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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Manchester and Salford Pain Centre Induction Pack
Contents
Introduction
Referrals
Team Profiles
Triage
Clinical Activity
Point of First Contact Clinics
Review Clinics
Theatre Sessions
Specialised Treatments offered at the MSPC
Spinal Cord Stimulation
Pain Management Programmes
Guidelines for observers
Patient Information Leaflets
General Information
Resources
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Introduction
The Manchester and Salford Pain Centre is one of the country’s leading clinics for
the management of all forms of pain.
We are an interdisciplinary clinical team of doctors, physiotherapists, psychologists
and nurses who are expert in managing all forms of pain ably supported by reception
and administration staff
Referrals are received from General Practitioners and from within the Trust .In
addition we also encourage referral of patients with complicated pain conditions from
other pain clinics for our more advanced treatment options such as intensive pain
management programmes and spinal cord stimulation
MSPC
Salford Royal Hospital,
Stott Lane, Salford,
M6 8HD
Telephone: +44 (0) 161 206 4002
Fax:
+44 (0) 161 206 4169
E-Mail: [email protected]
Referrals
Patients can be referred to the centre either by their GP or by a Consultant from
another specialty within the Trust. The letter of referral should be sent to the centre
outlining the patient’s clinical problem, investigations performed, past medical history
and current medications.
Referral letters are initially triaged via the nursing team supported by the medical
consultants. A decision is made with regards to how urgently the patient needs to be
seen. Patients with chronic pain conditions are sent a questionnaire which includes
psychometric tests measuring depression, pain anxiety and disability .The completed
questionnaire enables the team to gain more information about the patient’s pain and
the impact it has on their life. Once this questionnaire is returned the information is
triaged and the patient is given an appointment in the most appropriate speciality
clinic.
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
Patient Pathway for MSPC*
Referral
Triage
Non-MSK Referral
Nurse Only
4 x 45 mins
Questionnaires
Urgent
Non-MSK Referral
Doctor Only/(CRPS)
5x 45 mins
NHS
* Discharge from any Level
Team
Triage
MSK Referral
Doctor / Psych
Doctor / Physio
Dr 4 x 45 mins
Psy 2 x 90 mins
4 x 60 mins
Doctor
Review
Nurse
Review
9 x 20 mins
PHYSIOTHERAPY or PSYCHOLOGY TRIAGE
Physiotherapist
Pain Management
Review:
Physio = 3 x 60 mins
(CES-D <30)
Psychologist
Pain Management
Review:
Psych = 2 x 90 mins
(CES-D  30)
Individual
Inter / Uni-disciplinary
Pain
Management
Pre-programme Assessment Clinic (Goal Orientation & Logistics) 3 x 60 mins
Foundation
FoundationPain
PainManagement
ManagementProgramme
Programme
16 sessions (Group)
16 sessions (Group)
1, 3, 6 month Follow-up
1, 3, 6 month Follow-up
Intensive
IntensivePain
PainManagement
Management
30 Sessions (Group)
30 Sessions (Group)
1, 3, 6 month Follow-up
1, 3, 6 month Follow-up
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Team Profiles
Nursing
The nursing team consists of 6 clinical nurse specialists in pain management led by a
consultant nurse. The nursing team work across the Trust providing advice, support
and intervention for inpatients with acute pain. The team also provide an outpatient
based service for those with chronic pain in the form of medication review and TENS
clinics. Their core duties include:
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Acute pain management within the hospital trust
Nurse led chronic pain clinics
Ongoing identification and improvement of patient pathways of care
Education and Development of Trust staff, students and the wider health care
community in the management of pain
Clinical governance activities including clinical audit and patient safety
Continuous service review and improvement
Physiotherapy
The Physiotherapy Team consists of four full-time Physiotherapists who specialise in
the field pain management. Physiotherapists are involved at many different stages of
the patient’s pain management experience. Patients attending the M.S.P.C. may see
a Physiotherapist at their first appointment as the Physiotherapists run regular
assessment clinics both individually and in conjunction with the Pain Doctors
(Consultants in Pain Management and Anaesthesia). If after an initial assessment, it
is thought that a patient may benefit from pain management physiotherapy or a pain
management programme, they may go on to attend further appointments with one of
the centre’s Physiotherapists.
The Physiotherapy Team utilise a combination of exercise therapy, education and
advice on strategies such as pacing and goal setting to help people with chronic pain
work towards their personal rehabilitation goals. The Physiotherapists work within a
cognitive behavioural approach and work closely with the M.S.P.C. Clinical
Psychology Team, providing multidisciplinary joint treatment sessions and pain
management programmes. Overall, the M.S.P.C. Physiotherapists aim to enable
people with chronic pain to develop self-management strategies to improve their
physical function and quality of life despite their pain.
The Physiotherapy Team also provide training and educational sessions for other
Healthcare Professionals and local Universities.
Clinical Psychology
