Supporting people in Dorset to lead healthier lives Commissioning the Dorset Community Persistent Pain Management Service Why is it so Painful to Commission Pain Services? 18th December 2012 Nichola Arathoon

Supporting people in Dorset to lead healthier lives The Commissioning Cycle Health Needs Assessment Prioritisation and Workplan Development Current Service Review Service Design and Planning Securing the services Contracting & Implementation Manage Performance and Demand Manage Quality and Outcomes

Supporting people in Dorset to lead healthier lives Secondary care delivered injection based service in three acute providers Long waits for repeat injections Patient complaints Press involvement Board of Governors Background

Supporting people in Dorset to lead healthier lives Service review Pan Dorset Complaints Pathway Activity Capacity Funding Service Review

Supporting people in Dorset to lead healthier lives Best practice research Interventional Procedures in the Management of Spinal Pain Policy Multidisciplinary team triage of new patient referrals Post injection patient diary Increased funding for backlog patients on to new pathway Service Redesign

Supporting people in Dorset to lead healthier lives Service Specification for bio psychosocial model of pain management Dorset Clinical Commissioning Group MSK Clinical commissioning Programme Dorset Pain Society Patient and carer involvement Secondary care involvement Primary care involvement Education Service Redesign

Supporting people in Dorset to lead healthier lives ETHOS: To enable adults living with persistent pain (of at least 3 months duration with a definitive diagnosis, including Medically Unexplained Symptoms, and/or when the patient and GP agree and accept that the pain has become chronic) to understand and come to terms with their pain and to adopt strategies for living, which allow them to lead as fulfilling and independent lives as possible. Dorset Community Persistent Pain Management Service

Supporting people in Dorset to lead healthier lives To encompass: Primary care education The provision of supported self-care and optimised medical therapy delivery in Primary Care at the onset of pain and appropriate onward referral to the Community Pain Management Service The clinical service The provision of enhanced pain management treatments and strategies Dorset Community Persistent Pain Management Service

Supporting people in Dorset to lead healthier lives To support GPs in enabling their patients to live with persistent pain To work with and educate GPs to safely optimise the use of analgesia To educate GPs in the benefits of self management tools and techniques including motivational interviewing, the Expert Patient Programme and the Pain toolkit To identify and work with GPs with a Special Interest in persistent pain management To refer patients to the community persistent pain management service in a timely manner Primary Care Education

Supporting people in Dorset to lead healthier lives Community based Locality provided Single point of access Multidisciplinary pain specialist team: Physiotherapist, Occupational therapist, Psychologist, Doctor and Nurse Interdisciplinary working with Secondary Care clinicians, community health services, medicines management teams, community mental health teams, substance misuse teams, community matrons, return to work services and voluntary agencies The Clinical Service

Supporting people in Dorset to lead healthier lives Triage of referral form Individual assessment and screening in to appropriate support/treatment Personal care plan with goal setting and review with key worker Provision of cognitive and behavioural therapies with psychological support 1:1 and/or group pain management – health professional or peer led Interventional therapy The Clinical Service

Supporting people in Dorset to lead healthier lives Within groups Pain Chain/buddy Telephone help line Dorset Pain Society Peer led pain management courses Peer Support

Supporting people in Dorset to lead healthier lives Stakeholder engagement Secondary care clinicians and managers Primary care clinicians Patients and public Communication strategy Current providers Current patients Media Information and activity From current service in to new service Lessons learned

Supporting people in Dorset to lead healthier lives Health Needs Assessment Prioritisation and Workplan Development Current Service Review Service Design and Planning Securing the services Contracting & Implementation Manage Performance and Demand Manage Quality and Outcomes The Commissioning Cycle

Supporting people in Dorset to lead healthier lives Any questions? Thank You