Pain Speak
Pain Speak
Voices in Pain - Prof Denis Martin
My guest for this episode is Professor Denis Martin, Professor of Rehabilitation. He is Director of the Centre for Rehabilitation, Lifestyle medicine and Human performance at Teesside university. With academic roots at the University of Ulster and Napier University, he forged an impressive career spanning roles at Sheffield Hallam University and Queen Margaret University, Edinburgh. During his time in Scotland, he also served as a chair of the pain association, Scotland and vice chair of the Scottish Parliament cross party group. He is renowned for his research in pain, disability and rehabilitation, and has over £25 million pounds secured in funding and an extensive publication record. Prof. Martin has led significant projects, exploring the use of extended reality and digital technologies and rehabilitation, and he currently serves as the vice chair of the XR for rehab network and leads a research theme on physical, mental and social health in the Applied Research collaboration (ARC) NENC area of NE England.
The focus of this episode is the Citizens' Jury Report that Denis has led on at the North East Nprth Cumbria. This is going to be officially released on 13th Nov 2025 at NewCastle.
More information of the work of HINENC is available here at https://healthinnovationnenc.org.uk/what-we-do/improving-population-health/medicines-optimisation/citizens-jury-pain-management/
A summary report is available at https://healthinnovationnenc.org.uk/wp-content/uploads/2025/08/CIT-JURY-SUMMARY.pdf
The link to the event on 13th November and further details on how to register can be found by clicking below
https://healthinnovationnenc.org.uk/event/citizens-jury-on-pain-management/
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The Pain Speak podcast is presented by Prof Deepak Ravindran, a NHS Consultant specialising in Pain and Lifestyle Medicine. Dr Ravindran is also the author of the book, 'The Pain Free Mindset'
Get in touch:
Twitter: @deepakravindra5
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Website: www.deepakravindran.co.uk
Linktree: https://linktr.ee/DrDeepakRavindran
Youtube Channel: https://www.youtube.com/@drdeepakravindran5361
For Clinical Queries and consultations, please go to Berkshire Pain Clinic
Order a copy of the Pain Free Mindset here
For Season 1 and 3:
Mixed and edited by Rob Cao at https://dynamiqgroup.co.uk/
Huge Thanks to the The Podcast Coach at www.thepodcastcoach.co.uk
This is PainSpeak with Dr. Deepak Ravindran.
SPEAKER_00:Hello and welcome to PainSpeak. I'm Deepak Ravindran, consultant in pain and lifestyle medicine, honorary professor at the Teesside University, Director at the Bakshire Pain Clinic, and author of the Pain-Free Mindset. In this podcast, I bring you the science, the stories, and the strategies that are transforming how we think about and treat persistent pain. You'll hear from leading clinicians, researchers, and most importantly, people living with pain as we explore what truly helps. From neuroscience and nutrition to trauma recovery, sleep, movement, and mindset. Together, we'll uncover practical insights, the most advanced neuroscience understanding, and fresh hope for a life beyond pain. I'm glad you're here, so let's begin today's conversation. My guest for today is Professor Dennis Martin. He's a professor for rehabilitation and director of the Center for Rehabilitation, Lifestyle Medicine and Human Performance at Teaside University. We've known each other a few years now and we've had the pleasure of collaborating on a few projects. With academic roots at the University of Ulster and Napier University, Professor Martin has forged an impressive career, spanning roles at Sheffield Hallam University and Queen Margaret University Edinburgh. During his time in Scotland, he also served as the chair of the Pain Association Scotland and vice chair of the Scottish Parliament Cross-Party Group. He is renowned for his research in pain, disability, and rehabilitation, and has over£25 million secured in funding and an extensive publication record. Professor Martin has led significant projects exploring the use of extended reality and digital technologies and rehabilitation, and he currently serves as the vice chair of the XR for Rehab Network and leads a research team in the applied research collaboration of Northeastern North Cumbria region. In this conversation today, we focus on the Citizens' Jury report on persistent pain management for the NE and C region. Now, this is quite a large geographical area in the northeast of England, and one of the main challenges historically has been the higher rates of deprivation combined with the relative over-prescribing of opioids. Now, before some of you wonder what a citizen's jury is, let me tell you. A citizens' jury is actually a very recognized and a very innovative public involvement process that brings together people from all walks of life to explore complex issues, to debate possible solutions, and to reach informed decisions. Dennis has been part of the team at the Health Innovation Northeastern North Cumbria region, and they have worked collaboratively with another organization called All of Us to deliver this initiative to shape the future of persistent pain care in Northeastern North Cumbria. I think the report produced here could very well serve as a template for how we can provide patient-centered pain care to the rest of the United Kingdom. An official release is planned on the 13th of November 2025. And if you're in the local area and can make it, please do register. So without further ado, let's dive in. So today I've got uh Dennis with me, Professor Dennis Martin from the Teaside University, and we're going to be exploring and talking about a new project report that has come out that I had the pleasure of being involved in as part of the oversight group. But uh I'm very fortunate to have Dennis with me on this episode of the Pain Speak Podcast to tell us a little bit more about the Citizens' Jury report and what it means for pain management, especially in the Northeastern North Cumbria, which is where this report evolved from. So welcome Dennis to this episode then. Thank you, Deep. Thanks for the invite. I'm glad to be here. Brilliant, wonderful. So before we start off there and look deeper into the report, do you want to tell us a little bit more about yourself, your role, and your background?
