Chronic Pain Service 2014

Dr J M Davies

Consultant Anaesthetist

Development timeline

• Appointed 2002, 2 clinics per month, Oban

• 2004, Monthly clinics, Oban 3. Peripheral clinics delivered in primary care

(Lorn, C’town.,Tarbert, Connel and LGH medical centres)

• 2007, 3 Oban monthly, C’town. and Lochgilphead 0.5

Time line

• 2011 0.5 wte Pain Nurse appointed, provision increased, 5 Oban, 0.5 C’town. +LGH monthly.

• 2014 Oban sessions increased for treatments.

3 Block sessions, 2Nurse treatment clinics2 Outpatient clinics per monthSome treatments now delivered in LGH and C’town. with nurse support.

Service

2014

Services provided

• Outpatient clinics– Assessment– Advice– Investigation– Minor procedures

• Treatment OP– Interventions (Blocks)– Acupuncture– Qutenza

• Day case procedures– x-ray guided blocks– complex needs patients– Higher risk interventions

Activity

Outpatients(Aug12-July13)

• Oban, 24 clinics per year– 59 New, 155 reviews

• Lochgilphead 6 clinics per year– 11 New, 48 reviews

• C’town., 6 clinics per year– 15 New, 41 reviews

Interventions(2013)

• Consultant blocks, 25 clinics– X-ray 81treatments– Non-x-ray 89 treatments

• Nurse led sessions– Acupuncture,49 sessions, 141 treatments– Quatenza,11 sessions (shared Aug. 2013)

15 treatments

List of consultant procedures• Facet nerve blocks• Epidural injections• Nerve root injections• Lidocaine infusions• Botox injections• Specific nerve blocks• Joint injections

To name a few!

Referred out of area

• Complex interventions• Comprehensive psychology• Other specialties for intervention

– Neurosurgery– Rheumatology– Orthopaedics– others

The way ahead

• Currently a Highland wide review underway as part of a National process.

• Movement towards a more telephone based triage system.

• Improve psychology input locally, PMP• Expand the team including other

disciplines

Thank you.