Integrated Pain Management HIT's successes in 2017-18

Professor David Wynick and Lisa Buckle give an update on the work of the Integrated Pain Management Health Integration Team (IPM HIT) in 2017-18.

Our main focus during the past 12 months has been reviewing and revising the chronic pain patient pathway, as part of a wider redesign of musculoskeletal services. The project is co-led by the Integrated Pain Management (IPM) and Bristol Bones and Joints Health Integration Teams (HITs), alongside the Sustainability and Transformation Partnership (STP) for the Bristol, North Somerset and South Gloucestershire area. Staff, patients and commissioners from different services, including pain, rheumatology and orthopaedics, were involved in the redesign. The new pathway, starting in 2019/20, aims to reduce delays for patients accessing treatment and to help them to be seen closer to home.

We have launched a new clinical service at Royal United Hospitals Bath offering rehabilitation for people with persistent pain following cancer treatment. We also received ethical approval for the PAIRED research database, which captures clinical treatment data from a range of Bristol and Bath pain rehabilitation services.

The PROactive (Research, Innovation and Rehabilitation) collaborative continues to thrive. It’s published key research on patients’ views and experiences of pain rehabilitation, exploring the management of painful diabetic neuropathy, and the development of an internationally agreed minimum core outcome measure dataset for complex regional pain syndrome. It’s been awarded research grants from Arthritis Research UK for the development of a clinical tool for screening older women with back pain for fractures, plus a study exploring brain networks and patient descriptions of body perception. The National Institute for Health Research is funding a study looking at ways to reduce pain in people with knee osteoarthritis. Funding from the Scleroderma Clinical Trials Consortium will develop a framework for a patient-reported outcome tool to assess ulcers in people with sclerosis.

The Bath Pain Forums attract a wide variety of healthcare professionals from the local area and offer the latest research and clinical updates. Topics have ranged from new ways of assessing and treating chronic pain, to how age and developmental factors affect pain-related disability. A number of these events are co-organised by the IPM Project Manager.

Senior IPM members have also contributed to national and international policy. We have representatives on the Specialised Pain Clinical Reference Group (CRG), the National Institute for Clinical Excellence (NICE) committee for chronic pain, the Arthritis Research UK Pain Roadmap, the European Pain Federation and the British Society for Rheumatology. Our members’ clinical practice and research, along with patient input, has informed the updated Royal College of Physicians guidelines for complex regional pain syndrome, to be published in 2018.