The Clinical Psychology team consists of three full time and one part time clinical
psychologist. Clinical Psychologists are highly specialised practitioners in the
assessment and treatment of psychological distress. In addition to this a Clinical
Psychologist in a Pain Centre has specialised knowledge about the impact of being
diagnosed with a chronic pain condition, and the bearing that this can have upon an
individual’s quality of life. We do not believe that psychological distress triggers or
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
causes the onset of a chronic pain condition but we understand that chronic pain can
sometimes lead to low mood and heightened anxiety as it affects all areas of an
individual’s life.
Specifically, we assess the impact of chronic pain on people’s lives, particularly the
effects on family life, work, social activities and mood. We help people to learn new
coping strategies to reduce the impact of pain in these areas, so that people can
gradually get back to doing the things they have had to give up. Our work isn’t aimed
at reducing the pain itself, but reducing the problems that are caused by the pain.
People often tell us that pain makes it much more difficult to cope with other
problems so we may start off by looking at stress management techniques such as
breathing and relaxation exercises. This helps people to remain calm and think
clearly in stressful situations. This also works well when combined with the stretching
exercises given by the physiotherapists.
We also help people to rebuild their confidence by learning to recognise and
challenge any negative thoughts or unhelpful thinking styles. This helps people to
feel less frustrated, more realistic about dealing with problems and more in control of
their lives again.
Medical Consultants
The MSPC has a 5 medical consultant team. Pain Clinics originally developed
through procedures being performed by anaesthetists for cancer pain. This role then
expanded to include chronic non-malignant pain culminating in the kind of
interdisciplinary working which we have here. The Consultants in the Pain Centre
therefore have Anaesthesia as their base speciality (Dr Johnson and Dr McDowell
however no longer practice as anaesthetists)
The consultants are involved in assessing patients at point of first contact clinics. The
purpose of the medical review is to exclude disease processes which may be more
appropriately referred to other specialists as well as instituting pharmacological
therapy for the management of pain. In addition patients are listed for interventional
pain procedures if suitable. We offer medical support to the pain management
programmes and also conduct Acute Pain Ward rounds.
Core duties include:
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Point of first contact clinics
Review clinics
Interventional Pain Procedures including Spinal Cord Stimulation
Acute Pain Ward Rounds
Pain management Programmes
Intrathecal Baclofen for the management of spasticity
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Triage
A once weekly triage meeting is held every Wednesday at 1.30pm (Seminar Room
2nd floor). At least one member of the physiotherapy and psychology team is
present alongside a medic. The referral letter, completed patient questionnaires and
analysis of psychometric scores are reviewed. Using the criteria detailed below
patient’s are then triaged into the appropriate clinic. The criteria for each of the
clinics are detailed below:
1.
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Doctor Only
Aged 70+
Patients presenting with- cancer
- post-herpetic neuralgia
- CRPS (less than 1yr)
- non MSK pain e.g. headache, abdo pain
- complex medical history
 Significant indication of resistance to psychology
 No evidence of rehabilitation potential
2.
Doctor/Psychology
 Score of 45 or more on CES-D or indication in referral of more
significant distress
 Indication of suicidal ideation in referral/questionnaires
 Evidence of personality disorder/longstanding mental health difficulties
3.
Doctor/Physio
 CES-D score of 44 or less
 Musculoskeletal pain
 Could benefit from rehab approach
4.
5.
6.
CRPS
 Specific diagnosis/suggestion of CRPS in referral/questionnaires
 Painful swollen limb
Trigeminal Neuralgia Clinic
 Specific diagnosis of TGN from neurology
NB-complex/undiagnosed cases to be seen by medic
Full Team Assessment
 Patient lives far away therefore main option is for an intensive Pain
Management Programme with accommodation locally
SCS - There are no specific clinics for referral for SCS - Referrals should be
discussed at triage and comments made as to the appropriate clinic with specific
medic if required (DMcD/AGL or RM).
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Criteria for priority of appointment
Urgent (within 48hrs)
Cancer
Uncontrolled TGN
Priority (within 4/52)
Routine
Suicidal ideation/intent
All remaining
CRPS (less than 1 yr duration)
Staff member
Inference of imminent break-up of relationship
Patient’s job at risk
Clinical activity
The team at the MSPC are involved in varied clinical activity. The clinic template is
available on the P:drive. A weekly template is on the Pain Fellows notice board in the
Medical Consultants office. A brief description of each of the clinics can be found
below alongside the abbreviation it will correspond to on the template. A list of
initials and corresponding clinicians is also available.
NB - Please see guidelines regarding observation of clinics.
Point of First Contact Clinics

