Managing Chronic Pain with Pure Unity Health

At THC Primary Care, we provide resources for primary care leaders, and the focus of this blog is chronic pain.

Managing services for chronic pain has become an increasing focus for Primary Care Networks (PCNs), and for good reason. Chronic pain is a complex issue that often leads to:

• Repeat GP appointments

• Long-term prescribing

• Reduced quality of life for patients

When I spoke with Adam Davies, National Health and Wellbeing Service Lead at Pure Unity Health, we discussed their approach to chronic pain management.

This blog and video is for you if:

• You’re exploring ways to support patients with chronic pain.

• You’re curious about what a chronic pain service might look like in your PCN.

• You’d like to understand how to track patient progress and outcomes within a chronic pain service.

  
  

  Let's jump in!

  
  

Why your PCN should take a closer look at chronic pain

Chronic pain has had a clear impact, both on patients and on demand for services. Often, patients with chronic pain find themselves stuck in a cycle: persistent symptoms, long-term medication use, and no clear plan for support.

The challenge?

Chronic pain isn’t something that can be addressed in a single appointment. It requires time, and a personalised, holistic approach.

This is where Pure Unity Health's service model offers something different for PCNs. 

A quick overview of Pure Physiotherapy’s chronic pain service

The service is led by health and wellbeing coaches, who are accredited through the Personalised Care Institute (PCI) and receive additional specialist training in chronic pain. Many of the coaches have personal or family experience with chronic pain, which helps them connect more meaningfully with patients.

This is not a short-term or secondary care intervention. It’s designed to sit within primary care, with quick access, minimal administrative steps, and long-term support for those who need it.

The service can be delivered:

• Remotely (by phone or video call)

• Face-to-face (where space allows)

• As a hybrid model (a mix of both)

Each PCN tailors the service to proactively meet the needs of their local population. For example:

• One PCN may focus on patients diagnosed with fibromyalgia

• Another may target those on long-term prescriptions, such as high-dose co-codamol

What does the chronic pain pathway include?

Pure's model is structured around three key resources:

1. Understanding pain

Patients are supported in understanding recent developments in pain science. This helps reduce fear, challenge myths, and build confidence about what’s possible when living with chronic pain.

2. Personalised goal setting

Patients are encouraged to reflect on what matters to them, whether that’s walking their dog, socialising again, or managing a flare-up with greater confidence. They then co-create a personalised care plan with their coach.

3. Lifestyle strategies

This includes support with sleep, diet, physical activity, and building social connections. It’s not about “fixing” the pain, it’s about helping people live better with it.

Patients receive consistent one-to-one coaching, and in some areas, they can also attend Pain Cafés, which are informal group sessions where patients within the PCN share what’s working for them and support one another.

How patients are identified

PCNs can refer patients directly, but many also choose to work with Pure Physiotherapy to run proactive searches. These might include:

• Patients on repeat prescriptions for pain relief.

• Patients with conditions like fibromyalgia.

• Frequent attenders with pain-related issues.

The aim is to reach patients who might otherwise not be referred, or who may have stopped asking for help.

Where the chronic pain service fits within your PCN

The service works entirely within primary care and complements other roles, such as GPs, clinical pharmacists, and social prescribing link workers.

Adam described how patients are often referred directly or proactively contacted following a search. And because most appointments are virtual, there’s no need to worry about clinic space, though face-to-face sessions can be arranged where needed.

How outcomes are measured

PCN managers may quite rightly want to ask: “How do we know this pathway is working?

Pure Physiotherapy provides outcome data every month, including:

• Pain Self-Efficacy Questionnaire (PSEQ) scores – showing an average 50–60% improvement. (The minimum meaningful change is considered to be 9–14%)

• Medication reduction – In one audit, 93% of patients reduced or stopped their medication when supported alongside a GP.

• GP attendance – 80–90% of patients did not visit their GP at all during the pathway, and this was often sustained afterwards.

Where the service works best

This service is most effective in PCNs that:

• Have a significant cohort of patients living with chronic pain.

• Are open to using coaching to complement clinical care.

• Can commit to regularly referring patients into the service.

Adam and I both emphasised the importance of network-wide support when implementing a new pathway.

If just one person (for example, the Clinical Director) is championing the service, it can be difficult for the coach to gain traction.

Successful services are those where GPs, practice managers, and wider staff are engaged and involved.

Who is this service not for?

If your PCN is not currently prioritising chronic pain, or if the team prefers a medication-led approach without exploring alternatives, this service may not be the right fit at this time.

Final takeaway

Chronic pain remains a key area of demand in general practice, particularly in relation to prescribing and appointment pressures.

The approach taken by Pure Physiotherapy offers one pathway option to help patients living with chronic pain. This type of pathway won’t be the right fit for every network.

But if your PCN is exploring new ways to support patients living with chronic pain, and wants to offer something beyond medication, it may be worth talking to Adam and the team at Pure.

Contact Adam here: adam.davies@purephysiotherapy.co.uk

About Us

THC Primary Care is an award-winning healthcare consultancy specialising in Primary Care Network Management and the creator of the Business of Healthcare Podcast. We've supported more than 200 PCNs through interim management, training, and consultancy.

Our expertise spans project management and business development across both private and public sectors. Our work has been published in the London Journal of Primary Care, and we've authored over 250 blogs sharing insights about primary care networks.

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