Innovative and successful new pain clinic for the survivors of torture

Chelsea and Westminster Hospital’s Pain Clinic for Survivors of Torture, which started work in November, is the only one of its kind in the UK—and one of the few found in the world—providing an all-encompassing pain service that takes each patient’s physical and psychological needs into account.

The Trust’s Consultant Clinical Psychologist Dr Susan Childs says: “Refugees, asylum seekers and survivors of torture often have a high level of chronic pain. A study from 2013 cited that 25% had post-traumatic stress disorder and 35% of that population were at risk of suicide”—suggesting this population has specific needs that may not be addressed in the usual pain clinic pathway.

Patients are referred to the pain clinic by their GP as a tertiary referral. They then receive a letter about the clinic, explaining how it works and what it aims to achieve.

Dr Childs says: “Often, people have moved from place to place and received different medicines and advice along the way, so one of the first things is for a full medical review to take place.

“Before the clinic was set up, patients would have been offered standard pain management treatment, which could sometimes make the situation worse because some aspects of their care may have triggered memories of terrible experiences—we call this re-traumatisation.”

Dr Childs works with her colleagues Dr Bianca Kuehler, a Specialty Doctor in Pain Medicine, and Sarah Thomas, the lead Clinical Nurse Specialist.

Each session lasts an hour and a half and aims to ensure all the needs of the patient are taken into consideration, whether that is physical treatment, medication management or psychological care.

Dr Kuehler says: “We aim to establish what we can do to improve the lives of the people we see, which may not always be apparent at first.

“For example, through our discussions we found that one man simply wanted to be able to play with his children, so hydrotherapy was the best option in helping him gain the flexibility he needed.

“Often we find that it is not expensive drugs or treatment that people need, but a combination of support services that help them continue to live as good a life as possible.”

The Pain Clinic for Survivors of Torture looks at how the care pathway could be improved for patients, how it can be more joined up and meet all of a person’s needs.

This innovative service is already seeing some dramatic results and looks certain to change the way healthcare is provided for survivors of torture from across the world.