Dr (Dr Only)
The patient group triaged into this clinic have co-morbidities which have to be
evaluated prior to a decision being made with regards to rehabilitation. These
patients are often elderly or have predominantly neuropathic pain.

Dr and Physiotherapist (Dr/Physio)
The patient group triaged into this clinic have predominantly musculoskeletal
problems and reduced quality of life which may be amenable to a rehabilitation
approach.

Dr and Psychologist (Dr/Psych)
The patient group triaged into this clinic are typically highly distressed (identified as a
result of either heightened scores on their psychometric measures or indications
within the free text of their referral questionnaires). These patients may also often
have long standing mental health difficulties.
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Doctor / Psych Clinics with “Doctor Only” patient slots
Psychologist Times
A.M. Clinic 8.30 – 10.00
P.M. Clinic 1.00 – 2.30
Doctor Times
A.M. Clinic 8.30 – 9.15
P.M. Clinic 1.00 – 1.45
Dr / Psych patient 1.
Doctor Only patient “A”.
A.M. Clinic 9.15 – 10.00
P.M. Clinic 1.45 – 2.30
Dr / Psych patient 2.
Initial Hand-over:
A.M. Clinic 10.00 – 10.15
P.M. Clinic 2.30 – 2.45
A.M. Clinic 10.15 – 11.45
P.M. Clinic 2.45 – 4.15
A.M. Clinic 10.15 – 11.00
P.M. Clinic 2.45 – 3.30
Dr / Psych patient 2.
Dr / Psych patient 1.
A.M. Clinic 11.00 – 11.45
P.M. Clinic 3.30 – 4.15
Doctor Only patient “B”.
Final Feedback :
A.M. Clinic 11.45– 12.30
P.M. Clinic 4.15 – 5.00

Trigeminal Neuralgia (TGN)
This is a consultant nurse led clinic and offers a regional service. Patients are
typically referred from Neurology/ Neurosurgery with refractory Trigeminal Neuralgia
via the clinical pathway. Patients are triaged via the standard clinical pathway and
any patients identified as highly distressed would follow the Dr Psychology pathway.

Complex Regional Pain Syndrome (CRPS)
This specialist clinic runs once monthly and will see any patients referred with a
possible CRPS diagnosis. Assessment documentation has been developed in
conjunction with the national CRPS clinical and research group. The pain clinic has
partners in Rheumatology and specialist upper limb physiotherapy and occupational
therapy with a specialist interest in research and clinical management of this patient
group.
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Review Clinics
Medic led follow up clinics

Medical Review Clinic
The purpose of the review clinic is broad and therefore offers the learner the
opportunity to see the effects of treatment. Patients are reviewed after receiving
therapeutic injections and also to judge the efficacy of medication changes. Patients
are also brought back for repeat procedures (acupuncture, trigger point injections)
which do not require a theatre environment. Clinics usually have in excess of 12
patients and there is therefore the opportunity to be exposed to a range of conditions
and their ongoing management.

Spinal Cord Stimulator Clinic
Spinal cord stimulation modifies the perception of pain by stimulating the dorsal
columns of the spinal cord and may relieve pain of neuropathic origin. Patients are
assessed in this clinic with regards to their suitability for this therapy. Patients who
already have Spinal Cord Stimulators in situ are reviewed in this clinic as well.
Physiotherapy led clinics

Physiotherapy Pain Management Review Clinic (Physio PMR)
The aim of this clinic is to help the patient understand the pain management
approach and to engage them in this process. The most appropriate treatment can
then be offered with a view to moving the patient forwards to a pain management
programme if possible.

Physiotherapy Pre-Programme (Pre-Prog)
The aim of this clinic is to carry out a final assessment to identify any barriers to a
patient attending a pain management programme. This assessment includes
observation of physical manoeuvres which the patient needs to be capable of in
order to manage the exercise and relaxation component of the programme. If the
patient is deemed suitable then a consent form will be signed and the patient then
listed for a programme.
Psychology led clinics

Individual Psychology Assessment (IPA)
The aim of this clinic is to assess a patient’s suitability for some form of psychological
intervention here at the Pain Centre. A standard psychological assessment is
completed with the aim of determining the most appropriate plan of action for the
patient.
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Manchester & Salford Pain Centre

Salford Royal NHS Foundation Trust
NHS
Psychology Pain Management Review Clinic (Psych PMR)
As with the physiotherapy pain management review clinic, the aim of this clinic is
predominantly to identify a patient’s suitability for some form of pain management
intervention (either a pain management programme, or individual/joint working). In
addition to the content covered in the physiotherapy pain management review clinic,
a brief psychosocial screening assessment is also completed as patients seen in this
clinic demonstrate higher levels of distress (as indicated by their scores of the
psychometric measures or clinical judgement).

Psychology Pre-Programme (Pre-Prog)
As with the physiotherapy pre-programme clinic, the aim of this clinic is to carry out a
final assessment to identify any barriers to a patient attending a pain management
programme. Rather than assessing a patient’s physical suitability for a programme,
this clinic primary focuses on an assessment of psychological factors which may
impact on their suitability for a programme (including mood, psychosocial history,
other stressors, interpersonal issues, goal areas etc). If the patient is deemed
suitable then a consent form will be signed and the patient listed for a programme.

