Summary of consultation model

Below is a summary of the primary care consultation model. It can be adapted based on the individual’s stage of change (level one to four).

Validate

Validation is the recognition and acceptance of another person's thoughts, feelings, sensations and behaviours as understandable.

It can be helpful to summarise what you have heard; i.e. “I understand that you feel this pain has taken away a lot of the things you enjoyed doing.” Validation does not mean agreeing.

Values and goals

Help individual to identify the ‘who or what’ matters to them.

Sometimes people will say things like “to get back to how I was before.” A useful response is “do you think that is realistic?” and they will usually agree it is not realistic. This builds an acceptance of a ‘new normal’ for the person.

What matters most to the person? This usually starts with an initial “to feel better” but when specified it is often practical things that matter; such as getting out more, housework, playing a more active family role, staying in work.

Discuss appropriate goals with the individual. 

Educate / normalise

Explain to the individual the difference between short and long term pain. Tissue damage vs active nervous system.

Signposting

• National guide: NHS Inform Chronic Pain
• Explanation videos:
  • Tame the beast
  • understanding pain in less than 5 minutes
  • Flippin Pain
• Condition Specific: Flippin Osteoarthritis and Flippin Fibromyalgia

Support options

• Relatives, Pharmacist, Physiotherapist/OT, Mental Health Liaison Nurse, Community link worker.
• Third Sector:
  • Pain Concern – 0300 123 0789
  • Arthritis UK – 0800 5200 520
  • Pain Association Scotland

Pain management plan    

• Give key messages around holistic approach and limits of medication.
• Agree prescribing e.g. trial, based on individual’s goals and review. Stop if no improvement in function.
• Live Well with Pain 10 Footsteps for Rehabilitation Plan

Flare up plan          

• NHS Inform flare plan

Clinician resources          

• Live Well with Pain 10 footsteps a practitioners guide
• Primary Care MDT Toolkit – see this resource for example letters to patients