Shared medical appointments for patients with chronic pain Devon Doctors Ltd

Around 14 million people in England live with chronic pain and frequently consult their GP. A quarter of these patients are unable to carry out normal daily activities, including work, and many rely on opioid medication to manage their pain.

This project from Devon Doctors Ltd aimed to increase self-management and peer support, as well reduce opioid use, through a holistic approach combining medical and non-medical care for chronic pain.

As an innovative alternative to traditional appointments at a Plymouth GP surgery, groups of eight chronic pain patients attended two-hour shared medical appointments (SMAs) facilitated by a multidisciplinary team including a GP, health and wellbeing practitioner, and practice administrator.

Patients took part in medical consultations, group discussions, simple exercises and some expert sessions, including mindfulness and relaxation with psychologists, and advice from people with lived experience.

Continuity of care helped patients build relationships with their caregivers, and peer support reduced feelings of isolation, improved mental health and encouraged shared learning. Clinicians also benefited from better mental wellbeing and collaborative working in an open, reflective environment.

The average 4.6 SMAs attended by each patient had a significant impact on practice workload, reducing clinical contacts, out-of-hours contacts, medication queries and emergency department attendances by 35%, 14%, 67% and 63%, respectively, compared with the previous year. Over 12 months, an SMA with eight patients was estimated to save 28 GP appointments, and around £406.20 per patient.

Although addressing wide-ranging patient concerns and group dynamics proved challenging, SMAs evolved to become increasingly patient-led, take advantage of pooled expertise and clearly demonstrate an economic and wellbeing case for their use in chronic pain to benefit both those receiving and delivering care.

Contact information

For more information about this project, please contact Elizabeth Edwards-Smith, Project and Change Manager, Evalesco Consulting.