Your child's appointment with our chronic (long-term) pain service

How do I get an appointment?

Your child will need to be under the care of a consultant paediatrician to have an appointment.

Referrals can be made by their consultant, therapist or GP in conjunction with your child's consultant paediatrician.

We'll contact you to book an appointment after we've received a referral and met with the person who referred your child or their consultant paediatrician.

Changing or cancelling your appointment

Phone: 020 7188 4000
Email: PaediatricAppointmentsRheumatology@gstt.nhs.uk

Please let us know if you need to change or cancel your appointment as soon as possible so we can offer it to another patient and book another appointment for your child.

If you cancel, rearrange or do not bring your child to 2 appointments in a row we may discharge your child from the service. If you arrive more than 20 minutes late for an appointment we'll probably need to reschedule it.

Before your appointment

Your appointment will be at one of our clinics on:

Ocean, ground floor, children's outpatients, Evelina London Children's Hospital, or
Penguin children's outpatients, 3rd floor, South Wing, St Thomas Hospital

Please bring:

any letters from other medical teams involved in your child's care
a pair of shorts and a vest or t-shirt so we can examine your child easier
a list of medicines your child is taking, including the dose and how often they take it
a list of contact details of health professionals who you would like to receive copies of appointment letters
things for your child to do while you wait for your appointment, plus a snack and a drink

About your appointment

Your first appointment will last 1 hour. You'll see a clinical specialist paediatric physiotherapist. It will be virtual or face-to-face.

We'll ask you to complete questionnaires before the appointment.

At the appointment we'll ask you about your child's:

pain and how it is affecting their life, mood, education and the rest of the family
medical history
pain journey
goals

After your first appointment

At the end of the appointment, we'll make a plan with you and your child.

We'll write to the person who referred your child to explain what happened at the appointment and what will happen next. We'll also send a copy of this letter to you, your GP and any other professionals involved in your child's care. It is helpful for you to bring a list of professionals who you would like to receive a copy of this letter. We aim to work with local services and ask for permission to contact other health, education, social care and third sector professionals about your child's care as needed to best meet your child’s needs.

If we think your child needs chronic pain rehabilitation, we'll offer you an appointment in our multidisciplinary clinic to understand more and make a care plan for your child.

Before your appointment

We need all relevant medical investigations to be completed before your appointment and to be sent to us beforehand. If you know there are investigations or results that haven’t been sent to us please let us know, as we may need to delay your appointment.

What to expect at your appointment

When you arrive, your child's height, weight and blood pressure will be taken before we see them.

The appointment will last approximately 1 hour and and 20 minutes. This includes a 10 to 15 minute 'thinking break' for you to think about our conversation and for the team to talk about next steps.

It is not always possible to predict the needs of our patients during appointments. This can sometimes lead to longer waiting times, but we'll always try to see you as soon as possible.

There will be a doctor at this clinic to ask medical questions.

During the appointment:

a member of the team will talk to you about the conversation you had at your first appointment about how your child's pain is affecting their life, mood, education and your family as a whole
a physiotherapist and doctor will examine how your child’s muscles and joints work
we may spend time with your child alone as a part of our assessment
we’ll discuss whether this is the right time for your child to have rehabilitation to support their daily life

We may offer you a feedback questionnaire to complete which helps with our assessment and improve our service.

As we are a teaching hospital, students and visitors may be observing the team. We'll always ask your permission for them to observe your appointment.

After your appointment

We'll send you a letter about the appointment and what we agreed. We will share a copy with other health professionals involved in your child’s care.

We may work with with other organisations such as schools, healthcare professionals, social care and safeguarding teams.

After the chronic pain clinic you may:

continue care with our team which usually involves a compulsory pain education workshop before we can offer your child more rehabilitation support with our therapists
be referred to a local service, such as physiotherapy, occupational therapy, child and adolescent mental health services (CAMHS), safeguarding, social care, or other organisations
be referred to another team in the hospital
be discharged, if we are not the best service for your child at this time

After you have had a chronic pain clinic appointment, you'll need to attend one pain education workshop before you can have any more appointments with us.

The workshop is aimed at children, young people, and their families. The workshop will be online or face-to-face and usually lasts half a day. 4 to 12 families will attend, so you can meet other people experiencing pain.

The workshop covers topics including:

the impact of pain on daily life
how pain works
ways your child could manage their pain, like
- pacing and physical activity
- relaxation and distraction
- sleep hygiene
relationships between thoughts, feelings, pain and what we do in response
resources that may help you

There will be an opportunity for you to ask questions.

We offer a range to therapeutic appointments to support young people and families who are having chronic pain rehabilitation.

You may see one or a combination of occupational therapists, physiotherapists or clinical psychologists depending on your child's needs. We may work together with local services to best meet your needs.

Appointments often last 50 to 60 minutes and are mostly face-face. However, we consider virtual appointments if you need them.

Our team page has more information about how occupational therapists, physiotherapists and psychologists can help you.