Spinal Cord Stimulator Assessment (SCS)
During this assessment clinic the Psychologist will determine whether there are any
psychological contraindications for SCS.
Nurse Led Clinics

Tens
The TENS clinic runs weekly by specialist nurses. This clinic template allows for two
new patients and three review patients to be seen each week.

Nurse Led Review
In this clinic patients are referred for medicines management and /or education/
information regarding their pain management plan. Medicines management in this
clinic often involves titration of medicines for neuropathic pain. Patients may also be
seen for trial of TENS if this is in conjunction with medicines management plan.
Patients discharged from hospital on complex medication regimes will also be
reviewed in this clinic prior to team assessment (as indicated).
Theatre Sessions
The learner has the opportunity to observe commonly performed therapeutic
injections.
Monday AM (Theatre D Level 1). Mainly insertion of Spinal Cord Stimulators.
Thursday PM (Theatre 9 Level 3)
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Tuesday PM –alternate weeks (Theatre 9 Level 3)
Friday PM (Theatre 9 Level 3)
Specialised Treatments offered at the MSPC
Spinal Cord Stimulation
Spinal Cord Stimulation was first used in 1967 and is a method of providing pain
relief. Here at the Manchester and Salford Pain Centre, patients have benefited from
this technique since 1987 and approximately 50 new patients each year have a
spinal cord stimulator implanted as part of their treatment.
Chronic Pain is a common condition and severely affects the quality of life of those
who suffer from this disease. Living with an implanted stimulator may improve a
patient’s quality of life and demands a high level of commitment from the patient in
order to increase its chances of success.
This technique is not suitable for everybody and the decision to provide this therapy
involves a thorough multidisciplinary assessment involving a number of professionals
such as a Pain Consultant, Psychologist, Specialist Nurse and Physiotherapist. The
National Institute of Clinical Excellence have advised that patients who suffer from
certain chronic pain conditions should be considered for this type of pain relief
technology.
Spinal cord stimulation involves the placement of a wire (called a lead) in the space
above the spinal cord. When activated by a hand held programmer, the device sends
mild electrical signals to the spinal cord. These signals mask the pain signals from
reaching the brain by producing a sensation of tingling at the place where pain is
normally felt. After a trial period (if the patient obtains 30% or more pain relief from
the device) the spinal cord stimulator is connected to a pacemaker-like device, which
is surgically implanted underneath the skin, usually in the abdomen.
Patients may be referred to the Manchester and Salford Pain Centre by their General
Practitioner or Hospital Doctor .The patient is assessed by the Spinal Cord Stimulator
team at the Salford Royal NHS Foundation Trust who also carry out the procedure.
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Pain Management Programmes
The Manchester and Salford Pain Centre is a national centre for excellence in the
delivery of interdisciplinary Pain Management Programmes (PMPs). PMPs have
been running in Salford since 1983 and are currently provided on a residential and
out-patient basis as part of the comprehensive pain management service at
Manchester and Salford Pain Centre (MSPC). The service accepts referrals from
throughout the UK.
The Pain Management Programme service at Manchester & Salford Pain Centre
complies with the current guidelines for PMPs by the British Pain Society. PMPs are
advocated by the British Pain Society for the management of chronic pain.
What is a Pain Management Programme (PMP)?
A PMP is a group rehabilitation programme for patients who are suffering from
chronic pain. Usually 8 to 10 patients attend each programme. The programme
team is made up of a clinical psychologist, physiotherapist and medical doctor all of
whom specialise in the management of chronic pain.
Chronic pain is pain that has lasted more than 6 months and remains unresolved
despite many different treatments. It can often affect many areas of life including
work, social life, home life, mood and sleep.
Prior to attending a PMP a patient will undergo detailed and comprehensive
biomedical, functional and psychosocial assessment. On the basis of their clinical
assessment the programme team will determine which programme the patient is
likely to gain most benefit from. If a PMP is not thought to be suitable the reasons for
this will be fully explained and other recommendations will be made if possible.
Who is Suitable?
A patient may be suitable for a PMP if the following criteria are fulfilled:
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Chronic pain causing significant disability and / or distress.
Over 18 years old.
All appropriate investigations and treatments for pain have been completed.
No planned referrals to other specialities regarding the pain problem.
Other health problems should not be risk factors for active rehabilitation (e.g.
uncontrolled angina or asthma).
