The BMJ Awards 2017: InnovationBMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1727 (Published 06 April 2017) Cite this as: BMJ 2017;357:j1727
- Nigel Hawkes, freelance journalist
- London, UK
Patients with persistent and intractable pain often ricochet from service to service without finding relief. Their problems are more deep seated, says David McGavin, a GP in Greenwich, south east London, who offers a “whole person” approach based on gaining patients’ trust and encouraging their rehabilitation through gentle therapies.
The patients who find their way to Vanbrugh Community Pain Management Clinic suffer from multimorbidities, of which pain is a manifestation. “You have to move in their direction and see what’s important to them,” he says. “We have an hour long interview to try to find out about them, so they move from being a set of symptoms to being a person in trouble. They’re often debilitated, angry, and suspicious of doctors.”
He uses two therapies, rhythmical massage and eurythmy, a movement therapy, which aim to restore sleep patterns and lift anxiety. Social activities such as crafts, cookery, singing in a choir, and gardening are backed by practical help such as representing patients at appeals to the Department of Work and Pensions.
McGavin works with former pain consultant Ellen Wright, and is funded by a charity, Kairos Rehabilitation Trust, which was essential to get started. “Once you are onside with them, patients want to do what the NHS would want them to do—come off medication, become more self reliant,” McGavin says. Results in 29 patients show a statistically significant improvement in health status, a reduction in depression, and lower prescribing levels and costs. Outpatient appointments dropped by 51% and special therapy appointments by 86%. The combination of practical help and alternative therapies may not be mainstream, but patients …