Referral Guidelines for Chronic Pain Management in East Kent
Pain services in East Kent consist of a comprehensive multidisciplinary service within
primary care and an interventional service within secondary care to support patients to
develop self-management strategies, enhance their quality of life and reduce
dependency on healthcare services. There is a Single Point of Access based at
St. Augustine’s Business Centre, where all letters are triaged by senior clinicians on a
daily basis.
Referral Criteria - (Please see overleaf for explanatory notes)
Exclusions - (Please see overleaf for explanatory notes)
Your referral should include the following information:
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Diagnosis and brief history of pain
Details of current medications
Treatments tried
Relevant investigations/results
List other medical problems ( summary only)
Psychosocial history, if appropriate
Any past psychiatric history
Details of any previous pain clinic referrals
Patients’ and referrers’ expectations
For help and advice:
Email to: kcht.chronicpainreferralpoint@nhs.net. We will reply to your questions
within 48 hrs (normal working days).
Where to send your referral:
Chronic Pain Referral Point (East Kent)
St Augustine’s Business Centre
125 Canterbury Road
Westgate-on-Sea
CT8 8NL
Email: kcht.chronicpainreferralpoint@nhs.net
.
Tel: 0300 1232105/ 0300 1232531
Fax: 08712214988
Referrals can be made via Choose and Book (indirectly bookable) to Chronic Pain
Referral Point (East Kent).
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CRITERIA
Explanatory Notes
Regular Paracetamol +Have tried first line
NSAIDS (where appropriate)+medication appropriate to Low dose opiates ( where appropriate)
the type of pain.
Tricylics / Anticonvulsants for neuropathic pain, as indicated by
local guidelines
The Pain Clinic does not offer diagnostic work-ups.
Acceptance and development of self-management strategies is
impeded when patients are expecting a solution or cure for their
Have had investigations to
pain.
rule out treatable
pathology and diagnostic
In the case of Widespread Body Pain with Fatigue (i.e. suspected
pathway completed.
Fibromyalgia/CFS), the EKHUFT Rheumatology Dept. advise the
following: FBC/ESR/ U+E/LFT/TFT/CRP/CPK/ANF/RF/Vit D (or
refer Rheumatology if in doubt). Also see the Maidstone CFS
service criteria on their website.
Patients have completed Patients should not be seeing other teams for the same problem
their involvement with
as this hampers acceptance and confuses pathways (unless truly
other clinical services and requiring on-going therapy, for instance Biologicals in
are now discharged.
Rheumatology).
We do not have access to this information.
Appropriate
information/documentation It will help us triage the referral appropriately and allocate your
is attached. This would
patient to the most appropriate clinician on a timely basis.
include medical problem
list, medications and
It enables safer treatment suggestions and prevents duplicating
copies of consultant
pathways.
letters or imaging reports.
It helps us create meaning for patients out of past diagnoses.
This is in line with accepted definitions of “chronic pain”.
Have had pain for more
Acute conditions need appropriate investigation/management.
than 3 months.
(Acute Complex Regional Pain Syndrome is an exception.)
There is evidence that
active rehabilitation has
The Chronic Pain Service is aimed at those patients who have
been sought for
not responded to standard treatments, not those who have not
musculoskeletal
yet been exposed to standard treatments.
conditions.
Chronic Pain is a routine service. Patients requiring urgent
No “red flags” (direct
attention should be referred to the appropriate clinical discipline
referral to secondary care)
in secondary care.
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EXCLUSIONS
Explanatory Notes
This would pose a barrier to the methods used in chronic pain
Severe unstable
management and prevents the patient from achieving a successful
psychiatric illness, certain
outcome.
personality disorders,
severe untreated
The Pain Clinic psychologists do not provide general psychology
depression.
services.
Current substance
It is recognised that these patients are unable to engage in pain
abusers not undergoing
management. They need to be stabilized by the Addiction Services
addiction management.
first.
Requests for single /
Referrals are only accepted for holistic pain management, which may
stand-alone therapies ie
include a trial of previously untried therapies.
acupuncture.
This is an adult service.
Children under 13 years
Children between 13-16 yrs could be accepted, if deemed able to
old.
engage with pain management modalities.
We do not provide a Home visiting service.
Housebound patients.
You can contact us directly if you require medication advice.
There is no point in embarking on a biopsychosocial pain
Patients awaiting definitive
management program, if a possible solution is still awaited.
treatment for the problem,
You can contact us directly if you require medication advice in the
for instance surgery.
interim.
Patients with active
cancers, requiring pain
This falls under Palliative care. We do not provide symptom
management other than a
management.
specific intervention in
secondary care.
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