The patient has been under the recent care of Acute Pain Service (APS) and fulfils at least one of the following criteria:

• The patient will be discharged from hospital on opiates that have been started during this hospital admission and are likely to be required for more than 7 days after discharge
• The patient will be discharged on adjuvant analgesics that have been started during this hospital admission and is likely to need ongoing management of these medications for over 7 days after discharge
• The patient has persistent pain following surgery or following an injury that impairs activities of daily living
• The patient requires education on simple, holistic lifestyle measures in order to help manage their pain.

Primary Care Referral

• If the patient's acute pain is proving to be too difficult to control, the patient's GP may refer them for follow up within 14 days post discharge from ACH. However we can only accept referrals from patients who were known to APS as inpatients and other referral criteria are met and the patient is suitable (see below).

The GP will need to ring and discuss the referral with the Nurse Specialist.  If the patient appears to be too complex for nurse specialist management a relevant medical pain specialist will be contacted.

Patients who are generally not suitable for referral:

• Those with a history of chronic pain prior to the most recent admission to hospital
• Patients currently under the care of TARPS
• Those with a history of anxiety/depression that is considered unstable
• Diagnosed psychiatric history that is considered unstable
• Recurrent admissions to emergency departments/hospitals for pain management
• Patients with a history of drug and alcohol abuse.

The above patients will generally require a consultant review at TARPS.

www.adhb.health.nz