635: A Review of Referral Patterns and Consultation Outcomes of a Pain Clinic in North East England

Topic: Education, Societal Impact, and Others
Subtopic: Organisation of clinical pain care

Background and Aims: Pain management clinics receive referrals from a range of primary and secondary care services. Understanding referral sources and subsequent management decisions can inform service planning and pathway optimisation. This audit aimed to analyse the referral origins and subsequent consultation outcomes of new patients attending a pain management clinic in Newcastle upon Tyne, England, with particular focus on onward referral, intervention planning, and follow-up arrangements.

Methods: A prospective audit was conducted of 107 new patient consultations at a university hospital pain management clinic in Newcastle upon Tyne. Data were extracted from clinic records, including referral source, whether patients were referred to local pain or physiotherapy services, listed for pain interventions and/or referred on to any other specialties, as well as the planned follow-up with each patient. Data were collected using Microsoft Excel and were analysed along with descriptive comments.

Results: Forty-seven referrals originated from general practitioners (47/107, 43.9%), followed by consultant to consultant referrals (35/107, 32.7%), multidisciplinary musculoskeletal services accounted for 15% of referrals (16/107), others accounted for 8.4% of referrals. Following the consultation, 54/107 patients were referred to physiotherapy services (50.5%). 31/107 patients were listed for pain interventions (29%). Follow-up outcomes included Patient-Initiated Follow-Up (PIFU) in 55.1% of cases, discharge back to primary care in13.1%, scheduled pain consultant review appointments in 1.9%. There were 11/107 (10.3%) onward referrals to other specialties, most commonly to sleep and mental health services.

Conclusions: This audit analysed the journey of patients through the pain management service in Newcastle upon Tyne University Teaching Hospital. Most patients entered the service via general practitioner referral or onward referral from another consultant, illustrating the clinic’s role within established secondary care pathways. The audit also demonstrated substantial use of non-pharmacological pain management strategies, with almost one third of patients listed for interventions, such as steroid injections, nerve blocks, or capsaicin plasters. Patient-initiated follow-up was widely adopted, and a notable proportion of patients were discharged, suggesting effective progression through the pain service and resource optimisation.

References: (1) NHS Confederation. Patient-initiated follow-up. London: NHS Confederation; 2024 [cited 2026 Feb 9]. Available from: https://www.nhsconfed.org/publications/patient-initiated-follow
(2) Getting It Right First Time (GIRFT). Chronic pain. London: NHS England; 2025 [cited 2026 Feb 9]. Available from: https://gettingitrightfirsttime.co.uk/medical_specialties/chronic-pain/

Presenting Author: Luke Davis
Submitting Author: Luke Davis

Senior Author: Sailesh Mishra

IASP 2026 Global Year theme of Neuropathic Pain: No

• Luke Davis: MBBS - Newcastle University
• Edward Ellison: MBBS - Newcastle University
• Martyna Fugiel: MBBS - Newcastle University
• Dr Paul Wilkinson: MBBS, FRCA, FFPMRCA - Royal Victoria Infirmary
• Iain Jones: MBBS, FRCA, FFPMRCA - Royal Victoria Infirmary
• Sachin Rastogi: MBBS, FRCA, FFPMRCA - Royal Victoria Infirmary
• Richard Makin: MBBS, FRCA, FFPMRCA - Royal Victoria Infirmary
• Christopher Coe: MBBS, FRCA, FFPMRCA - Royal Victoria Infirmary
• Sailesh Mishra: MBBS, FRCA, FFPMRCA, MD - Royal Victoria Infirmary