Can manage basic activities of daily living and is self-caring.
No major substance misuse (including alcohol).
No major psychiatric disorders of current significance.
The patient is willing to participate in a group programme involving psychological
and activity-based interventions.
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Types of Pain Management Programme
There are currently 2 types of pain management programme at Manchester and
Salford Pain Centre, the Intensive Programme and the Foundation Programme.
The Intensive Programme
The intensive programme runs each day Monday to Friday (9.30am to 4.30pm) over
3 consecutive weeks. For those patients who live too far from the centre to travel,
local hotel accommodation is provided for the duration of the programme (at no cost
to the patient).
The Foundation Programme
The foundation programme runs for 2 days per week (9.30am to 4.30pm) over 4
consecutive weeks.
For both PMPs there are 2 half-day follow up sessions at intervals of 1 month and 3
months after the programme. Six months after attending the PMP, patients attend an
individual appointment for follow-up assessment and complete a questionnaire.
Twelve months after attending the PMP the patient is sent a questionnaire by post to
complete.
Aims of the PMP
Overall, the aim of the PMP is to help the patient focus on self-management, helping
them to address both the physical and emotional impact of chronic pain on their life.
The programme uses well-established, evidence-based cognitive behavioural (CBT)
approaches throughout all sessions.
Programme Content
Activities include:
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Information and education about pain and pain management
A structured graded exercise programme
Activity management
Goal planning
Flare-up management
Partner / friend / family member session
Chronic pain and intimate relationships (optional session)
Applied relaxation training
Sleep management
Stress management
Problem solving training
Maintaining change
Medication review and advice
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Efficacy
There is strong evidence for the efficacy of both outpatient and inpatient cognitivebehavioural PMPs as a package, compared with either no treatment or standard
treatments. Analysis of Manchester & Salford Pain Centre outcome PMP data
demonstrates statistically and clinically significant improvements across a range of
standardised measures. Patients attending either Intensive or Foundation PMPs can
expect:
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Improvements in interpersonal relationships
Reduced depression and anxiety
Increased physical fitness
Increased likelihood of work retention or readiness to return to work
Optimised medication use
Reduction in health care use
Guidelines for observers
Due to the unique nature of the Manchester and Salford Pain Centre in terms of;
clinicians, inter disciplinary working, varied clinics and interventions offered it is likely
that much of your time spent with us will involve observation. This is in no way a
reflection on your capabilities but simply a chance for you to observe, learn and
make the most of the opportunities available to you to gain insight into pain
management.
The following guidelines will ensure that the team works effectively and cohesively
and avoids misunderstandings developing:
Prior to observing any session(s) please request permission from the clinician(s)
involved. In certain circumstances it may not be possible for you to observe a
particular clinic/session e.g. if a patient is particularly distressed or if there is already
another observer in the clinic. This also ensures that the clinician is able to plan time
in advance to spend with you explaining what will be covered in the session and
providing you with any necessary pre session reading material to enhance your
understanding. Please also document your initials on the timetable in the medics
office by the clinic you have been permission to observe. This ensures multiple
observers are not attached to a clinic as only one observer can be accommodated.
1) The observer is to adhere to the following guidelines in line with professional
code of conduct
Punctuality
Confidentiality
Appropriate work attire
Mobiles/pagers switched off
2) The observer is to ‘observe’ only and not become actively involved in
discussion unless invited to do so by the lead clinician. However observers
are encouraged to remain passively and thoughtfully involved. Clinicians will
be happy to answer questions following sessions.
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Manchester & Salford Pain Centre
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NHS
3) The observer should be prepared to spend time pre and post sessions with
clinicians for explanation and discussion. This is an opportunity to reflect
upon the content of the session.
4) Please remain respectful of your professional colleagues; physiotherapists,
nurses and clinical psychologists. There may be times when you feel that you
are able or wish to offer your opinion regarding a patient’s clinical care.
However, in your role as an observer you do not have responsibility for the
patient’s care and if a medical opinion is required the lead clinician will consult
