The last ten years have seen a gradual increase in the number of community-based pain management services established throughout the UK. Just like their counterparts in large general hospitals, these local services bring together a multi-disciplinary group of clinicians who are available to see patients at clinics held in smaller hospitals, GP surgeries, community centres or even in the patient’s own home.
Advantages of staying local
Such services bring a number of advantages to the patient, of which ease of access is the most obvious. Many people suffering chronic pain experience difficulties in travelling any significant distance, particularly when there may be related issues such as the availability of parking at a large general hospital. Those using community-based services also often say that they provide a better prospect of seeing the same clinician at successive appointments. In addition, users report that in a community environment, clinicians seem to have more time to spend with each patient.
Another advantage is that waiting lists tend to be significantly shorter than for hospital-based pain management.
So, given all of these advantages, why aren’t more people treated in the community?
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Availability of services
The biggest problem is availability, or rather, the lack of it. It really is a postcode lottery as to whether there is such a service in your area. It is worth asking your GP or current treatment provider whether there is a community-based alternative available to you (but see below). If they are uncertain, they should be in a position to find out!
Lack of awareness
Most people access these services through their GP, district nurse, physiotherapist, occupational therapist or through a hospital-based pain clinician. However, many health care professionals are simply unaware of the existence of community-based pain management services. One client told us that neither his GP or occupational therapist was aware of the service in his locality until he presented them with a leaflet.
Limitations of ‘local’
Of course, community-based services do have their limitations. Certain treatments and therapies are only available in a larger hospital environment. These include hydrotherapy services and drug-infusions, the latter requiring other medical services to be readily on hand in case of complications developing.
Funding
As with so many community-based services, we understand that some local pain services are under threat. The NHS budget deficit has resulted in a push in some quarters towards the consolidation of services and this could mean that those currently accessing treatment locally may have to return to a larger, regional, hospital-based environment.
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