Use the tables on this page to determine where to refer patients for pain management.
Consider the chronic pain service directory for details of the pain management programs at each service.
Refer to Which patient for which program (PDF 486.0 KB) to understand the patient characteristics suitable for different types of pain management programs.
Download the service flows summary (PDF 2.2 MB)
Published: 2021. Next review: 2026.
Service flow tables
The role of tier 2 services is to assess, triage and identify potential need to refer to tier 3 services when complexity is high or resources insufficient to manage locally.
| Local health district | Tier 2 service | Tier 3 service |
|---|---|---|
|
Central Coast Far West (north) Mid North Coast Nepean Blue Mountains Northern NSW Northern Sydney South Eastern Sydney South Western Sydney Sydney Western NSW Western Sydney |
Coffs Harbour* Gosford* Lismore* | The Children’s Hospital Westmead |
|
Far West (south) Illawarra Shoalhaven Murrumbidgee Southern NSW |
Orange* Port Kembla* | Sydney Children’s Hospital |
| Hunter New England |
John Hunter Children's Hospital Tamworth* | The Children’s Hospital Westmead |
* Adult regional pain clinics
Metropolitan service flows
| Local Health District | Tier 2 service | Tier 3 service |
|---|---|---|
Central Coast | Gosford | John Hunter Royal North Shore |
Illawarra Shoalhaven | Port Kembla St George | Prince of Wales St Vincent’s |
Nepean Blue Mountains | Nepean | |
Northern Sydney | Royal North Shore | |
South Eastern Sydney | Port Kembla St George | Prince of Wales St Vincent’s |
South Western Sydney | Liverpool | |
Sydney | Concord | Royal Prince Alfred |
Western Sydney | Westmead |
Rural service flows
Local Health District | Tier 2 service | Tier 3 service |
|---|---|---|
Far West | Orange | Royal Prince Alfred Westmead |
Hunter New England | Tamworth | John Hunter |
Mid North Coast | Coffs Harbour | John Hunter Royal North Shore |
Murrumbidgee | Nepean St Vincent’s | |
Northern NSW | Lismore | Royal North Shore |
Southern NSW | Port Kembla St George | Prince of Wales |
Western NSW | Orange | Nepean Royal Prince Alfred Westmead |
Special services
High intensity programs of 60 hours or more are available only at Royal Prince Alfred, Royal North Shore, St George and Lismore hospitals. These programs are suitable for people able to participate in a group setting with high to moderate complexity pain as measured by the electronic persistent pain outcomes collaboration (EPPOC) outcome questionnaires.
Implants and stimulators are offered to public patients at Liverpool, Nepean, Prince of Wales, Royal North Shore, Royal Prince Alfred and Westmead hospitals.
Specialised services are available at these pain clinics:
- HIV related chronic pain: St Vincent’s Hospital
- Burns: Concord Hospital
- Spinal cord injury related pain: Royal North Shore and Prince of Wales hospitals.
Service level definition
Tier 2 services
- Offer low or medium intensity programs
- Offer triage or assessment of high complexity patients with management and referral plan forwarded to appropriate service
- Have a minimum multidisciplinary staffing complement which includes nurses, medical officers, physiotherapists and psychologists
- Are not accredited by the Australian and New Zealand College of Anaesthetists Faculty of Pain Medicine as a training facility.
Tier 3 services
Tier 3 services have all tier 2 characteristics and are accredited by the Australian and New Zealand College of Anaesthetists Faculty of Pain Medicine.
NSW pain service locations