SPEAKER_01:Sure. Um I'm a physiotherapist by background, and um I've been working in the area of PN research for 25, 30 years perhaps. Dear me. Um I'm uh professor of rehabilitation at Teesside University, and I lead up the theme for the regional arc on um physical, mental, and social health. Um I got involved with the citizens' jury. Um really, it's it's an idea that has been in my head for a long, long time. Um many years ago I came across the concept of citizens' jury. Um it was something I read about a group in America called the Jefferson Centre, and they were pushing this idea, it was a new um way of engaging the public in policy making. Um and as I say, when I was in Scotland, we I actually made links with the Jefferson Centre, and they had agreed to come over to look at the idea of running a citizen's jury. Um but uh there was some um I I can't remember the specifics in the states, but um they didn't want to fly. And basically the idea got shelved and moved on to other things, and uh um it stuck with me though, and I'd seen it coming up as an exercise which um was becoming popular in Ireland and for some of the um policy-making things they were doing over there, and then it's seen that it was something was on the government's agenda actually as a vehicle for exploring issues with the public. So it's sort of emerge with it, and within the role in the arc, um it it it was something that was fitting. Um and then I spoke to Julia Newton in Heinink, and Julia um worked really hard to get the funding together. Um, she put me in contact with Vicky Strassheim in Heinink, and then the two of us working together in Heinink.
SPEAKER_00:Heinink is essentially the health innovation network of Northeast and North Cumbria overall. That's it, that's it, yeah, yeah.
SPEAKER_01:And um myself and Vicky then worked with Olive, um, previously known as Stand, um, and Olive us were the company who we um contracted with to deliver the the jury process. So that's basically it. It was my idea, um, funded by Julia in Heinck, and in partnership with Vicky, and we worked with Olivus to design and deliver the whole thing.
SPEAKER_00:Brought it all together. So is this a first of its kind then? Because when I was sort of invited to be part of the oversight group, I'd never heard of it before. Is it the first of its kind in the UK and specifically in healthcare?
SPEAKER_01:It's been um been done before in various aspects of healthcare. Not a lot, not a lot. The the one I'm um most familiar with was one um I was doing some work with the AHSN, as it was then, um, about um people giving their health and social care data up to big databases. Right. Um, a team in Manchester um ran a citizens' jury on that. So I um went to their dissemination event and saw the um the report, and it it was fascinating what they did. And I thought, well, it it kind of kept the idea brewing in my mind for this. So there's been a few, um, but not many, and I think this is this is very much the first one on pain management.
SPEAKER_00:And for those of us within healthcare, but specifically within the side of secondary care and primary care hospitals set up there. What do you what would what is unique about the citizens' jury and in what ways is it different from doing the standard sort of PPI, patient partner involvement at the start of any trial or there? What are the salient differences you feel?
SPEAKER_01:Yeah, yeah. It's linked in with all of those, and those are all very valuable and um useful processes, great, great processes. Um the difference with this one is um I think what this one does, it gives it it's in the title of deliberative. Um, and it gives the opportunity for people gives to um take the time to really become familiar with an issue. It gives them the space to think about the issue and think about the wide uh areas of the issue, think about it in the round, and it gives um the sort of the culture to debate it and listen to the various things, and then try and sort of um form up an opinion. So a lot I think it's the time, the sort of um supply and condensing of the information and the openness and the culture to come to an informed decision rather than sometimes give a snapshot of what you're thinking at the time.
