Australis Specialist Pain Clinic is a Christchurch-based specialist pain service which provides Specialist Pain Medicine Physician (SPMP) assessments to ACC community pain services.

Our specialists are Dr Chris Rumball, who is vocationally registered in both Pain Medicine and Occupational & Environmental Medicine, and Dr Palanisamy Vijayanand, who is vocationally registered in Pain Medicine with a background in anaesthesia and interventional pain management.

What the service is

 An SPMP Specialist Assessment under the ACC Pain Management Services community contract. The contract allows the core interdisciplinary team to refer a client to a specialist where there is clinical need for expertise beyond the team. It is a discrete assessment that feeds back into your programme. The client stays with you.

The specialist assessment is done face to face at our rooms at 40 Stewart Street in Christchurch. Video works well for case discussion with your team and for any agreed follow-up contact, but not for the assessment itself as the ACC contract typically requires an in-person assessment.  If there is approval and a clinical reason why we cannot see the patient in person, please contact us to discuss.

What the assessment includes

• Review of prior medical records, imaging and investigation results

• An in-person assessment with the client, usually 60 to 90 minutes, including pain-oriented sensory examination

• Discussion with the IDT

• A written report setting out diagnoses and differentials with reasoning, a formulation, and recommendations for treatment and rehabilitation

• A clear distinction between what is attributable to the covered injury and what is not

• Reasonable communication with your team through the period of the programme

What it does not include

• Ongoing specialist follow-up. If follow-up is clinically indicated we will say so in the report, and it will need to be funded separately

• Interventional procedures. These are separate items and need to be supported by the core IDT and included in the care plan

• Medicolegal or independent opinions. We do not provide these — all of our work is for treatment purposes

When to refer

Refer when a specialist medical opinion would change what your team does next. Refer to the ACC Service Schedule for details, but the common reasons are:

• Diagnostic uncertainty — the pain does not fit the injury, or is spreading, changing or progressing

• Suspected Complex Regional Pain Syndrome. Refer early. Treatment options narrow quickly with time

• Neuropathic pain that needs characterising before treatment decisions are made

• A complicated medication picture — opioids, gabapentinoids, several failed trials, or a deprescribing plan that needs specialist backing

• The programme has stalled, or the team cannot agree on a formulation

• A question about whether further investigation or a procedure is warranted

• Return-to-work decisions needing a medical view on capacity, prognosis or restrictions

How to refer

We have specific appointment slots available for community pain service patients.  You will see the available slots on this referral form, so you are able to arrange the appropriate appointment time directly with your patient.  If you cannot find an appropriate slot on the form, please contact us to discuss.

A information form for patients about this service is available here - it is important that they have a good understanding of the process involved.

We welcome key workers, and patient support such as whanau at our appointments.