Improving access to the pain service and embedding technology thro the pathway

At the beginning of the year, the complex Pain service at Royal Berkshire started implementing validated questionnaire based stratification of patients referred to the service. They were all then invited to a group MDT education session that has now been recorded and can go online as a webinar. Virtual telephone and video consults were already being introduced as move to go digital. The pandemic has now accelerated the second part where those patients referred for previously a group PMP are now further supported with PAM scores to more personalised online care. High scores of activation on PAM will be offered a unique app based (available on android and apple devices) modular software solution called MyPain, developed in the UK. It is a highly sophisticated digital interface that simplifies cutting edge behavioural science and incorporates it alongside traditional CBT and ACT techniques to enable chronic pain patients break out of unhelpful automatic behaviours. It will be clinican guided as well with automated PROM collection pre and post programmes. Patients with lower scores of activation will be offered a more intensive clinican led online program similar to those before COVID but now done online. We also have concerns about therapeutic alliance and the loss of peer support so are looking into some option of intermitten face to face but these have to be worked out still. It will also allow us to identify a cohort of patients (very low scorers on PAM) more clearly who will need a different commissioned model that accepts long term open care/behavioural coaching and social prescribing) that can be done in partnership with primary care accepting that long term support is the ideal rather than cure and discharge.