SPEAKER_00:Right. So it's it's the deliberative aspect of it, of it then, and the time there, and certainly that that came out there. So the report in itself, the guiding question that the oversight group, which I was part of, and we were helpframing there, and I'm very curious to know when you talked about you, Vicky, and all of us there, how was the decision made around choosing who would the jury be? And is the oversight group then necessary for every citizen's jury, or was this a specific amendment in this case by yourself?
SPEAKER_01:Yeah, um the the oversight group, the oversight group are really central to this, and it's it's a lot to do with the the question. Now the question, the question is really central to the whole process. That's really important to get to get right. And one of the key things with that is that the question should be relevant to agencies who can actually make a change. Right? So a temptation would be, for example, for me as somebody with my idea, for me to come up with a question, and I had loads of questions, and I really had to uh pull myself back from uh pushing my agenda. Right, because I can't make the change. I just can't, um, and that's fine. Um so the idea with the oversight group is that we can get a question and then it goes to the oversight group who can help to shape it. So the oversight group are there to provide a sort of a diverse range of expertise and opinion from agencies and groups who can actually help to deliver the change or make recommendations that can possibly result in change. We maybe come back to that um as an important part of the outcome. So the oversight group were central to it, and setting the question was the the real sort of link with that.
SPEAKER_00:And and the oversight group, I think we came to this arrangement, or rather, and I remember the a lot of thinking and to and froing in arriving at that, and that was felt like a very essential part of the process, like you highlighted. And the question was how do we achieve a shift away from medical intervention in order to better support people who live with persistent pain? I know there was a lot of deliberation and specific thinking in how to exactly get the wording right. And then in your view, as one of the chief uh instigators and and the person who's brought this to life now, why is that wording important and how do you think it shaped how the jury then deliberated on it?
SPEAKER_01:Yeah, um as I say, I think the question was central, and I mean it in some ways it was torturous um coming to it. And it took it took a long, long time. I remember yes, absolutely even before it got presented to the oversight group. Um there were lots of options that were floated and dismissed. Um but we came to this one um now and I think what was important with this one was um this was linked with something which had been brewing within the ICB. Now it came up from some documents from their medicine strategy where it was highlighted that um it was linked with um moves for deprescribing with opioids, and it was sort of highlighted that one of the key things to help that would be to get a culture shift in the population away from the reliance and sole reliance often on medicines. So you you you could see how initial questions were sort of put forward that you know, should we de-prescribe, how should we de-prescribe? And that kind of thing was seen as perhaps a bit narrow. Um, but when we looked back and saw this statement um which was floating about, it was a powerful statement, it was an ambitious aspiration, and that was one which um seemed to connect with the wide issues, and then we presented that as one of the options to the oversight group who it connected and they took it and shaped it, but there were and there were subtle things in that. For example, the question had culture in it, the word um culture was in the question, but actually within the group that changed into the phrase a shift away from, which sounds a little bit um nitpicky, but actually I I think that wording was important because culture presenting that to the jury could have taken off in a different direction. So there was a lot of back and forward um and a lot of time and effort, but I I think it really, really worked um for that. And it's interesting to look at the question. There was a new and spit in it, and you can see that the question is how can we shift away from yeah now that was deliberate rather than asking, should we do that? We did take a jump and thought, okay, right, the starting point is um there should be a shift from then. And I emphasize the over-reliance on a medical approach. So we didn't primarily ask that question, should we? It was more how should we to try and feed into that what we saw was an ongoing debate. Okay. So it went round the houses a lot, but I think it was vital to the process. The oversight group were vital. It would have been different without them, it wouldn't have been as good without them.
SPEAKER_00:Well, before we delve sort of deeper into the report and how it came about, do you want to give a sort of high-level overview of the final output and the six recommendations that you arrived at?
SPEAKER_01:Yeah, um the the recommendations um they're in the report we had um we've got six. We have um in no particular order in my head, and there's one about um having a public awareness campaign or more public awareness campaigns, but specifically taking a social marketing approach to that.
SPEAKER_00:Right.
