Frequently Asked Questions

The Persistent Physical Symptoms Service, or PPSS for short, supports patients suffering from long-term physical health conditions. Sometimes, patients we see may have been given a name for their condition, such as Fibromyalgia, Chronic Fatigue Syndrome/ME, Functional Neurological Symptoms (including Non-Epileptic Attacks), Irritable Bowel Syndrome, or Chronic Pain. Some people may have been told they have more than one condition, and some may not have been given a diagnosis at all.

We are a rehabilitation service designed to support people in understanding and managing their symptoms, with the aim of improving both their day-to-day activities of daily living as well as improving their mood.

We've tried to answer some of the questions we are commonly asked on this page, but if there is anything you think we have missed, please use the Contact Us link to the right to let us know.

How do I access the service?

Most of our referrals come via patients' GPs, although in some cases we can take referrals from other physical health professionals, for example physiotherapists and neurologists. Please speak to your GP if you think our service may be able to help you.

What happens once I have been referred?

The team will review your referral, and if we feel that our service may meet your needs, we will send a letter to you to book an assessment appointment with us. Once you have ‘opted in’ to the service, we will send you a questionnaire booklet. The questionnaire helps the team to understand your symptoms, as well as the way they affect your daily life.

If we don't feel that our service is appropriate for your needs, we will advise your GP of the reasons for this, and suggest alternative options.

What will my assessment appointment be like?

You will be sent a questionnaire booklet with your appointment letter; the questionnaire will help the team to understand your symptoms and how they affect your daily life. Please complete the questionnaire before your appointment, and bring the booklet along with you. It would also be helpful if you could bring a list of your current medication.

The actual assessment appointment will take around 45-60 minutes and will usually be with two members of the team. We will discuss a number of topics, including the history of your symptoms and the difficulties they cause, as well as exploring any short- and long-term goals we may be able to help you with. It can be helpful to think about what these goals may be before your appointment.

What should I do if I am struggling to complete the questionnaire?

The answers you give us in the questionnaire and at the assessment session will give us an indication of what you are struggling with, and how we may be able to help you. We recognise that the nature of your medical problems may make completing the questionnaire difficult for you. If that is the case, or you aren’t sure how to answer some of the questions, then please complete as much as you are able and bring the booklet along to the appointment.

What treatment options will you consider for me?

At the end of the assessment appointment, we will discuss the options that are available for you, together with any recommendations for your specific needs and goals. Options include the opportunity to attend one of our Living Well groups, which run in numerous locations across Cumbria. Alternatively, you may be offered one-to-one support with a Psychologist, CBT Therapist, Occupational Therapist, Physiotherapist, Rehabilitation Assistant, or our Pain Medication Consultant.

Our most common options available will be:

  • Attending a Living Well Group
  • Individual sessions
  • A combination of the above
  • A review of pain medication by our pain consultant.

How will the physiotherapists help me?

Physiotherapists recognise that physical, psychological, social and environmental factors can impact on movement, function and quality of life. They use their knowledge and skills to identify what is limiting an individual's movement and performance, and to help individuals decide how to address their needs. Pain is frequently associated with substantial emotional distress, disruption in physical and social functioning, and reduction in quality of life. Your Specialist Physiotherapist has an expertise in Persistent Physical symptoms. They will assess you in order see if physiotherapy would help you to respond in more helpful ways to your pain and to lessen the impact that pain and its related suffering is having on your life.

Why have I been referred to a service including psychologists for a physical health issue?

Don't worry - we know your symptoms are not “all in your head”!

We understand that living with a physical health issue can have a huge impact on your mood, quality of life and well-being. Your physical symptoms may be the primary issue, but they can also lead to a variety of issues in other areas, such as sleep, stress, and keeping up with activities that you want or need to do. These are known as the secondary effects. Our service therefore supports you to learn techniques that can minimise these secondary effects, and reduce the impact that your illness has on your life. You can find out more about the different between primary and secondary effects of your illness here.

Can you prescribe or change medication?

We are a rehabilitation service, which means that we do not prescribe or change medications. However, the team will be working collaboratively with your GP, who will support you with your medication. If you are concerned about your medication, please discuss this with your GP.

If you are on certain medications for pain, you may have been referred to us to review the amount of medication you are taking, or support you in thinking about alternatives. New research has shown that Opioids (such as Codeine, Fentanyl, Morphine, Methadone, or others) and Gabapentinoids (such as Gabapentin or Pregabalin) aren’t very effective at treating long-term pain. They can also cause unhelpful side effects.  We can work with you to understand the causes of your pain and help you manage it in different ways.

Do you see people over 65?

Yes. Our service is available to anyone over the age of 18, and there is no upper age limit.