Dear Cwm Taf University Health Board,

1. Has the Pain Management team consultant Mr. Raj Mohammed Noori Khaffaf and pain management nurse Sara, of the Cwm Taf pain management team, had any specific training in recognising pain symptoms in those with an Autistic Spectrum Disorder?

2. Are the referenced consultant and nurse aware that those with an Autistic Spectrum Disoder, often do not display physical indications of pain via facial features and body language?

3. Are the referenced consultant and nurse aware that people with Autism have sensory problems, making specific areas of the body under-sensitive, or over-sensitive?

4. Are the referenced consultant and nurse aware that people with Autism often do not display symptoms of pain in the same way that those with neuro-typical brains do?

5. Can you list the training received by the referenced consultant and nurse above in relation to Autistic Spectrum Disorders?

6. Are the above referenced consultant and nurse aware of the recent guidance issued on Complex Regional Pain Syndrome?

7. Are they aware that the guidance for CRPS states that those with a confirmed diagnosis of CRPS are to be believed, rather than dismissed?

8. How many complaints have been received in relation to the above consultant and nurse, since May 2017 - when the consultant started working for Cwm Taf Health Board?

9. What would be the procedure for an autistic patient with a confirmed NHS diagnosis of CRPS follow, if the referenced Pain Management consultant and nurse, refused to treat the individual with Autism as they did not recognise they had pain symptoms, due to Autistic people not displaying typical visual pain responses? How does the individual access alternative specialist pain management service within Cwm Taf?

10. Would an individual with a dystonic limb due to CRPS, that had been issued a corrective brace via Cwm Taf NHS services. Be refused pain management support by the referenced above pain management consultant and nurse, because the individual was able to tolerate wearing the brace due to work with the Cwm Taf physiotherapy team?

11. Do the referenced consultant and nurse, believe a person diagnosed with CRPS can only have CRPS if they are unable to wear clothing or footwear over their affected limb? Does the wearing of clothing on an affected limb, indicate that the diagnosis of CRPS is incorrect?

12. Does the above referenced consultant and nurse understand that a lack of pain management support for those with CRPS can lead to suicide attempts?

13. Do the referenced pain management consultant and nurse understand that refusal to provide pain management treatment in CRPS, can lead to amputation of a limb?

Yours faithfully,
Mr. Jason Thomas
Disability Support Services