SPEAKER_01:Now that's interesting. That's rather than a sort of a a blast to the whole population, it's identifying and segmenting the population and targeting the message in the media to them. That's that's that's got a lot of potential. Um there was uh one about pushing um persistent pain as uh recognizing that as a long-term condition in itself, which um is something that's been around for a long time. I think that's a very powerful one. Um there was one about uh that education on persistent pain should be mandatory in training for health professionals. And again, um it was interesting to see that that's one that the jury picked up on. Some of these things you it's something you could look at and go, okay, well, that's obvious, and there's maybe something you know we've been hearing about um before. But what's really interesting is how the the jury, the members of the public, picked on those and pushed them. That's where the real sort of value and advantage of this comes in. Um there's an interesting one about um a call to have an independent institute for that, yeah. Yeah, that that that's something I think we'd really like to explore and see um what what was really driving that. Um and there was one about that the jury should be kept involved um and should be able to feed back into the process. And I think the word was keep the agencies accountable for working with the recommendations. And the other one, the last one, um, was that uh it it it was a desire to see local hubs put in place and where people could um get support and advice um and access to um facilities that were of relevance to them locally and geographically accessible. Um so I think I think those recommendations came up and the fact that they were picked on and deliberated and these emerged from that group, I think were really, really powerful to see them.
SPEAKER_00:Definitely. I I think and it resonated very well with what we were hearing in different parts. You know, I'm based in the southeast in Berkshire, and I would say that at one time or the other, any of those six recommendations are things that patients have also requested for. I think apart from the the request for an independent pain science institute, this was probably the only one that surprised me and what emerged from that, but I can understand the feeling that came through there. With the citizen involvement, you know, which was the call of citizen's duty there. I saw in the report there that over 300 people applied, and then 14 were selected to reflect the population, many of them with lived experience. How did you arrive at that final number? What was the process, selection process involved, and was that challenging on its own?
SPEAKER_01:Yeah, well, um this was um the this was really something that all of us did. All of us were really, really good with the um the organization of this. Um the positions were advertised as jobs, right? Okay. So they were paid, and so they went out as job adverts, people applied, and then all of us did um uh sort of a sifting and a recruitment process. And the idea was to try and get a range, a suitably diverse range of opinions and um experiences and backgrounds. That that was the idea, and um it had a mix of some people who were experiencing persistent pain and some people who didn't. Um the number that that number of 14 is it sort of fits in with the recommendations for running a citizen's jury. Right. It seems large enough to get that diversity, but small enough to keep your process manageable.
SPEAKER_00:Okay, so it's almost a validated number that's come from prior citizen juries that have been had. Okay, that makes it. And does that reflect the same with the expert witnesses? Also, your choice of having about 17 expert witnesses there. Was that also again uh a number that arrived at to get the broadest opinions?
SPEAKER_01:Yes, yeah, yeah. And um the the the idea behind that and how that number came up, it was to um it was to get as much relevant opinion and diversity of opinion as we could, and trying to get not just one opinion, but trying to trying to get um different sides of it. That was important. Um we also um wanted to keep keep the number again manageable so that the information that was given to the jurors by the witnesses was done in manageable chunks and didn't overwhelm them, but was comprehensive enough so they could get get the picture. And um again that that that worked really, really well. And the oversight group were really important in that in helping to identify um what opinions were necessary and who um was around and who was expert in that field to try and get everybody together.
SPEAKER_00:Okay, absolutely there. So when we now look at the recommendations, you outlined the the six recommendations that are there, you know, from the pain campaign to a pain institute there. Which, in your opinion, with with your long sort of experience of dealing with with the NHS and from the outside with your academic hat on, which of these six recommendations do you think has the most potential to drive change, and if so, why?
SPEAKER_01:Yeah, I think they all do. That's not me sitting on the fence. I think they all do, and they all link together, right? They all link together, and I think that that's wholly appropriate befits such a sort of a complex issue and um linked to the question. So I think they all they all do link together very well. My opinion is I think the long-term condition one has the potential to make a lot of change. Um I think if and when that's done or where that's done, I think what I saw was it it can open up the doors to um have pain linked in with formal policies and strategies about long-term condition management. For example, up here I've I've I've seen a document um from the ICB about uh policies and processes and systems for dealing with long-term conditions and multiple long-term conditions, and these are really good. I think these are really good. They do link into um sort of biopsychosocial approaches, which I think um is is firmly in what we need for persistent pain management. But pain doesn't it it doesn't merit a mention at all within that. So those systems and policies, when I look at those, those fit very closely with what um I've always heard should be there for persistent pain, but it's not there. I think seeing it as a long-term condition puts it into that and place, puts it into people's minds, and I think it could make a lot of difference. Otherwise, I think it can get lost and overlooked.
