1. Chronic Pain Service 2014 Dr J M Davies Consultant Anaesthetist

2. 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

3. 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 clinics 2 Outpatient clinics per month Some treatments now delivered in LGH and C’town. with nurse support.

4. Service 2014

5. 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

6. Activity

7. 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

8. 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

9. 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!

10. Referred out of area Complex interventions Comprehensive psychology Other specialties for intervention –Neurosurgery –Rheumatology –Orthopaedics –others

12. 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

13. Thank you.