Consultants needed to be made aware of the purpose and process of the STAR care pathway
neuropathic pain
Overall, there was generally a shared understanding of the purpose of the care pathway among those directly involved in its delivery. However, ESPs in four centres reported that some surgeons were concerned when their patients were seen in the STAR clinic or referred back to them, and they suggested that this was possibly because the surgeons perceived their work was being checked by the ESPs, or that something had gone wrong with the knee replacement. ESPs at two sites suggested they were not sure how well some surgeons understood the reasoning behind referrals back to them, or how the STAR care pathway worked. A consultant surgeon suggested that it was often “a surprise” when a patient was referred back to them because they had expected the patient to be doing well, especially if they were recovering well at the 6-week follow-up. One ESP also suggested that the STAR care pathway gave them more confidence to justify their decisions about referring on for neuropathic pain medication.