SPEAKER_00:Definitely, Dennis. I I would also agree, and uh I was having a recent discussion with some of the members from the Getting It Right First team. So, you know, GURFT now in the UK has got a separate team for persistent pain and high impact chronic pain. And one of the conversations that has happened in there is what are the mechanisms to get persistent pain to be recognized as a proper long-term condition alongside diabetes or obesity or asthma or COPD, because absolutely like that. That would make a big difference in how primary care and how GPs and commissioners and policy makers view the condition and allocate funding, which then, as you said, can drive a couple of the other recommendations much easier.
SPEAKER_01:Yeah, we had this in Scotland actually. Um, when I worked up there, I was chair of Pain Association Scotland. Right, okay, which was fabulous. And um was that? Okay. Yeah, a Pain Association. Uh we we set up a public meeting um which was um really good and invited Nicholas Sturgeon along, who was the health minister up there at the time. Yeah, and Pain Association, a lot of colleagues around, had been lobbying very hard to do that to get recognition uh of um chronic pain, as we called it, uh, as a condition in its own right. And actually, um the the Glasgow Herald uh on the morning of this public meeting ran with a story how Nicholas Sturgeon had said that persistent or chronic pain was a condition in its own right. Um she turned up and presented at the meeting. The meeting was to try and force her actually to move on the thing, and she did it on the morning of. So she shot the fox, I think. But um it it I think it does open up um opportunities, it it opens doors for um to I don't know, provide a framework for doing the things that people are trying to do. with within the existing system. That I'm very important. Social marketing thing, I think in the public campaigns, I would love to see that happening. That'd be fascinating. I think really bringing in marketing and advertising expertise and um in with the practice and academic and research expertise I think would open up a a new scene of activity with absolutely I think that that is an angle we need to get better at doing it.
SPEAKER_00:Some of what I'm trying to do now with some of my social media and and podcasts is to get the same message across in different formats.
SPEAKER_01:And I think one of the recommendations that came out this kind of social approach to marketing and the awareness campaign that's built around and and specifically it's about taking the eye out of pain isn't it is that is that what one of the theme or the tagline for the social media campaign was yeah yeah um ash one of the jurors um ash was very engaged with this and he came up with that idea yeah and that idea is very much that it's not um something that people should be dealing with on their own it requires that um support and network and understanding and and again that uh you know it it it looks like a simple thing but um that idea I think could grow and it was interesting the jury the jury really did latch onto that social marketing aspect of the campaign they'd seen they talked about this uh um at length they'd asked um for evidence uh for the the effectiveness of um public campaigns and some of them were skeptical about it um but they they looked at the evidence and saw there was um strong evidence but they they saw the need for more they saw that that um these things could be improved and social marketing and was something they picked up from some of the witness statements that they thought was something and should be put in place so yeah there you go no absolutely and I think definitely and it it's quite a catchy one there and as you say we'd have to put probably the money behind it and a steam behind it to see it take off and and start to come on billboards everywhere and get people talking about it. So I think I look forward to seeing how high Nank in the first instance presumably this report is going to be in front of the Northeastern North Cumbria ICB as it were and and it got me thinking about the one of the other recommendations that you talked about as well and that's in the report is this concept of frequent meeting with the jurors to have some kind of accountability it feels a little tricky do you think that the local commissioners would be looking at this in a more favorable option with the NHS culture that's happening now I think could do could do and I I think um the the conversations are there people are talking about that involving the public more involving patients more and people with experience and I think the the value of that experience is recognized and um there are systems and processes put in place to do that. So I think there is the expressed willingness and there is some direction to do that. I think that needs to be picked up more mainstream. What you have here with this jury now is a uniquely very very well informed um group on this particular issue and a willingness and desire to stay part of the process.
