mental health



Bringing together physical and mental health

1 2 3 4

5 6 7

Appendix B: Integrated persistent pain pathway in Oldham


The integrated persistent pain pathway in Oldham is provided jointly by Pennine

MSK Partnership, Pennine Care NHS Foundation Trust and The Pennine Acute

Hospitals NHS Trust, and commissioned by Oldham CCG.

The Pennine MSK Partnership Ltd provides comprehensive services in Oldham

for rheumatology, orthopaedics and chronic musculoskeletal pain. Led by a

team of clinicians, the partnership operates as an integrated pathway hub across

all musculoskeletal conditions. The partnership has its own outcomes-based

programme budget and can sub-contract various services to provide more holistic

care. Recognising that psychological support is a key component of its work,

the partnership sub-contracts mental health services from Pennine Care NHS

Foundation Trust and works with The Pennine Acute Hospitals NHS Trust to deliver

an integrated service for persistent pain.

The new integrated persistent pain pathway went live in June 2015 and bases the

assessment and treatment of pain on the biopsychosocial model. Pennine MSK

Partnership takes the lead role for ‘tier 2’ of the pathway and the acute trust takes

the lead role for ‘tier 3’ (see below). The community-based pathway supports people

to make informed decisions to manage their care and have an improved quality

of life.

Service description

People who are suffering with persistent pain that is hard to manage, despite

treatment, are referred by GPs to the hub. They are assessed by members of

a multidisciplinary team, including pain specialist nurses, pain specialist

physiotherapists, cognitive behaviour therapists and clinical psychologists, supported

by pain consultants and liaison psychiatrists where necessary. The assessment

determines which of the following tiers of service each patient will receive.

• • Tier 1 is co-ordinated by general practice. Patients can access help from

community physiotherapists and psychological therapists, the latter being

based in Improving Access to Psychological Therapy (IAPT) services.

Appendices: case study site profiles 77

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