On this page:


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.

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 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.

Websites with information on managing pain and offering support

Pain Concern 

Arthritis Care