the patient’s lead medic.
5) Finally, with specific reference to the observation of clinical psychology led
sessions, the psychologists will utilise a Socratic dialogue to elicit clinical
information in a systematic process. During assessment sessions this may
mean that sensitive issues are brought up but are not explored in great depth
as you are not observing a therapeutic intervention.
Why can’t I observe rehabilitation intervention sessions, such as individual
physiotherapy/psychology appointments, or a joint physiotherapy/psychology
session?
It is not possible to observe the treatment/intervention sessions run by the
physiotherapists and/or clinical psychologists. Effective interventions require trust
and therapeutic rapport, this is not conducive when observers are only able to “dip in
and out” of sessions. In addition, therapy is a process of both the content of
psychological therapy, but also the dynamic within the therapeutic setting. When
observers are present this can be disruptive to this process and can potentially have
negative effects upon the efficacy of the patient’s treatment.
Unfortunately it may not be possible to observe the PMP due to priority of staff
requiring training and timing of programmes, time commitment and requirement of
attendance of all sessions on the programme. However where possible professional
needs will be met and you are encouraged to seek out observation opportunities
pertinent to your particular profession/interest whilst also gaining a broad knowledge
of the interdisciplinary team.
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Patient Information Leaflets
The following leaflets have been produced by the Manchester and Salford Pain
Centre and are available in the clinic rooms for distribution to patients. You are
welcome to read and take away a copy of any that you feel may be relevant to your
learning objectives.
Chronic Pain Information:
Explaining Pain
Drug Information:
Pregablin
Oxycarbazepine
Gabapentin
Gabapentin Regime 1
Gabapentin Regime 2
Nortriptyline
Amitrityline
Amitryptiline Regime 1
Amitryptiline Regime 2
Pain Management Programme Information:
Pain Management Programmes (flyer)
Pain Management Programmes-Information for Health Care Professionals
Pain Management Programmes- Information for patients
Intervention Information:
Facet joint injections
GENERAL INFORMATION
Sickness and Absence
The Trust expects its staff to attend regularly for work and not make minor unrelated
ailments a regular cause of absence from work.
Reporting Procedure
If you are unable to attend work for whatever reason, you must personally (if
possible) telephone your Line Manager/Educational Supervisor or leave a message
via Reception as soon as possible 0161 2064791.
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Manchester & Salford Pain Centre
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NHS
For the first three days no certificate is required. For the following 3-7 days a selfcertification note is required. For 7 days or more a medical certificate is required.
Please keep your Line Manager/Educational Supervisor informed of your progress.
Carers leave and compassionate leave days are at the discretion of your
Manager/Educational Supervisor.
On Your Return
You must notify your Line Manager/Educational Supervisor and inform or leave a
message with reception as soon as possible as to the date and time of your return.
Holidays
If you are entitled to annual leave please arrange this with your Line Manager by
completing a standard annual leave form, which should then be communicated to
Karen Johnson.
If you are on placement with MSPC and require any time off please discuss this with
your Educational Supervisor as soon as possible.
Car Parking
If you require a car parking space, there is a waiting list. Priority for the Multi Storey
Car Park is given to shift workers. Those attending MSPC on placement will most
likely need to park on one of the off site car parks at Altram or Store Room. Please
contact the car parking office on 60330 for more information.
If you are a salaried member of staff and are applying for a car parking permit you
will need to complete an application form from the car parking office outside Entrance
3 next door to communications/switch building.
You must not park on the patients/visitors car park, as your car could be clamped.
Catering Facilities
The restaurant is situated opposite the A & E Department at the Stott Lane end of the
hospital.
Catering facilities outside restaurant opening hours are provided by vending
machines, situated by the patients’ kitchen/renal unit, the Accident and Emergency
Department, Theatre, ground floor of Worthington House, The Plaza and on the link
corridor to ladywell (purple area).
The Shopping Mall (Plaza)
The shopping mall is situated in the Outpatients Department, Level Zero, Phase One.
There is a newsagent shop (Open 07.30 to 19.30 weekdays and 10.00 to 18.00 SatSun) which sells sandwiches and cans of soft drinks. There is also a coffee shop
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
(Open 09.00 to 20.00 7 days a week) that sells coffee, sandwiches, hot and cold
meals, cakes etc. It also provides a take away service. A cash machine is situated
