News About PMH Complex Pain Service

I’ve just had an email from Bronwen Kelly at PMH answering some of my questions regarding the new pain service at PMH.

Here’s a summary of where it’s up to.  Thank you Bronwen, I appreciate this useful update.

Q. Where is the PMH Pain Service planning up to?

A. The first paediatric complex pain service in WA has been established at PMH, with the first outpatient-based clinic for children and young people with persistent or complex pain occurring on 23 December, 2013. Regular fortnightly clinics will commence in February, 2014.

The PMH Complex Pain Service continues to be developed, with the renovation process of the designated clinic space currently underway and the recruitment of additional multidisciplinary health professionals and implementation of group therapy sessions for patients and parents, expected to be complete by May 2014.

 Q. When might parents expect to gain access to this service?

A. Parents can expect their child to be assessed and treated by an interdisciplinary team involving doctors, physios, occupational therapists and clinical psychologists. Treatment may take the form of group or individual sessions. A key component of the service will be education and mentoring for parents to help them support their child.

 Q. Can you give us some idea of how the funding compares to the Pain Unit at Fremantle Hospital?

A. The integrated treatment team at PMH will involve doctors, physiotherapists, clinical psychologists and occupational therapists, similar to adult services, to address all aspects of the child’s pain.

However, the needs of children with complex pain conditions vary greatly from those of adults. The conditions they present with are often quite different and their treatment has to reflect their psychological and physical developmental stage. It is therefore not appropriate to make comparisons to adult services.

Q. Parents are keen that PMH is able to deliver WA children with the same standard of pain service that adults have access to at Fremantle Hospital – can you clarify what additional resources would be needed to achieve equity in this type of service delivery?

A. (See above)

Q. Quote Pain specialist .. Professor Cousins argues that “to improve the current situation children’s hospitals and palliative care services need administratively co-ordinated dedicated interdisciplinary teams of health professionals, working together to allow equality of access to specialist expertise which includes palliative medicine and pain medicine specialists.” Can you please clarify whether your planning includes provision for dedicated interdisciplinary teams?

A. The PMH Complex Pain Service will be an administratively co-ordinated dedicated interdisciplinary teams of health professionals accessible to any child in WA under the age of 16. Yes as detailed above. Our team will be fully integrated.

Q. Will the proposed pain service be led by a specialist in children’s pain?


Q. Can people in remote areas arrange to consult with the Pain Service via Skype?

A. One of the first interventions the service will offer will be PACE (Pain Activity and Coping Education) Telehealth, which is a pain program that utilises Telehealth technology similar to Skype, designed specifically for Western Australian families where travel may be a significant barrier to treatment. This will allow a child and their parent/s to attend PMH for a one day workshop to learn pain management skills and later receive Telehealth support sessions as they practice these skills. Resources and content for these sessions are currently being developed.

Q. Children with a chronic condition miss a lot of school because of the need to attend appointments and stay home on sick days. This can have a big impact on parents employment. Will there be any early morning, evening or week-end appointments to assist with issues of school attendance and parents ability to work?

A.We aim to provide after-hours appointments and also anticipate that the Telehealth program will help reduce the impact of hospital visits on both a child’s school attendance and a parent’s ability to work.

 Q. Teenagers with chronic pain can become isolated, are there any plans for group sessions to bring these young people together?

A. Children and adolescents and parents who have completed a treatment program will be invited to attend ongoing support sessions run by our team. Parent and patient sessions will be run simultaneously so that young people can spend time with their peers in a supportive environment, while their parents can benefit from spending time with other parents dealing with similar issues.

 Q. Parents play a key role in supporting young people with chronic pain. At the moment there is no training in how they might fulfil this critical role. Is there any plan to educate and support parents to better understand what they can do to promote a good outcome for their child?

A. Parents of children participating in our group programs will receive the same amount of input as their child, with sessions running in parallel.

I’ve requested some more information from PMH about specific contact details for the clinic.  I’ll pass this information on when I get it.