To Be Completed by the RAPM/Independent Assessor(S) for Each Hospital Providing APT

Approval Checklist Form version 1 (June 2014)

APPROVAL CHECKLIST FORM

To be completed by the RAPM/Independent Assessor(s) for each hospital providing APT

Yes/No (where applicable) / Details
(please provide details where applicable) / Acceptable for provision of training? Yes/No
Is training in all essential APT modules provided in one centre? / Yes / Paediatrics and Neuromodulation in Leeds / Yes
Are the following staffing levels available:
Consultants / Yes / 7 chronic pain and 3 acute pain consultants
CNS / Yes / 6 CNS
Psychologists / Yes
Physiotherapists / Yes
Others / Yes / ODP
Number of outpatient consultation sessions per week:
Consultant sessions / Yes / 11
CNS sessions / Yes
Psychology sessions / Yes
Physiotherapy sessions / Yes
Other sessions
Ward rounds per week:
Medical / Yes / 5 acute pain rounds session per week.
0.125 PA allocated to all the 7 consultants for
inpatient pain referral
CNS / Yes
Pharmacy / No
Total number of intervention lists with image intensifier per week: / Yes / 6.5
Any specialised interventions carried out: / Yes / SCS
Facilities including:
Library / Yes
IT support / Yes
Administrative/secretarial staff support / Yes
Training and education / Yes
Formal teaching / Yes
MDTs / Yes
Audit / Yes
Safety training / Yes
Access to written protocols/guidelines: / Yes
Access to PMP: / Yes
Number of PMP sessions per year: / Yes / PMP/ Psychology
Living With Pain Programme (PMP):
Location: Horton Park Surgery
99 Horton Park Avenue
Bradford
BD7 3EG
Brief summary of the personal involved and the format of the programme:
Offer 8 week ‘Living with Pain’ programme, comprises of 8 sessions and each session is 3 ½ hours. This offers patients an opportunity to learn a multitude of skills to help manage pain, and have the opportunity to meet other people with long term pain. This is co-facilitated by a Clinical Psychologist together with a Physiotherapist or Occupational Therapist. The group covers topics such as the differences between chronic and acute pain; goal setting; pacing; acceptance; understanding and managing emotions and distress; mindfulness; self-compassion; communication and assertiveness; healthy lifestyle; medication management; as well as sessional exercises to aid re-conditioning. Also liaise with, and refer on to, individual psychology, pain specialist physiotherapy, occupational therapy, and wider community resources as appropriate.
Access to MDT:
Spinal / No
Headaches / No
Palliative Care / No
Rheumatology / No
Other (please specify)
Service commitment: does the timetable demonstrate that trainees can spend day time hours in pain clinics? / Yes
Based on the timetable provided, are the current training arrangements provided acceptable? / Yes
Is the statistical information for the last 12 months acceptable based on the number of patients and procedures for APT? / Yes

Is centre suitable for Advanced Pain Training?YES NO

If the centre is not suitable, please provide reasons in the box below:

Assessor NameAssessor Signature

RAPM NameRAPM Signature