outside the newsagent’s shop.
Information Systems/ Meetings
Clinical Governance Committee Meetings
Bi-monthly meetings are held in the Seminar Room, dates are available on the
Clinical Governance notice board in the staff room; protected time is allocated to
ensure you can attend these meetings.
Directorate Meetings
Directorate meetings are held on the Wednesday afternoon of week 4 each month.
All team members are to attend.
E-mail
If you are a salaried member of staff an email address will be issued to you; this can
be used as your first line of communication.
Learning Resources Available
Departmental Library including pain related journals and texts-(see attached
recommended reading list)
Patient Information Leaflets-(see attached list of available leaflets)
Main Library (located in the Mayo building)
Recommended journal articles- (see induction pack)
Documentation
All records to be in black ink
Anything you do must be documented
Records must be legible
Each entry must be clearly dated and signed, with name and designation printed.
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
FIRE SAFETY EMERGENCY NUMBER- 2222
Raising the alarm
Any member of staff discovering or suspecting a fire must raise the alarm (permission not
needed).
Break the glass of the nearest fire alarm call point. These are located at
ward/department entrances and at fire exit doors. The most common break glass call point
is the ' press' type which normally states 'press' or 'push' hard on the glass. Press with your
thumb firmly; the glass will normally remain intact. The other type of call point is the
'smash' type use something firm to smash the glass for example the heel of your shoe or a
bunch of keys. Sometimes it needs several strikes before the glass breaks.
When the alarm is raised the fire alarm will normally sound with a continuous tone (bells),
this will inform other members of staff in your fire zone area. The alarm can also be
generated by a smoke detector.
STAFF GENERATING THE ALARM SHOULD TELEPHONE SWITCHBOARD VIA 2222
TO CONFIRM THE RECEIPT OF THE ALARM AND THE LOCATION.
Fire Doors
Close fire doors this prevents the spread of smoke and toxic fumes. Automatic fire doors
linked to the fire alarm system will close as a response to a fire alarm being generated or a
power failure.
DO NOT WEDGE ANY FIRE DOORS OPEN. DO NOT OPEN DOORS IF YOU SEE
SMOKE OR FIRE BEHIND OR THE DOOR FEELS HOT TO THE TOUCH
Evacuation
It is peculiar to hospitals and other health care buildings that the last thing we would want
to do is evacuate patients from ward areas. A minority of staff on duty care for the majority
of patients in hospital at certain times of the day. Staff should assess the situation for
instance, is there a fire or smoke? If not the movement of patients would be unnecessary.
Obviously if staff felt threatened by a fire situation they should start to move patients from
immediate danger. Staff should not wait for the arrival of the fire service before evacuation
commences.
There are three situations when an evacuation would take place
Extreme Emergency
 Immediate threat to life.
 Fire impossible to extinguish.
 Immediate threat to patient and staff.
 Keep low and move fast.
 Move ambulant patients first then non-ambulant patients next.
 Move horizontally i.e. corridor; to you're nearest safe evacuation point.
 Use your visitors to assist and evacuate with you.
Emergency
Intermittent Alarm Sound
 No immediate threat to life but fire or smoke is likely to spread from an
adjacent area.
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
 Evacuate patients and staff safely.
 Move ambulant patients first then non-ambulant patients next.
 Move horizontally i.e. corridor; to your nearest safe evacuation point.
Precautionary
Intermittent Alarm Sound
 No immediate threat to life but fire is an adjoining area. Follow information stated
for emergency situation.
DO NOT USE LIFTS
N.B. The fire alarm is tested every Tuesday afternoon and can be heard as an intermittent
ring
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Ensure as part of your induction process that you have made yourself aware
of the following in each clinical area.
Date
Inductee
Signature
Trainers
Signature
Emergency
Number
Alarm points
Fire doors/
extinguishers
and locations
When
to evacuate
Evacuation
route & point
Mandatory
Training-if
applicable
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Staff members (plus initials for those on timetable)
Medical Team
TWJ
Dr Tim Johnson
AGL
Dr Abdul Lalkhen
RM
Dr Rick Makin
DMcD
Dr Dave McDowell
JT
Dr Justin Turner
Pain Nursing team
JB
Jill Bentley
AD
Alison Dwyer
MH
Martin Howarth
AL
Angela Leonard
FM
Fionn Murison
CS
Clare Stubbs
Health Care Assistant
Heather Ellis
Psychology Team
HB
Hannah Bashforth
KB
Kerry Booker
KT
Karla Toye
LH
Liane Hubbins
Physiotherapy Team
AC
Andrea Cain
HF
Helen Firth
LM
Lorraine Moores
NS
Naomi Smith
Administration Team
Marie Higgin
Adam Duran
Julie Foster
Karen Johnson
Claire Jones
Deborah Sumner
Vicki Poynton
Wendy Bramer
Reception Team
Denise Kelly
Rosemarie Riding
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
MANCHESTER & SALFORD PAIN CENTRE – STAFF TELEPHONE LIST
CENTRE NO.
CENTRE FAX NO.
0161 206 4002/4791
0161 206 1929
Medical Team
Dave McDowell
