North Wales - Glan Clwyd Hospital
Background information
Staffing for acute pain
- 2 acute pain nurses
- 1 consultant (2 sessions each week)
Staffing for chronic pain - Pain Management Service (PMS)
- 2 consultants (6 sessions each week)
- 1 clinical nurse specialist
- 2 psychologists
- 1 ESP physiotherapist
Each week a 'standard' Pain Clinic session takes place with both consultants, one psychologist and clinical nurse specialist in attendance. MultiDisciplinary Team assessment of new patients occurs weekly divided into those with complex or non-complex psychological needs (determined through a robust questionnaire and psychometrics based triage). An Interventional Pain Medicine session is run by one of the consultants on alternate weeks offering a wide range of treatments.
Two consultant led acute pain ward rounds take place each week.
Higher training
To build upon what they have learned as basic trainees SpRs receive a block programme of training as follows:
- Acute Pain Management
- Standard Pain Clinic
- MultiDisciplinary Team assessment
- Psychology - individual sessions
- Physiotherapy - individual sessions
- Pain Management Programme (outpatient) - following one cohort of patients
The PMP is run over 8 weeks with attendance for a single day each week.
A Pacing clinic is run by the clinical nurse specialist , TNS clinic by CNS and/or physiotherapist and a joint psychology/physiotherapy clinic form those with specific needs identified at MDT assessment. Acupuncture is provided both within the PMS (where time allows) and in the physiotherapy department.
The North Wales Cancer Treatment Centre is located at Glan Clwyd Hospital allowing easy allocation to:
- Palliative Care - ward and medical clinic under the tutelage of a consultant in Palliative Medicine
- Radiotherapy marking up session
Walton Centre - trainees from North Wales can be attached for exposure to implantation lists (neurosurgery and pain medicine)
Rheumatology attachment under the tutelage of a consultant rheumatologist
Conwy & Denbighshire NHS trust is developing an improved system of management for patients with musculoskeletal disorders bringing together the Pain Management Service with orthopaedics, rheumatology, musculoskeletal medicine, acute spinal pain triage and therapy services. Working alongside colleagues in other specialties will give an excellent opportunity of training access across all the 'musculoskeletal' disciplines.
Trainees will be encouraged to undertake audit project(s) and make presentations to departmental meetings.
