Chronic Pain Service
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Referrals
The Chronic Pain Service at St. George’s Hospital provides care for patients in the locality of the hospital. We accept referrals from GPs, and also from recognised senior physiotherapists.
Referrals to Pain Clinic can only be made by GP’s through e-Referral Service (eRS) – The St George’s Clinical Commissioner Reference Group (CCRG) and Clinical Quality Review Group (CQRG) have agreed that patients requiring Pain Clinic should be referred back to primary care to seek GP advice on management of cases and local pathways, and therefore Pain Clinic does NOT accept direct consultant-to-consultant referrals.
Referral to the Chronic Pain Self Management Team is by letter only. If a direct referral is made to the Chronic Pain Self Management Team this must be done by a medical doctor or extended scope practitioner physiotherapist only. Referrers will need to ensure that medical management has been optimised prior to referral to the Chronic Pain Self Management Team. Please see the Chronic Pain Self Management Team referrer leaflet.
Referrals to either Pain Clinic or the Chronic Pain Self Management Team must include information regarding –
- comprehensive pain history
- previous treatments and their outcome
- current and past pharmacology
- relevant past medical history
- Social and occupational impact of pain
- Patient’s expectations / objectives for intervention
Referrals that do not contain this information cannot be accepted.
In keeping with British Pain Society guidance, patients should ideally initially be seen in their local Chronic Pain Service. However, we will accept referrals for people who do not live locally to St George’s Hospital if a referral is made directly (or at the request) of their local Chronic Pain Service. The referral must include information from the local service regarding a comprehensive and up to date pain assessment, including assessment of needs and the reason(s) for requesting onward referral. This is to enable partnership working close to the person’s home.
Chronic Pain Service Description
Chronic (or persistent) pain is the term used to describe pain which has lasted longer than the usual healing time after an illness or injury – usually given as three to six months. Chronic pain can occur in any part of the body. It can be caused by an accident or injury. There are also many different health conditions that can lead to someone experiencing chronic pain, for example, arthritis. However, people can also experience chronic pain when there is no clear identifiable health condition, illness or injury present. This does not mean that chronic pain is not real but shows that chronic pain can be a very complex problem.
1 in 7 adults in the UK live with chronic pain making it a common problem. However, chronic pain is a highly individual experience. People react to living with pain in many different ways. People with chronic pain can have difficulties carrying out daily activities, including work, leisure activities and exercise. This can be very distressing and people will often describe feeling low and anxious because of their pain problem.
The St George’s Chronic Pain Service is designed to help people living with chronic pain manage the challenges this condition can bring.
Contact details
Clinics are held in
- Atkinson Morley Wing, St George’s Hospital, Tooting
- Phoenix Centre, St George’s Hospital, Tooting
- Queen Mary’s Hospital, Roehampton.
Pain Clinic, Atkinson Morley Wing, St George’s Hospital
Please contact the booking team for appointment bookings, cancellations and referrals
Telephone:
- 020 8725 4321 – new appointments and follow-up appointments
For all other queries please contact medical secretaries:
Pain Clinic
Atkinson Morley Wing
St George’s Hospital
Tooting
London SW17 0QT
- Telephone: 020 8266 6577 or 6524
- Fax: 020 8266 6526
Pain Clinic at Queen Mary’s Hospital, Roehampton
Central booking team for appointment bookings, cancellations and referrals
- Telephone: 020 8487 6290
- Fax: 020 8487 6304
Medical secretary for all other queries
- Telephone: 020 8487 6038
Chronic Pain Self Management Team
For appointment bookings, cancellations, referrals and all other queries, please contact the team co-ordinator –
- Telephone: 020 8266 6545
- Fax: 020 8266 6515
- email: CPSMT@stgeorges.nhs.uk
The Phoenix Centre
Perimeter Road
St George’s Hospital
Tooting
London, SW17 0QT
Treatments
The Chronic Pain Service offers a range of medical and non-medical interventions for people living with chronic pain. The multidisciplinary team includes consultants in pain medicine, nurses, physiotherapists, occupational therapists and clinical psychologists, all specialising in chronic pain management. We take a multidisciplinary approach to treatment, recognising that chronic pain as a complex biopsychosocial problem. This means that we understand that it is important to consider not just the physical symptoms of pain but also the emotional and social impact of pain too.
There are two main parts of the Chronic Pain Service:
- Pain Clinic
- Chronic Pain Self Management team
Pain Clinic
A range of medical treatments can be offered in Pain Clinic. The aim is to try and reduce pain as much as possible and to increase function and quality of life. The medical management of your pain may include recommending the use of medication for pain relief or trying to improve the effect of the pain medication that you are already taking. However, it may be that you find that medication is not very effective or that you do not tolerate it very well. For example, you find that you get side effects. If this is the case we can work with you to reduce or stop taking medication.
