Living with chronic pain can be unbearable, and prescription pain medication brings its own problems: imagine if there were an effective alternative. Imagine If Partnership is a not-for-profit enterprise with a background in community collaborations. Their latest project aims to look at medicine-free (or medicine-reduced) pain management programmes, with social prescriptions, peer support and a wide-reaching digital element.

With a mantra of “skills not pills”, Imagine If has launched Cornwall Connected By Pain with a new community concept known as “Pain Cafés”. Here’s how Smartline helped.

The Background

Imagine If is a Cornwall-based social enterprise, founded in 2019 by community psychologist Kevin Feaviour. A lot of their work involves realising the potential within communities, alongside an understanding of the role that wellbeing and a sense of purpose give the individuals in these communities. Is there untapped potential within a community of patients to manage pain, using tools such as peer support and social prescribing?

Working with pain management specialists, Imagine If took the lead to develop a new model of pain management in Cornwall. The working group, the Chronic Pain In Cornwall team (CPIC) came up with the following goal:

“People in Cornwall living with chronic pain are enabled to manage their condition better using a wide variety of treatments such that opioid usage is reduced and no-one is on greater than 120mg morphine per day (or equivalent)”

The CPIC programme partnered with Dr Frances Cole, who has been researching self-management of chronic pain for many years, resulting in her “10 footsteps” for patients to “live well with pain”.

The Opportunity

The five-year project would see the launch of 15 “Pain Cafes” across Cornwall (initially). These would be led by “Pain Baristas”, a mix of social prescribers, health coaches and physiotherapists, who would be trained in the 10 Footsteps as well as in developing peer support groups. The inaugural meeting for Pain Baristas took place at the Eden Project in January 2023.

Instead of medication, patients would try approaches such as mindfulness, CBT, exercise and tai chi, with a goal to reduce or even stop using pain medication. The power of the peer group would play an enormous role in this, hence these 15 proposed new community hubs. There are so many benefits from this approach, not least mutual support, the reduced stress of community-led treatment, and the reduction of those debilitating “dopey” feelings associated with long-term opioid use.

However, there was a limitation to these plans: geography and access. Cornwall has large rural areas, which makes attending a physical group difficult for many individuals.

To be able to reach more people, the project needed a digital element. Kevin wanted to create an interactive online space, “generated by a community of patients”.

How Smartline Helped

Kevin approached us for support in building and launching a website for Cornwall Connected By Pain. This would be far more than an information portal: it would become a hub for idea sharing, used by both patients and practitioners. Above all, it would create a genuine online community, underpinned by the same peer support values behind the Pain Cafés.

Smartline had worked with Imagine If back in 2021 on an initial Knowledge Exchange diagnostic report for the Pain Café model. Now, Kevin approached us again for a Follow-on Research grant, which would enable them to scope out and create a digital resource. With its focus on interactive community engagement to support health and wellbeing, this project was an excellent fit for Smartline’s remit.

Dr Ria Poole, Smartline Research Fellow, summarises the success of Smartline’s work with Kevin:

“It was great to be able to assist Imagine If with this project and help them consider ways in which they can find out from their service users about how they experience, or wish to experience, the pain cafes, and what is most important for them.  We also supported the team with reflecting on the learning objectives from each session, and how these can inform the evaluation.”

Find out more from Kevin how Smartline helped Imagine If create the Cornwall Connected By Pain digital resource

What are the next steps?

The Eden Project launch was a great success, even making the national press. The website is now live, with helpful Pain Café information pages, and the team will continue to develop the digital portal.

To better understand the impact of Imagine If’s pain-management approach, watch this interview with the project’s patient expert , Sean Jennings.

Sean had struggled with chronic pain for many years, following an operation. Wanting to reduce opioids and feel less “dopey”, he had asked to be referred to a pain management programme. Taking away the medical element, he explained, takes away a lot of stress from the individual, and “stress turns the volume up for the pain patient”.

Sean praises the camaraderie within the community created by Imagine If.

You’re self-managing, but you’re also helping to manage their problems too, because we’re all the same.

The realisation that it “isn’t just me” was crucial for Sean. With plans to take their pain-management model nationwide, Imagine If and CPIC have the opportunity to change so many lives for the better.

Who is involved?

This Smartline project was funded by European Regional Development Funds (ERDF). Smartline’s Dr  Lewis Elliott, Emma McBurney, Dr Ria Poole and Dr Tim Walker worked with Kevin Feaviour from Imagine If Partnership Ltd.

Kevin and colleague Nikki Kelly worked with pain specialist Dr Frances Cole, NHS General Practice Pain Lead for Cornwall Dr Jim Huddy, Royal Cornwall Hospital Trust Pain Consultant Dr Keith and Expert Patient Sean Jennings, along with South West Academic Health Science Network.