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IMPACT Community Pain Service

IMPACT Community Pain Service

 Interdisciplinary Musculoskeletal Pain Assessment and Community Treatment Service

Summary

Launched in 2009, IMPACT is a specialist interdisciplinary chronic pain service. The service aims to improve quality of life and functioning for adults with longstanding widespread or localised pain. All of our treatments are evidence-based. The service is based at the Haywood Hospital and also runs clinics at Leek Moorlands Hospital and Milehouse Primary Care Centre near Knutton, Newcastle under Lyme. IMPACT is affiliated with the Arthritis UK National Primary Care Centre at Keele University. The clinical team consists of a Consultant Anaesthetist, a Consultant Rheumatologist, a Consultant Clinical Psychologist, a Consultant Physiotherapist, a Specialist Nurse, a Specialist Physiotherapist and a Clinical Psychologist. Trainee Clinical Psychologists are regularly on placement with the team. At present, the IMPACT service is commissioned by North Staffordshire CCG and is therefore available only to those patients who have a GP in the North Staffordshire CCG area. In July 2013, the IMPACT Service won a national Care Integration Award (Pain Management Category) for our innovative, interdisciplinary approach to helping people with chronic pain.

Information about chronic pain

Pain is a common experience. Most pain goes away fairly quickly, either of its own accord or with treatment. This sort of pain is called acute pain. However sometimes pain persists. When it continues longer term, it is called chronic pain. Chronic pain can occur with certain conditions, after surgery or illness, or sometimes for no apparent reason. In some cases, it is thought the body's pain system becomes over sensitive, so that even light touch or every day movement can be painful. Frequently there is no obvious cause for this and even when a cause can be identified, there is often no 'cure'. Chronic pain often does not respond well to the usual medical treatments. Today's treatments are sometimes unable to achieve long term relief from chronic pain and any associated symptoms. People can spend lots of time and money seeing different specialists and trying different treatments, which give only modest improvement or perhaps contribute to additional problems. Most importantly, these treatments do not allow people to 'get their life back' - in other words, they do not allow the individual to return to activities that are important to them. Physical activity tends to increase pain and is therefore often avoided in an effort to control or minimise pain. This can lead to stopping important activities, resulting in loss of independence, loss of work, changes in mood and poorer relationships with partners, family and friends. Chronic pain does not mean there is ongoing damage to the body. It is safe to do activities with increased pain, but it can be hard to stay active on a consistent basis. Overdoing things usually requires an extended period of time to recover before being active again. Also maintaining certain aspects of life can often come at the expense of other important areas.

Referral to the IMPACT Service

Our service may be able to help if you have longstanding pain and would like to do more of the things that are important to you, or if you are struggling to maintain participation in these activities. Our service is designed for people whose pain is leading to disability, distress or questions/concerns about medication and other treatments. Referrals are accepted from General Practitioners (GPs) either by letter or the Choose and Book System. Referrals are also accepted from musculoskeletal interface services, secondary care musculoskeletal services and secondary care pain services.


Note for referrers:

At present the service is only available for patients whose GP is from North Staffordshire PCT.  Please contact the service for full eligibility criteria on 01782 673751.

 


 

What does treatment with the IMPACT Service involve?

Even when pain continues, it is still possible to live a full life. We understand that trying to achieve this can feel impossible and previous efforts to do so may have been unsuccessful. Treatment with the IMPACT service aims to help people with pain return to activities that are important to them, on a sustainable and consistent basis. All those referred to the IMPACT service will be offered an initial assessment to find out more about the pain and the effect it is having on their life. They will be asked to complete some questionnaires and the appointment may involve a physical examination. This assessment reviews what previous treatments have been tried and explores whether there are other options likely to reduce pain in the longer term. An individual plan of care is made. For many patients this involves ‘rehabilitation’, with the aim of improving quality of life and engagement in meaningful activities. This may be done in a group setting or on a one to one basis. We aim to improve quality of life for people with chronic pain, rather than to reduce, change or control pain. The focus is on those things that we and you can change - improving your ability to participate in what is important to you. The pain rehabilitation group involves attending a small group programme which runs for two days a week for four weeks. There are also two half day follow up appointments held three and six months after the programme. Research has shown that the approach offered by the IMPACT service is the most effective way to improve quality of life in those with chronic pain. The data we collect supports this.

Treatment outcomes (based on 2009 - 2010 groups)

The diagram below shows satisfaction scores of patients who have completed the group programme.

Satisfaction scores

How satisfied are you that treatment met your needs? In other words, how happy are you with the outcomes that were achieved and the treatment delivered?

Treatment satisfaction

How satisfied are you with the programme staff? In other words, how happy are you with how you were treated?

Staff satisfaction

Feedback from patients who have attended the IMPACT Group Rehabilitation Programme

At the end of each group programme, we ask every patient for feedback. One question we ask is 'What would you say to someone with pain who was thinking about coming on a programme?'

Some of their comments are below:  

'It has enabled me to not let pain be the focus of my life... I did not believe this programme was for me. I was anxious about attending. However I now feel this has been very rewarding.'

'Don't worry about people thinking the pain is all in your mind. The pain is there and is real. What I gained from the course wasn't what I thought I wanted, however I am a much happier person for completing it. I can't believe the difference it has made to myself and to my family. By going on the course with an open mind you have nothing to lose and maybe everything to gain. My pain levels are similar to before, but my reaction to my pain is completely different’

‘I feel I have some of the old me back again’ ‘At first I was very skeptical… but thankfully it has opened my eyes to what I have been missing out on in life.’

‘You know that you’re not alone’ ‘It’s hard at first facing up to things, but give it time. A very worthwhile 8 days!’ ‘It has been the start of my journey towards a better, more rewarding life’.

Research, training and education

The Service is affiliated with the Arthritis UK National Primary Care Centre at Keele University and we contribute to research projects and papers for publication. We routinely collect and analyse outcome data and we ensure that our treatments are based on research evidence and theoretical developments. The IMPACT Service Team also offers training and support for clinicians who work with people with chronic pain.

Contact details for the IMPACT Service:

IMPACT Service Staffordshire and Stoke-on-Trent Partnership Trust

Haywood Hospital

High Lane Burslem

Stoke on Trent, ST6 7AG

Tel: 01782 673751

Fax: 01782 673912