Besides medication, we may recommend other pain interventions and we offer a wide range of injection treatments and have particular expertise in guided injection treatments. We will also give you information about your pain condition and advice on what you can do to try and improve your pain. Where appropriate, we may recommend referral to another team for further help and advice,
It is important to remember that not everyone with chronic pain needs to be seen in Pain Clinic. Your family doctor, current medical or surgical team or other health care professional may be more than capable of helping you to manage your pain. However, if things are not improving we are here to try and help if we can in the Pain Clinic.
Chronic Pain Self Management Team
Medical management of chronic pain can be successful. However, for some patients, the benefits of medical help can be limited. In situations like this, people can be offered support to help them cope with living with chronic pain. The Chronic Pain Self Management Team aim to work with people to –
- improve ability to manage pain and related problems
- increase levels of physical activity
- use medication effectively
- improve mood and reduce worries about activity and pain
- achieve goals and return to daily activities
We run group based Pain Management Programmes and we offer individual support, where appropriate. Information about Pain Management Programmes can be found on the Healthtalk website and the British Pain Society website.
Key staff
Consultants in Pain Medicine:
- Dr Andrew Nicolaou (lead)
- Dr James Blackman
- Dr Andrzej Krol
- Dr Oliver Seyfried
- Dr Hadi Bedran
- Dr Moein Tavakkoli-Zadeh
To contact any of the above consultants, please contact the St George’s Hospital Pain Clinic on 020 8266 6577 or 020 8266 6524.
Consultant Clinical Psychologist
- Dr Claire Copland (lead for the Chronic Pain Self Management Team)
Please contact the Chronic Pain Self Management team on 020 8266 6545 or email CPSMT@stgeorges.nhs.uk
Clinic information / what to expect at an appointment
Pain Clinic
During the first appointment a history of your pain will be taken. You will be asked how and when the pain started, what symptoms you experience now, what previous treatments that you have tried for you pain and how the pain affects your life. You will also be asked about your general health and lifestyle. It is important to mention any other medical conditions that you have and also any other treatments that you are currently having. It can be helpful to bring a list of your medications. Discussion with the doctor may be followed by a physical examination and sometimes further investigations, before a treatment plan is discussed and agreed with you. The plan may involve treatment under the care of Pain Clinic or a referral may be made to another team who can offer you the most appropriate treatment for your needs. Following your assessment, a letter will be written to the GP and referring healthcare professional to ensure continuity of care. If you attend for further appointments your GP with receive an update on your progress.
Chronic Pain Self Management Team
You will first be invited to attend an Introduction Session. In this session we will present information on chronic pain and why it is not always possible to reduce or control pain. We will explain how chronic pain commonly impacts on people and we will describe various strategies that can help people to improve how they cope with the impact of chronic pain. We will explain the type of support that can be offered by the Chronic Pain Self Management Team and ask you to decide whether you feel this type of support is right for you. You will be offered the opportunity to book an assessment appointment with the team. In the assessment appointment you will meet with members of the team including a clinical psychologist, nurse and physiotherapist. We will review your individual needs and work with you to develop a care plan that helps you to feel more confident about coping with your pain.
Chronic Pain Self Management Team – Introduction session leaflet cpsmt-patient-leaflet
Friends and Family session leaflet – ff-leaflet-final-pdf
Information for people living with chronic pain
There the huge amount of information available about chronic pain. Below is a selection of helpful resources on a range of topics relevant to understanding and living with chronic pain.
Understanding Chronic Pain
British Pain Society – Understanding and Managing Pain
This booklet has been produced to help patients understand and manage their pain. Whether the pain is recent or long-term, severe or less severe, this booklet explores how to get the best out of the patient and healthcare professional partnership. It looks at what pain is, what can be done about it and who can help.
Information about medication use in chronic pain
British Pain Society – Opioids for persistent pain: information for patients
General support
Healthtalk
Healthtalk is an award winning website where you can read about and listen to other people’s experiences of living with pain.
Pain Toolkit
The Pain Toolkit gives you practical advice and ideas about pain management
British Pain Society
The largest professional organisation for pain management in the UK. There is a useful section on their website for people living with pain
Living with Chronic Pain
Dr Neil Berry is a Consultant Clinical Psychologist who works with people with chronic pain. He has produced a package of advice for coping with pain. This can be bought in the form of a CD or downloaded free of charge from the website.
