Pain Plans in Practice

What Else Might a Pain Plan Be Called?

The name of a Pain Plan may vary between hospitals and NHS organisations. You may see it referred to as a:

  • Personalised Pain Plan
  • Individualised Pain Plan
  • Individual Care Plan
  • Sickle Cell Pain Plan
  • Emergency Department (ED) Management Plan

Regardless of the name, its purpose is the same—to provide personalised guidance that supports timely, consistent and individualised care.

Why It Matters

A personalised Pain Plan is developed by the patient's specialist team and is designed to guide treatment during an acute sickle cell crisis. Using the plan early can help reduce delays, support more consistent care and avoid unnecessary trial-and-error prescribing.

Where available, it should be used to guide treatment in line with local protocols and NICE guidance, unless there is a clear clinical reason to take a different approach.

If You Find a Pain Plan

Use it as the starting point for care.

  • Review it as early as possible.
  • Use it to guide prescribing and treatment.
  • Continue to reassess the patient's response.
  • Explain any significant changes from the agreed plan.

Can't Find the Pain Plan?

Don't delay treatment while searching for it.


Continue looking by checking:

  • Electronic patient record
  • Previous admission notes
  • A patient-held copy (if available)
  • The specialist haemoglobinopathy team
  • The patient's haematology team


Remember: NICE recommends offering analgesia within 30 minutes of arrival for all patients presenting with an acute painful sickle cell episode.

No Pain Plan?

Treatment should still begin promptly.

Ask the patient:

  • What treatments have worked well during previous crises?
  • Is this pain similar to previous episodes?
  • Have you received this medication before?

People living with sickle cell often know which treatments have been most effective for them and this information should help inform their immediate management.

Remember

A Pain Plan is a guide—not a limit.

If pain remains uncontrolled, reassess the patient and escalate treatment where appropriate.

A patient's needs may differ between crises, and clinical judgement should always be used alongside the Pain Plan.

Sources

NICE CG143 – Sickle Cell Disease: Managing Acute Painful Episodes in Hospital

RCEM Best Practice Guideline – Management of Acute Presentations of Sickle Cell Disease