Managing people's pain is a vital part of the care that any hospital provides. Pain which happens as a result of a sudden painful event, such as an operation or an accident, is called "acute pain". There is a dedicated team of doctors and nurses who visit patients around the hospital ensuring that all patient's acute pain is well managed.

More persistent pain that has not responded to simple treatments may require a combination of advanced pain relief techniques and coping strategies. This is addressed by the Chronic Pain Service.

We have recently also developed a dedicated pain team for children coming to Derriford Hospital who have different needs to adults.

Chronic Pain Management
The Plymouth Pain Management Centre has six Consultants, three Senior Nurse Specialists, a Senior Sister, four other trained Nurses and two Healthcare Assistants in addition to three part time Secretaries and two Data Inputters/Administrators.

The Centre offers a full range of chronic pain management, dealing in particular with musculo-skeletal and sciatic problems, as well as managing cancer pain.

The Plymouth Management Centre is the biggest in the South West and sees in the region of 6,000 people per year.

The Centre provides a number of regional specialities:
• treatments for severe trigeminal neuralgia.
• a system whereby medications can be delivered directly to the spinal fluid (intrathecal drug delivery). This is used successfully to treat severe limb spasm and both cancer and non-cancer pain.
• A specialist fibromyalgia service
• specialist injections for many neck and back degenerative conditions.
• spinal cord stimulation.
For those with intractable pain that doesn’t respond easily to treatment, a full Pain Management Programme is offered.

Staff
Consultants
Dr M Taylor
Dr F Luscombe
Dr A Davies
Dr R Sawyer
Dr M Rocket
Dr A Dashfield

Paediatric Pain
Children's experiences of pain and how they show their pain varies greatly. This provides a real challenge for children's nurses and doctors to make sure that children get the best treatment for their pain after surgery or due to other problems.

Plymouth is the only hospital in the South West to have a dedicated children's pain team. It consists of one consultant paediatric anaesthetist and 3 children's nurses.

During the week, the team try to visit the wards every other day to make sure that the best pain management is being given to all the children. They are also available to be contacted every day for any particular pain problems. The team also take a lot of time to teach other doctors and nurses how to recognise and treat pain in children.

Staff
Dr S Courtman, Consutlant
Nurses: Sister Caroline Morrison, Sister Libby, Sally Church, Emma Rayment

  

Acute Pain Team
The Acute Pain Team comprises a dedicated team of doctors and nurses. Our primary role is to improve management of acute pain across the Trust.  This is important because controlling pain helps recovery. While we mainly deal with patients after surgery, we also review patients from non-surgical wards with acute pain problems.

The Acute Pain Service has developed the following approach to achieve this aim:

1.      Daily ward rounds:
Patients receiving specialist techniques for pain relief after major surgery are reviewed by a member of the Acute Pain Team to ensure that their pain relief is well managed. These specialist techniques include epidural and peripheral nerve infusions, intravenous ketamine and patient controlled opioid (PCA) infusions. We are also available to review patients with unrelieved pain not receiving one of these techniques.

2.      Education:
a.       Patients: to communicate unrelieved pain
b.       Ward Staff: to improve the monitoring and recording of pain, to respond appropriately to unrelieved pain, to manage these specialist techniques safely and to recognise when complications develop.

We have written technique specific observation charts, protocols and algorithms to assist ward staff in managing their patients safely and effectively

3.      Audit:
We perform a number of audits each year to determine the effectiveness of our service.

4.      Research:
We participate in research programmes appropriate to the service. Thereby we aim to keep up-to-date with developments in acute pain management and to incorporate them into our practice where appropriate.

Staff
Dr Iain Christie Consultant Anaesthetist
Dr Chris Seavell Consultant Anaesthetist
Dr Mark Rockett Consultant Anaesthetist/Pain Management Consultant
Dr Andy Porter Consultant Anaesthetist

Clinical Nurse Specialist Sally Church
Sister Louise Pengelly
Sister Mary Weeks
Sister Sara Mahoney
Senior Staff Nurse Sarah Porter 
Senior Staff Nurse Abigail Blee