Title: Fife Integrated Pain Management Service - 1 year on The ‘RIVERS’ Experience
1Fife Integrated Pain Management Service- 1 year
onThe RIVERS Experience
- Deborah Paton Lead Pharmacist, Fife Integrated
Pain management Service (FIPMS)
2Fife Pain Services pre 2010
- Secondary Care Pain Service delivered from QMH,
Dunfermline - Primary Care based pain programme (RIVERS)
delivered in West Fife locality only
3Fife Model pre bid
Pain Service- all services provided at QMH
Complex co-morbidity 3 5
RIVERS programme- West Fife locality only
Level 2
Poorly controlled single condition 15 20
Level 1 Self Management 70-80
Informal links to PAS
4Bid to Capacity Sustainability
- Key elements
- Integrated service across primary and secondary
care - Achieve equity across Fife- develop RIVERS in
Dunfermline locality, KL and GNEF CHPs - Shifting the Balance of Care- deliver more
complex interventions locally (40 target)
5Fifes Pain Service 2010 onwards
Patient requiring Pain Management -Referred by
GP/ Physio/ Other
Questionnaire/ Referral letter triaged to
intervention depending on complexity
6(No Transcript)
7Whats RIVERS?
- Primary Care based programme
- Exercise
- Education
- Medication review
- Developed 2004 in West Fife locality
- Now covers 60 GP practices, based in 5 sites in
Fife - Leisure Community centres
- Physio/ Pharmacy led
- Physio assistants/Expert Patient
- Redesign of PAIN services
- Meets Balance of Care and Long Term Conditions
agenda
8Whats it all about?
- Holistic way to manage pain
- Recognising how it affects patients quality of
life - Equipping patients with skills to manage their
pain - Increasing their physical activity
- Making the most of their medication
- Emphasis on Fun!
9RIVERS Programme
- Education/information session before programme (
2hr session) - Cover Pain Mechanisms, programme content basic
medication key messages - Patient signs up to programme
- Pre-assessed by Physio
- 6 week RIVERS programme (2-2.5hrs
sessions) - Groups 6-12 patients
10RIVERS content
- Medication
- Non- pharmacological self-management
- Relaxation/ distraction
- Managing Flare ups
- Addressing negative thoughts
- Good sleep hygiene
- Progressing activities
- Concepts of pain
- Home exercise programme
- Weekly exercise class
- Addressing Fear avoidance of activity
- Pacing, Planning, Prioritisation
- Posture
- Drainers Feeders
11Post RIVERS
- Established a weekly exercise maintenance class
in 3 Leisure Centres in Fife- Keeping Afloat - Run by Expert Patient Leisure attendant
- Collaboration with Fife Sports Leisure trust
- Formal referral to Pain Association Scotland-
skill maintenance
12Fife Model post bid
- Pain Service- Main centre QMH
- KPMP delivered on 2 sites
- Psychology OT delivered across Fife
- Other services planned
Complex co-morbidity 3 5
- RIVERS programme-
- 5 sites across Fife
- Further sites planned
Level 2
Poorly controlled single condition 15 20
Level 1 Self Management 70-80
- Formal links to PAS, Pain Concern voluntary
sector - Book Prescription
- Website
13Shifting the balance of care- of patients
referred to pain service triaged to primary care
target 40
57
48
50
14Benefits to Service
- Patients seen more locally
- Consultant wait time down to 6 weeks
- Physio wait time decreased
- More KPMP and wait decreased
- Developing Pharmacy input
15Pharmacy Team
- 4 pharmacists
- 1 WTE
- 0.4 WTE
- 0.3 WTE
- 0.1 WTE
- Independent prescribers
- Due to CD Regs work as Supplementary Prescribers
16Pharmacy input currently
- Information sessions and med reviews during
RIVERS programme - Information sessions for Kingdom Pain Management
programme - Medication Review pilot
- Prescribing Work-stream
17Pharmacy input over next year
- Roll-out of pilot medication reviews across Fife
- Collaborate on appropriate formulary section
reviews - Deliver Protected learning across Fife
- Deliver NES evening on Chronic Pain and develop a
programme for Community Pharmacists HCA - Expand RIVERS?
- Conquer the world.
18Any questions?dpaton_at_nhs.net