Chronic pain GP referral criteria - Hampshire Hospitals NHS ...
Chronic pain GP referral criteria - Hampshire Hospitals NHS ...
Chronic pain GP referral criteria - Hampshire Hospitals NHS ...
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Red flags<br />
Factors that should trigger <strong>referral</strong> to appropriate specialist care, not to <strong>Chronic</strong> Pain Clinic:<br />
Spine fracture<br />
• Major trauma such as a vehicle accident or fall from height<br />
• Minor trauma, or even just strenuous lifting, in people who may have osteoporosis<br />
Cancer or infection<br />
• Age over 50 years and new low back <strong>pain</strong>, or age under 20 years<br />
• History of cancer<br />
• Constitutional symptoms, e.g. fever, chills, unexplained weight loss<br />
• Recent bacterial infection (e.g. urinary tract infection)<br />
• Intravenous drug abuse<br />
• Immune suppression<br />
• Pain that worsens when supine; severe night-time <strong>pain</strong><br />
Cauda equina or rapidly progressing neurological deficit<br />
• Saddle anaesthesia<br />
• Recent onset bladder dysfunction (e.g. urine retention, increased frequency, overflow<br />
incontinence)<br />
• Severe or progressive neurological deficit in the lower extremities<br />
• Unexpected laxity of the anal sphincter<br />
• Perianal/perineal sensory loss<br />
• Major motor weakness: knee extension, ankle plantar eversion, foot dorsiflexion<br />
Urgent <strong>referral</strong>s/Acute<br />
Most chronic <strong>pain</strong> does not require urgent assessment/treatment.<br />
However, patients with the following may be referred urgently by Fax (01256 354224) and their assessment<br />
will be expedited:<br />
• Complex Regional Pain Syndrome<br />
• New onset neuropathic <strong>pain</strong><br />
• Requiring a block for cancer <strong>pain</strong><br />
Routine <strong>referral</strong>s<br />
For patients with chronic <strong>pain</strong>, i.e. <strong>pain</strong>, which has been persistent for a minimum period of 12 weeks,<br />
we will accept <strong>referral</strong>s by letter, together with completed patient assessment forms<br />
(see below), provided or if:<br />
• the above guidance has been followed<br />
• where possible, a diagnosis has been made<br />
• the patient has not been referred to another specialty for the same problem<br />
• patient is making excessive demands for treatment of their <strong>pain</strong>, or requesting a ‘second opinion’<br />
• where there is significant or increasing disability or distress due to chronic <strong>pain</strong><br />
• the patient has poor self-management leading to excessive demands on primary health care<br />
services<br />
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