Pain Management

The Department will periodically contact patients waiting for an outpatient clinic appointment via SMS, with a link to an electronic form.  This is part of routine waitlist auditing to ensure patient details are up to date.  If you receive this SMS, please update your details.

The Persistent Pain Service is a time limited and management advice service which aims to provide effective care and rehabilitation through education, improved self-management and teamwork. The PPS encourages active patient participation in this rehabilitation process.

Availability

North South North West Statewide

Scope

The Persistent Pain Service (PPS) is a multidisciplinary pain management centre, made up of Pain Medicine Specialists, psychologists, physiotherapists and nurses. This team works with people with persistent pain to assess and advise on and assist in the management of the physical, medical, work and social impacts of chronic pain.

Persistent Pain Management Services are intended to provide consultative, time limited treatment and management advice with the aim of helping people understand their pain, and improve their quality of life and functionality in the presence of persistent pain.

Please refer to Screening/Referral Guidelines

  • Low back pain: The Persistent Pain Service sees patients that are not suited for the Back Assessment Clinic. Referrals may be redirected to the Spinal Assessment Clinic.
  • Patients on waitlists or undergoing treatment with other specialist services for the same condition are not accepted.
  • Patients needing assessment for section 59E of Pharmaceutical Act are not seen.
  • Patients on Opioids who wish to improve their coping strategies and non-pharmaceutical management will be accepted.
  • Diagnostic procedural pathways are offered by secondary referral onward from other specialist outpatient services at THS.

Emergency conditions

Patients with the following symptoms and signs should be referred to other services urgently:

  • Previous history malignancy (however long ago)
  • Age 16< or >60 with new onset pain
  • Weight loss (unexplained)
  • Previous longstanding steroid use
  • Recent serious illness
  • Recent significant infection
  • Saddle anaesthesia
  • Reduced anal tone
  • Hip or knee weakness
  • Generalised neurological deficit
  • Progressive spinal deformity
  • Urinary retention

Referral process

A referral is required for all new appointments and must conform to the Referral Standards as outlined on For Clinicians, including imaging reports and films (if available). eReferral is now the preferred method of referral for this service and is available in all THS regions. Please refer via HealthLink SmartForm eReferral through your software system (either Best Practice, or Medical Director). For instructions, see Quick Guide: Creating an eReferral.

Please refer to Screening/Referral Guidelines.

See Persistent Pain Service Model of Care.

Patient Pathway

Patient Questionnaire

After the referral is received and accepted, the patient is then sent an in depth questionnaire which further informs us of their condition, assists subsequent triage and allows for nationwide benchmarking. Patients may require assistance to fill this out. They have 8 weeks to return the questionnaire, and if there is no response they are discharged from the service and the referrer will be informed.

After returning the questionnaire, most patients are invited to our ”Information session”, which provides information about our Biopsychosocial model of care, the multidisciplinary treatment approach and basics of modern pain science and rehabilitation approaches.

Patients then decide if they wish to continue with the service. Those who choose to continue are triaged again with the additional information we have obtained, and most are offered a MultiDisciplinary Assessment (‘MDA’). This is a thorough, biopsychosocially focussed, 4 hour assessment with a doctor and nurse, a physiotherapist, and a psychologist. We work with the patient to determine a case formulation and come up with an action plan. Summaries of this will be sent promptly to the patient’s referring GP.

A smaller number of patients are assessed by medical and nursing only, depending on the secondary triage results.

Subsequent treatment may take place at the PPS or be referred out to community therapists. The PPS offers both individual and group based therapies with medical and allied health clinicians.

Clinic Appointments - Appointments are based on clinical priority:

Emergency

Proceed to Emergency Department (ED).
LGH ED Reception  – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

Urgent / category 1

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent / category 2

We will endeavour to see these patients within 12 weeks

Routine / category 3

Next available appointment

Referral template

For use by health professionals only

Additional information

The Persistent Pain service is launching a variety of ongoing education options for clinicians across Tasmania. These details will be updated further as the services are rolled out through 2020.

PPS Pain ECHO:

Click Here to register your interest in attending the PPS Pain ECHO video conference/case discussions.

Please see Case Presentation Template - De-identify your patient.

The online PPS ECHO sessions will involve Tasmanian primary health clinicians and the PPS team. The sessions will be open to practitioners from multiple professions.

Each session will include learning through interactive discussions of patient cases (de-identified) brought by an attending clinician and short ‘theory’ presentations by the PPS team.  Please see Case Presentation Template - De-identify your patient.

The PPS Pain ECHO will be an opportunity to learn from the practical experience and knowledge of all the attending clinicians, to gain access to the PPS team and to get to know other local clinicians who are actively working with people with persistent pain.

The PPS team have consulted stakeholders state-wide to design the curriculum for the sessions - thank you if you were involved. We have built our skills in online education in preparation for the ECHO clinics.

The PPS Pain ECHO launched in August 2020.  It is run every 4th Tuesday, 8:30am to 9:30am.

Click Here to register your interest in attending the PPS Pain ECHO video conference/case discussions.

Please see Case Presentation Template - De-identify your patient.

Please see the Pain Clinical Reasoning Guide for managing pain.

For more information about the ECHO model itself:

Additional Files: