Hansard

Margo MacDonald makes a very fair point. One of our clear objectives is to raise awareness in the medical profession of not only chronic pain but what can and should be done to help people who suffer from it.

The second major point that I want to make is that we have already substantially reduced waiting times for psychological services from more than 80 weeks to just over 60 weeks. In the immediate period ahead, we will continue the drive to reduce waiting times significantly, particularly for services that are crucial to sufferers of chronic pain. I do not believe that it is right that people have to wait that length of time for essential services that they need fairly urgently.

The third point that I want to make concerns the petition that was submitted by Susan Archibald, which was supported by many people. It made the key point that, in delivering services for sufferers of chronic pain, we should think about not just a medical health model but a social model. We are very committed to that principle; indeed, the bill that was published today on the integration of adult health and social care should help us to deliver integrated health and social care services for sufferers of chronic pain. If there was ever an example of where the integration of services is important, it is in dealing with chronic pain.

I will set out some of the work that is already going on and the approaches that are being taken. I recognise that there is still a wide variation in access to certain services in Scotland. One of our key policy objectives is to ensure that there is no postcode lottery in the delivery of services; we want consistent delivery of high-quality services in both the primary care and acute sectors for the sufferers of chronic pain.

Clearly, a tiered approach is required, because most services will be delivered not in the acute sector but, inevitably, in the primary care sector. We have long advocated the role of managed clinical networks in co-ordinating a multidisciplinary approach to service provision. We need to ensure that they give a strong voice to patients in shaping local service delivery. As I will outline, we will place an obligation on the territorial health boards to provide a minimum level of good-quality services and, in doing so, we will require them to discuss the shape of their local services with local populations and stakeholder groups representing chronic pain sufferers.

Some areas have made more progress than others. For example, the MCN in NHS Greater Glasgow and Clyde, which has been operating for five years, has demonstrated real improvements, including developing a pain management programme, setting standards for chronic pain services, developing primary care guidelines and, more recently, setting up specialist nurse clinics to provide patients with more local care. That is a very good example of the ambition that we have for the delivery of the service.

The figures that were published yesterday on workforce development across the board show an increase in the appropriate skills and occupations in the health service that service chronic pain sufferers and others. For example, compared with last year, there has been a 5 per cent increase in the number of clinical and other applied psychologists working in the health service.

In the mental health strategy for Scotland for the next three years, there is a commitment to continue our work to deliver faster access to psychological therapies. The programme is delivered locally but supported nationally and includes support for local service redesign, which is aimed at achieving service improvement within existing resources. Obviously, the territorial boards are receiving a real-terms budget increase this year and next, so the resources should be in place to allow them all to deliver the quality of services that we demand.

We are supporting the development of MCNs and service improvement groups with pump-priming funding of up to £50,000 per year over two years for each group, with the purpose of each putting together a local improvement plan in their area. So far, the following health boards have participated in the programme: Ayrshire and Arran, Dumfries and Galloway, Forth valley, Lanarkshire, Lothian and Tayside. Between them, they cover 73 per cent of the population. Our aim is for the programme to have 100 per cent coverage to ensure that local service delivery plans are in place from next year at the very latest.

The main priority of those groups is to focus on and accelerate the implementation of the Scottish service model for chronic pain. In particular, as they develop, the groups will look to improve links with primary care services, paediatric services and the voluntary sector. Patient participation will be an essential feature of their work.

Some work is obviously in the early stages. For example, NHS Ayrshire and Arran’s work to improve chronic pain services has been closely aligned with the redesign of musculoskeletal services, which will allow for early identification and rapid triage and assessment, with timely onward referral to appropriate services, including chronic pain management, self-management support and working health services Scotland.

NHS Fife and NHS Borders are currently working on draft proposals for their groups. NHS Fife already has a fully integrated chronic pain management service—Rivers—which has been established for more three years and fulfils a number of aspects of the MCN approach. We will work with that group and others to take the programmes forward to ensure coverage throughout Scotland.

I have told boards to accelerate progress and I have set an expectation that improvement plans will be in place for every board by the end of this month. In addition, I have advised chairs of boards that I will be calling on them to update me on progress when I meet them in June. I will be looking to them to identify and seek solutions to barriers to delivery.

I have commissioned work to consider how most efficiently to include chronic pain in boards’ local delivery plans from 2014-15 and ensure that clear reporting mechanisms are in place to monitor progress through the annual national health service board review process.

I could mention many other initiatives, but no doubt other members will do so. The Minister for Public Health, Michael Matheson, will cover initiatives that I have not been able to get to. On behalf of the Scottish Government, I spell out our commitment to improving the chronic pain service throughout Scotland and to ensuring that we have the indigenous services in Scotland that our patients need, to deal with this very debilitating condition.

I move,

That the Parliament welcomes the Scottish Government’s plans for the implementation of the Scottish Service Model for Chronic Pain, which will ensure the best outcomes for the care and support of people living with chronic pain; further welcomes that the Scottish Government has committed to providing a highly specialist intensive pain management service in Scotland; notes that, prior to consultation, the NHS is working with partners, including patients and clinicians, to assess appropriate options for a Scottish intensive pain management service; also welcomes the decision of the Scottish Government to provide appropriate residential accommodation in the options for the new Scottish intensive pain management service, and further notes that each territorial NHS board in Scotland will be required to prepare and implement a service delivery plan for covering all aspects of chronic pain services, from April 2014.

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