SPEAKER_00:Wonderful and so these are people then will there be an opportunity to sort of reach out to them again in six months' time and this is what you mean by accountability and progress sort of giving them a progress report of what changes have been made or in the process of happening. Okay. One of the other interesting things was the training and education now has even opposed to five years ago when I uh came into this space and became aware of the various organizations we've got so many more national and regional organizations involved in training and education to me that recommendation kind of felt doable uh even in our own neck other words we're aware of Cormac's work and flipping pain that's there but do you think the barriers around funding and all that will be something that is addressed then locally to ensure how we bring about good quality training for healthcare professionals?
SPEAKER_01:The training thing is an interesting one deep hack now I think because I'm because this the this is my area yeah um it strikes me as bunkers why it isn't right but I think well I mean everything's there right everything's in place ethic the European federation have got a curriculum right it's set out um and it's pretty clear and it's adaptable it's something that um educators can take and use the it it's there's the expertise is there um but it's not it's not it it's not uh mandatory it's not in every place. There's examples of good practice. I think I I I think I I I know one of the issues is that the the curriculum is crowded and it's it's crowded and people who are are pushing their bit push the importance of it and rightly so and so it's where's the space in the curriculum that's a difficulty. I think again when I was up in Scotland um I set up an MSc in pain in Queen Margaret College as it was then now Queen Margaret University in Edinburgh and um set that up as one of the first in the UK and it worked really well and it was really when sort of pain management was a novel sort of approach. So I think it fitted all right there it was a self-selected group of students who took it at master's level and there were small numbers and they were there were specialists and that kind of fit it but it doesn't fit now paint management isn't a new thing and it's established it's across the board and I think um I think I I think it should be standard within the curriculum of all the ones I think it needs local champions within the courses to pick it up and really push it through. But again that that that that's difficult and it's not widespread. If the professional bodies I think if the professional bodies put out a statement this should be mandatory in the courses and your curriculum then it would happen.
SPEAKER_00:Yeah and I certainly I know that the RCGP and and a lot of other institutions do have a kind of pain study day or they have a complex pain study day persistent pain studies I do see the ads for it there. I think it's still almost left as a a subspeciality or a super specialty if you will people are expected to have the basic competencies in the field and then if they want some CPD points they're encouraged to come along and do another module or a study day on pain and somehow you're right that that is the part we need to change to see how we can get it further into the curriculum. Even within our Royal College and I think medical schools we've got most of the medical schools now willing to have some kind of a version of pain education in the second or third years but it's still often a special study module which is optional rather than something mandatory. That's the change we need to think about making it more necessary or ensuring that the basic pain science education that Plippin pain talks about is almost standard of care.
SPEAKER_01:Yeah yeah yeah it's I mean the the optional bit I think you hit the nail on the head I think in practice um dealing with people with persistent pain isn't an option doesn't matter where you are and given the prevalence of the problem we really can't let it be an optional state anymore. Yeah you will find them or they will find you exactly no absolutely I think no this has been really helpful and actually I wanted to go a little bit deeper into these parts here in in terms of the overall process you know as I said citizen juries is a new thing and and you've brought it finally it looks like it's one of those long dreams that you've realized through this process here um do you think obviously it sounds like it's been very valuable and now the final the next steps for this so tell us a little bit more about the next steps for this report how is it going to be made more public and what are the next steps looking like and from your personal perspective is this something that you feel you could now replicate in another place this deliberative model of health service design would you be keen to do it again in in another setting for another condition yeah yeah um I think the next step the next um next next formal step in November we're having a conference symposium uh dissemination day um and really that's presenting um this is on 13th of November in Gateshead um it's on eventbrite widely available all are welcome um and what we're going to do there is present the process present their recommendations and then really um put those recommendations out to the audience to again get the get their thoughts on them and again looking at the relevance of them for that group and for some ideas about how they can be implemented. The important thing and it's it it it's a strong point to make the recommendations the recommendations are there and they're out there for agencies who can make change and what what we want are people or groups organizations or whatever to look at those at the very least take them into consideration in the policy making but hopefully take them and try and do something with them. We talk in research about pathways to impact taking research findings taking um recommendations like this and then actually putting them into practice so really what I what I would like to see the recommendations are there now and we'd like to see groups or people taking them and making something with them.
SPEAKER_00:We're not precious about owning recommendations they're out there we've put them out there we'd like to see um them turned into to something real and there's this urban legend that sometimes getting research into implementation can take years if not a couple of decades is there a plan or a hope from your own perspective on how you could speed this up or how you could break that barriers down?
