc MDT audit of APS (e.g. thoracic, ortho, older people).• Attendance and Outcomes of CPN Led Pain Clinics (6 monthly)• Outcome of CPN Telephone Review Clinics (6 monthly).• Outcome of Adhoc CPN Telephone Consultations (6 monthly).• Patient satisfaction of APS (annually)• Patient Satisfaction Survey with Nurse Telephone Review Clinics

(annually).• Patient Satisfaction with attending outpatient chronic pain clinics

(annually).• Audit of Access and Referral Criteria Adherence (annually).• MYMOPs (an outcome assessment tool measuring benefit of

acupuncture) (annually).

Achievement of service objectives

Acute/chronic• Enhanced patient access, more time spent with

patients, individualized experience & journey.• Fully utilize the expert knowledge, skill and

experience of team members.

Chronic• Nurse-led conservative management pathway

decreases waiting time for initial consultation, treatment and review, achieving the targets laid down by DHSSPS.

Quality of life – Patient comments• ‘I live 60 miles from Belfast - with telephone review I have no journey to

make’• ‘Good advice on drugs and how they work’• ‘Told about more possible treatments’• ‘Delighted to have a review without leaving home’• ‘Many thanks for all the help and advice I have received’• ‘I'm really grateful to you for listening and explaining about my pain and

medications’• ‘I am able to continue at work, no need to cancel appointments or take

time off work’• ‘More info today than I've had in all the years I have been attending clinics’• ‘Feel more informed and happier about my future’

Thank youSr Liz Matthews (chronic)

Email: liz.matthews@belfasttrust.hscni.net

Sr Olga O’Neill (acute)

Email: olga.oneill@belfasttrust.hscni.net

Dr Donna Brown

Email: donna.brown@belfasttrust.hscni.net