Justin Turner
Rick Makin
Tim Johnson
Pain Fellow
Abdul Lalkhen
Extension
6 5927
6 2930
6 8259
6 5696
6 8288
6 0157
Pain Nursing Team
Acute Pain Bleep
DCS Bleep
Angela Leonard
Alison Dwyer
Clare Stubbs
Fionn Murison
Jill Bentley
Martin Howarth
Physiotherapy Team
Andrea Cain
Helen Firth
Lorraine Moores
Naomi Smith
Psychology Team
Hannah Bashforth
Karla Toye
Kerry Booker
Liane Hubbins
Administration Team
Adam Duran
Claire Jones
David Jones
Deborah Sumner
Denise Kelly
07966 263187
07762724774 (M)
07623611235 (P)
84 5272 or 07623 623107
07623 610663
6 1923
6 5939
6 4017
6 4248
6 4168
6 4169
07623 606680
6 1919
6 1917
6 8260
6 8261
6 1968
6 1967
6 1924
68262
6 3189
6 1963
6 1398
6 1941
6 4002
Heather Ellis
Julie Foster
Karen Johnson
Marie Higgin
Rosemarie Riding
Vicki Poynton
CLINIC ROOMS
Room 2
Room 4
Bleep/Mobile/Pager
6 4791
6 4103
6 4136
6 8340
6 4002
6 8031
6 8276
6 8271
Room 3
Room 5
6 8275
No Phone
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Manchester & Salford Pain Centre
Room 6
Room 8
Staff Room
6 8278
6 8273
6 8277
Salford Royal NHS Foundation Trust
Room 7
Room 9
Cleaning
Supervisor
NHS
6 8274
6 8272
6 3591 / 6 3018
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
Manchester and Salford Pain Centre’s Recommended Library
Resources
The following is a list of some of the resources available in the MSPC library
located on the 2nd floor. The access code is C4136. Please document any
books you borrow in the library loans book located in the library. There are
many other pain related books and journals available in the Library which may
be of interest. There is also a PC and photocopier available for general use.
MOSELEY, L
Painful Yarns
GIFFORD, L
Topical Issues in Pain, books 1-5
RICE
Clinical Pain Management Books 1-4
KEER, KEER &
GRAHAME
Hypermobility Syndrome: Diagnosis and
Management for Physiotherapists
MAIN, SULLIVAN and
WATSON
Pain Management
WADDELL, G
The Back Pain Revolution
SHONE, N
Coping successfully with pain
BIELING PJ,
McCABE RE &
ANTONY MM
WINTEROWD, C BECK,
AT & GRUENER D
Cognitive-behavioural Therapy in Groups
Cognitive Therapy with Chronic Pain
Patients
TAYLOR, RR
Cognitive behavioural therapy for chronic
illness and disability
MELZACK and WALL (eds) Textbook of Pain
BALLANTYNE
BASBAUM
The Massachusetts general Hospital
Handbook of Pain management
Science of Pain
COUSINS
Cousins and Bridenbaugh’s Neural
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Manchester & Salford Pain Centre
MACINTYRE
RAJ
RATHMELL
BENEDETTI, F
ROSS, J
Salford Royal NHS Foundation Trust
NHS
Blockade in Clinical Anaesthesia and Pain
Acute pain Management: A Practical
Guide
Interventional Pain management: Image
Guided Procedures
Atlas of image guided intervention in
regional Anaesthesia and pain Me
Placebo Effects: Understanding the
mechanisms in health and disease
Occupational Therapy and Vocational
Rehabilitation
HOLMES, J
Vocational rehabilitation
MOSKOWITZ, GP &
GRANT, H
The Psychology of Goals
D'ZURILLA, TJ and NEZU,
AM
Problem-solving Therapy: A Positive
Approach to Clinical Intervention
TURK, DC &
THORN, BE
Cognitive Therapy for Chronic Pain
Website Resources
Manchester and Salford Pain Centre-www.salfordpainmanagement.co.uk
The Physiotherapy Pain Association-www.ppaonline.co.uk
The British Psychological Society-www.bps.org.uk
The British Pain Society-www.britishpainsociety.org
National Institute for Health and Clinical Excellence-www.nice.org.uk
Recommended Articles
Eccleston C. Role of psychology in pain management. Br J Anaeth 2001;87:
144-52
Harding, V, Watson, P. Increasing Activity and Improving Function in Chronic
Pain Management. Physiotherapy 2000 ;86: 619-630.
Morley, S, Eccleston, C, Williams, A. Systematic review and meta-analysis of
randomized controlled trials of cognitive behaviour therapy and behaviour
therapy for chronic pain in adults, excluding headache. Pain 1999; 80: 1-13.
HELPFUL NUMBERS
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Manchester & Salford Pain Centre
Anaesthetic Department (Clerk)
Anaesthetic Department
Call Centre
Communications
Coding
CD Requests of Scans (David)
CT Scans
Dave’s Private Secretary
Day Surgery
EEG Results
ECG Results
Emergency/Cardiac Arrest
Help Desk
Haematology (Blood Results)
Health Records (request medical
notes)
I.T. Help Desk
MIU
Interpreter Services – Salford Link
Emergency 24 hours no.
MR Scans
Mobile Scanner
MR Booking Office
Laundry
Neurosurgery Physio Dept
PAS Help Desk
Pharmacy (inpatient)
Pharmacy (outpatient)
Physio Dept
Post Grad
Return Goods Store
Salford Link (Interpreters)
Security Emergency Line Only
Security
Shuttle Bus
Swan Taxis
Theatre Level 1
Theatre Level 3
Theatre Elaine Hughes (equipment)
X-ray (Gamma Camera)
Salford Royal NHS Foundation Trust
NHS
6 5107
6 5106
6 4100
6 5350
6 1539
6 4918
6 4928
01282 699914 (Lindsay Mon-Fri / Kirsty
Weds – Fri)
6 5374
6 4613/6 1262
6 4748
2222
6 4500
6 4979/6 4980
6 4805
6 4250
6 5688
0161 787 8219
0468 626 181
6 2091
6 4928
6 0111
6 4519/6 4530
6 1089
6 2445
6 4331
6 1388
6 5328
6 5401
6 1425
0161 787 8219
5555
64436
*6 1668
0161 707 3000
6 5377
6 5073
6 1424
6 4934
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Manchester & Salford Pain Centre
Salford Royal NHS Foundation Trust
NHS
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