SPEAKER_01:Well I think that that's the value of this event that we have now is trying to get people to come together who are interested in the recommendations and people who have um leverage to make that change and really try and put them out there and get people to take some ownership of them and push with them.
SPEAKER_00:Okay so and I think what will hopefully emerge from the November 13th meeting in Gate said is this going to be uh online or hybrid? It's an online option as well or is it just going to be it's in person.
SPEAKER_01:It's in person.
SPEAKER_00:We want people to to come together and mix and makes makes sense in terms of the networking and and the sort of effect of dissemination is much what better than it should be there in person.
SPEAKER_01:But I mean the the it as I say you know we we're not precious about them and I I think say if somebody right now pick one um pick one at random the local hubs right um a word that was put about a lot in the um discussions with the jury was this idea of synthesis and the the likes of the local hubs doesn't have to be something brand new that's set up could be if that if that fits but if there's something like that is already proposed then the recommendation there would be to make sure that pain persistent pain has a presence within it and and the value of the recommendations coming from the jury is if somebody has this idea that it's something they want to do, they want to make training mandatory in um education. If that's your idea a sort of a top-down idea when you've got this bottom-up recommendation take it use it put it into your proposal and help that to push what you're trying to do I think that makes so much sense and presumably you're also in the process of sort of writing it up and and publishing it as well as there so you're going to be really ensuring that there's reports available in every form in every format if possible. Yeah yeah um and we'll do that without um some um interest from various groups to to do that and one of the things um that I would like to get my teeth into is to look at the actual discussions that took part or took place and try and look to see how um the discussions changed opinions and where they were going where they came back to and came to the place that they are at the minute. Brilliant I mean and in some ways that ties in with one of the questions that I asked and I know we diverge off there um what has been your reflection would you run a citizen jury again would you do again like the process yes absolutely yeah I would um I would do and um I'd um I think what I would do I'd get as involved as I was and I would make sure that um we would link up with all of us all of all of us were central to this and in providing the organization keeping this the processes fresh and um Sue Ritchie in the deliberations for example was really really good at keeping things bouncing along um and keeping keeping the jury focused and excited and activated so yes I would and um I wouldn't do it on my own.
SPEAKER_00:Yes okay I wouldn't do it on my own I would make it seem like there's our big teamwork and it's always important to have organizations that can actually enable and facilitate this to happen at scale isn't it absolutely I think I enjoyed the experience as well of how it was conducted and supported as a member of the oversight group so really enjoyed it. Well now this is this is the part which I'm sort of trialing out as well new with my with my podcast there so these are going to be a set of slightly more snappier shorter questions and I'm looking up to see whether you're up for it a bit of a rapid file a word or a sentence or a few words to for these next few questions is that okay yeah okay so what's the first word that comes to your mind when you hear the words persistent pain persistent I think persistent is how it's managed to stay as an issue for so long okay if you had to describe the citizen jury and you want to give it three words what would they be? Oh gosh um privileged to be part of that's there's three words there okay we'll we'll we'll leave the prepositions out there okay which recommendation would you would you love to see implemented tomorrow if you could long term can recognition as a long-term condition I know you said that part there and yes I'd love that as well what would be one very surprising or really something that stuck to your head a word or a sentence or a reflection by a juror during that process anything that struck you um yeah there was one which struck me and surprised me and somebody not verbatim but sort of said first time anybody's listened to me.
