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Physiotherapy Pain Association endorses a Four Nation Strategy for Pain Management

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The PPA-endorsed strategy covers provision in all four parts of the UK


The Physiotherapy Pain Association (PPA) has helped the Faculty of Pain Medicine – which is linked to the Royal College of Anaesthetists – to produce guidance titled Four Nation Strategy for Pain Management.

The PPA is one of 13 patient and professional organisations that endorsed the UK-wide strategy, which the faculty launched at the end of last month (30 June).

Thanking the PPA and the other stakeholders for their help, the faculty said the strategy ‘provides a framework where pain management integrates across other stakeholder sectors of health and social care’.

‘It can be used to coordinate, deliver and further develop care using the resources and pathways already available while supporting future quality service developments.’ 

And John Hughes, dean of the faculty, said: ‘The Four Nation Strategy for Pain Management is patient focused from point of first contact including, self-help signposting, personalised care and shared decision making.'

Dr Hughes added: ‘It includes opportunities for health prevention and health promotion, social care, support to live with pain and support networks for those living in pain.’

Why specialist care is needed

Pointing out that many people living with pain can and should be managed in community or primary care, the strategy states that some need specialist pain management services or ‘shared care’ options are needed.

‘Specialist pain services are required where pain persists, does not respond as expected to management or is more complex across any or all components of the biopsychosocial spectrum.’

Specialist pain services also serve to support and work in a multidisciplinary way across services, including

  • primary and community care
  • musculoskeletal services
  • palliative care
  • orofacial pain
  • headache
  • complex endometriosis
  • they also work within specialist pain services, providing complex, individualised interventions across the physical, psychological, and social domains

The Four Nation Strategy for Pain Management is patient focused from point of first contact including, self-help signposting, personalised care and shared decision making [John Hughes, Faculty of Pain Medicine]

Education is 'key'

A key component of an effective service is to create ‘sustainable ways of working’. These would exist ‘across all levels of care including, community, primary, specialist, psychological, pharmacy, physiotherapy, occupational therapy, mental health and social services to maintain high quality, skills, knowledge and understanding of available management option’, the strategy states.

In a section titled People with Chronic Pain (primary Care, community services), the strategy notes: ‘Education is key to engage and support GPs, nurses, pharmacists, physiotherapists and other allied health practitioners to effectively use referral structures as well as support them to manage patients nearest to their locality where appropriate.’


almost eight million people in the UK live with pain of at least ‘moderate intensity’

four million of them have severe pain that stops them taking part in activities, such as the ability to work or looking after their families

there are inequalities in pain prevalence, which is higher in women, those of black ethnicity and people living in more deprived areas

prevalence rates double in people aged over 65

Source: Four Nation Strategy for Pain Management

For more information and to download a copy of the strategy, visit: https://fpm.ac.uk/publication-four-nation-strategy-pain-management

To find out more about the PPA, visit: https://ppa.csp.org.uk

Symposium for non-medical prescribers

Meanwhile, PPA chair Diarmuid Denneny is scheduled to deliver a presentation titled ‘Psychologically informed approaches to prescribing’ at an event in London on 16 November, which will also be available to attend online.

The symposium, titled Prescribing in Pain, is aimed in particular at non-medical prescribers with a recorded prescribing qualification (V300) who are prescribing for people with pain.

For more information about the symposium, visit: https://www.pips-uk.com

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