SPEAKER_01:I don't know why I was surprised about it because I've heard it frequently over the years but um still still came out there yeah exactly still there um how do the expert witnesses you had 17 expert witnesses there was there anyone whose information content took you by surprise or or stuck with you the most um of all of the all of the expert testimonies were really really good all all of them were superb they showed expertise they kept them short and snappy and to the point following the brief they were all brilliant um one which uh sits with my sort of personal interest at the minute Chris Eccleston spoke about the potential of digital technology for reaching out to the vast numbers where personal contact can't and perhaps is unlikely to ever be able to um Matt Catsy Matt who um unfortunately um died um recently since giving his his testimony um Matt spoke about Matt spoke really interestingly about the the culture in AE and paramedic practice which by its nature is very medical and very biomedical um which stuck with me about while I'm very very much for uh shifting away from a reliance on a biomedical approach um it really did sit with me about not chucking the baby out with the bathwater and recognizing the value of that expertise and practice while still shifting away. Matt's Matt's thing um was very powerful and you could see the jury got really engaged with that. No absolutely I can see that there right I have a feeling I might know the answer to the next one but I'll still go and ask it if you had the budget to design the billboard for paying information to the public what would that slogan be ah gosh um it would be cliched and embarrassing and cringy and I'd probably leave that up to the social the social marketing people who would take it up and um do it properly and effectively good a good way to deflect away from that okay I'll leave you away for that so what gives you the most hope for pain care within the NHS Dennis from all this that you've done um I hope it's not naive um but I think what what I see is um I see there's new generations of clinicians and um researchers and advocates coming up really pushing um the these ideas um there's a lot of a lot of history in it and a lot of the um people who've been really involved and for many years and Lorimer and Chris for example who were um some of the witnesses are really bringing people up and new to the fields then there's a lot of a lot of initiatives um I mean there was one I was part of a webinar um wasn't part of it a listen to it um and it showed a very exciting innovation and we've got in James Cook Hospital here in Middlesbrough there's the residential um program linked with the pain pathway right I remember was something years ago when all this was starting out was discussed and debated and it's kind of there now and you can see the people who are passionate in it and are really um pushing on it. So there's a lot of a lot of momentum and innovation and um really good people to push these ideas but it's still a push it's and I we we can see that from from the jury and from that process it is still a push and needs needs an awful lot of work still it is it is no I agree and I and I think that's what um gives me the encouragement and hope to also do the work that I'm doing now and trying this podcast and trying various ways because I think we all need to be part of that movement to keep the push on uh and and part of this podcast season and this episodes are all about trying to bring attention and shine a spotlight on so many wonderful organizations, people events that are raising sort of the awareness of how much there is to do for pain but how much there is already happening in terms of really good areas of practice and exemplars across the country and part of my effort is to just use my if channel and platform to shine a spotlight on on all of these happenings there.
SPEAKER_00:So I think I agree with you. I think the hope is there and I think we have still a long way to go as Robert Frost would say uh before we before we sleep.
SPEAKER_01:Brilliant I I I think what's what's really interesting deep hack is some of the things that for example were seen as very peripheral when I was starting out things like self-management um you know the likes of of Pete Moore and his toolkit um association and pushing these things were seen as very much extra different and are now you know through supported self-management seen very much as part of the picture social prescribing the lifestyle medicine and stuff that you're pushing these are all now seen as um key things and are being debated as such and in places implemented which I think is a um a big big plus and very progressive so and the fact that this is again becoming a common practice for a lot of other long-term conditions gives us the hope that if as you said if the one recommendation that comes away from this is we get pain to be recognized as a long-term condition, then it automatically means all that wraparound support that's being offered to diabetes and other long-term conditions will automatically be offered to our persistent pain population. Yeah and I I think actually you know sometimes what's interesting you hear I I hear the same questions being asked um that were sort of being asked years ago but maybe none of the things shifted from being why to why not why not and I think that's that's useful. Great and I I think that's a great way to end the conversation as well as to say why not and why are we not doing more of this well Dennis thank you so much for your time today uh is there anything else you wish to sort of talk about or bring to the attention of the audience there and if not where can people sort of learn more about you and your work are you active on any social media channels that I can sign post to um I I've nothing more to add Deepak and no I'm not on any social media things um I've I've never got into it um because I think I would probably find it too interesting and spend all my time on it. It's hypocritical when I'm trying to tell my kids not to um but uh um if you go to Teaside University um and into their research pages you can find me there.
SPEAKER_00:Brilliant we'll do that and leave some show notes. Once again thank you so much for making the time today to come and talk about the Citizens Jewry project and the report and I and wish you all the very best for the meeting in GateSet I'll put some details of that in the show notes as well and uh wish you all the best and thank you for all the work that you do. Thank you. Thank you Deep thank you thank you so much for joining me on PainSpeak if you found this conversation helpful please share it with someone who might benefit. And don't forget to subscribe or leave a short review. It really helps others discover the show you can find more resources talks and updates about my work at my website thepakravindran.co.uk or connect with me on the various social media platforms I frequent LinkedIn Instagram and YouTube and certainly subscribe to my YouTube channel. Until next time stay curious stay compassionate and remember small steps do make big changes on the journey to a pain free mindset. I'm Deepak Ravindran and this is PainSpeak