Chamber
Meeting of the Parliament 17 March 2011
17 Mar 2011 · S3 · Meeting of the Parliament
Item of business
Chronic Pain Services
Mary Scanlon’s point about the patient pathway is important. The solution is a managed clinical network. Good evidence is emerging from Glasgow on the benefits of the approach, which I want to be taken forward.
There is no doubt that pain management services in Scotland remain patchy, as the GRIPS report made clear. Our response to the recommendations in the report has been concentrated on the development of a Scottish service model for chronic pain, about which I will say a little.
First, the model is based on the provision of pain education for the Scottish population, which includes promoting people’s ability to self-manage and promoting the information that is available from the NHS inform website about lower-back pain, to help people to return to work. If a person had experienced pain for more than 12 weeks, they would be encouraged to refer themselves to a voluntary sector organisation-run self-management course or to their primary care team. They would then be referred to what the model calls a level 1, or outpatient, pain-management service. If necessary, they could be referred on to a level 2, or more specialist, in-patient, service. The model includes level 3, highly-specialised interventions, such as spinal-cord stimulation and residential pain-management programmes.
Mary Scanlon made an important point about spinal-cord stimulation. Access to what can be a life-transforming treatment, as she acknowledged, is provided for in the chronic pain service model that is under development. The chronic pain steering group will oversee implementation, to ensure equity of access for everyone who might benefit from the treatment. Spinal-cord stimulation is very much on the group’s radar screen.
The model also underlines the importance of early access to emotional and psychological support. Its aims are, in summary, to improve the prevention and management of chronic pain, to improve services at all levels and to ensure that people get the earliest and most appropriate treatment, locally where possible, but with ready access to the more specialist tiers of the service.
Taking the model forward will be the top priority for our next lead clinician for chronic pain and the steering group that the previous lead set up to support him. Interviews for the post were held yesterday, so we will know the result very soon. The chronic pain steering group will then carry out a scoping exercise with NHS boards to assess the level of service that is available in each area and how it relates to the service model. That will allow for a comprehensive examination of the pain management services throughout Scotland and what Scotland needs, including the level of demand for a residential facility of the kind that Bath offers.
The experience of people living with chronic pain highlights the importance of good communication between primary and secondary care, as well as the need for a multidisciplinary approach. People also stress the crying need for good information and the healing effect that proper peer support can have. All those factors underline the importance of a managed clinical network approach to pain services.
I thank all those who have put so much work into the development of the chronic pain MCN in NHS Greater Glasgow and Clyde. It has promoted equity of access to services by making sure that the Clyde area is included in the network’s scope. It is also producing really helpful information for patients and for staff who work in primary care. I urge all other boards in Scotland to learn from that MCN’s achievements.
The chronic pain steering group has also focused on an analysis of the need for education on chronic pain for those who work in primary care. It recently considered the findings of a report, which was commissioned by NHS Education for Scotland, that helps us with the way ahead.
Other valuable work includes NHS Quality Improvement Scotland’s decision to support the development of a clinical guideline on non-malignant chronic pain. There is an opportunity for people to have their say about the key questions on which the guideline should focus. That will also be a topic at the launch of the Scottish pain research community at the end of this month.
The steering group has also been developing a community website to act as the basis of a chronic pain information resource. It is intended primarily for NHS Scotland, but it will also be accessible to the public. Each board will have its own page on which it will be able to describe the pain management services that it provides. I consider that to be a real driver for equity of service, as boards and the public will be able to compare the range of services that are available in each part of the country.
I do not for a moment deny that there is still a journey to travel, but it has been helpful to set out during the debate some of the progress that has been made. The debate was constructive, and I thank every member for their contribution to it.
13:12 Meeting suspended until 14:15.
There is no doubt that pain management services in Scotland remain patchy, as the GRIPS report made clear. Our response to the recommendations in the report has been concentrated on the development of a Scottish service model for chronic pain, about which I will say a little.
First, the model is based on the provision of pain education for the Scottish population, which includes promoting people’s ability to self-manage and promoting the information that is available from the NHS inform website about lower-back pain, to help people to return to work. If a person had experienced pain for more than 12 weeks, they would be encouraged to refer themselves to a voluntary sector organisation-run self-management course or to their primary care team. They would then be referred to what the model calls a level 1, or outpatient, pain-management service. If necessary, they could be referred on to a level 2, or more specialist, in-patient, service. The model includes level 3, highly-specialised interventions, such as spinal-cord stimulation and residential pain-management programmes.
Mary Scanlon made an important point about spinal-cord stimulation. Access to what can be a life-transforming treatment, as she acknowledged, is provided for in the chronic pain service model that is under development. The chronic pain steering group will oversee implementation, to ensure equity of access for everyone who might benefit from the treatment. Spinal-cord stimulation is very much on the group’s radar screen.
The model also underlines the importance of early access to emotional and psychological support. Its aims are, in summary, to improve the prevention and management of chronic pain, to improve services at all levels and to ensure that people get the earliest and most appropriate treatment, locally where possible, but with ready access to the more specialist tiers of the service.
Taking the model forward will be the top priority for our next lead clinician for chronic pain and the steering group that the previous lead set up to support him. Interviews for the post were held yesterday, so we will know the result very soon. The chronic pain steering group will then carry out a scoping exercise with NHS boards to assess the level of service that is available in each area and how it relates to the service model. That will allow for a comprehensive examination of the pain management services throughout Scotland and what Scotland needs, including the level of demand for a residential facility of the kind that Bath offers.
The experience of people living with chronic pain highlights the importance of good communication between primary and secondary care, as well as the need for a multidisciplinary approach. People also stress the crying need for good information and the healing effect that proper peer support can have. All those factors underline the importance of a managed clinical network approach to pain services.
I thank all those who have put so much work into the development of the chronic pain MCN in NHS Greater Glasgow and Clyde. It has promoted equity of access to services by making sure that the Clyde area is included in the network’s scope. It is also producing really helpful information for patients and for staff who work in primary care. I urge all other boards in Scotland to learn from that MCN’s achievements.
The chronic pain steering group has also focused on an analysis of the need for education on chronic pain for those who work in primary care. It recently considered the findings of a report, which was commissioned by NHS Education for Scotland, that helps us with the way ahead.
Other valuable work includes NHS Quality Improvement Scotland’s decision to support the development of a clinical guideline on non-malignant chronic pain. There is an opportunity for people to have their say about the key questions on which the guideline should focus. That will also be a topic at the launch of the Scottish pain research community at the end of this month.
The steering group has also been developing a community website to act as the basis of a chronic pain information resource. It is intended primarily for NHS Scotland, but it will also be accessible to the public. Each board will have its own page on which it will be able to describe the pain management services that it provides. I consider that to be a real driver for equity of service, as boards and the public will be able to compare the range of services that are available in each part of the country.
I do not for a moment deny that there is still a journey to travel, but it has been helpful to set out during the debate some of the progress that has been made. The debate was constructive, and I thank every member for their contribution to it.
13:12 Meeting suspended until 14:15.
In the same item of business
The Deputy Presiding Officer (Alasdair Morgan)
SNP
The next item of business is a members’ business debate on motion S3M-7853, in the name of Mary Scanlon, on chronic pain services in Scotland. The debate wil...
Mary Scanlon (Highlands and Islands) (Con)
Con
The previous debate on chronic pain in the Parliament was secured by Dorothy-Grace Elder in February 2002. Nine years on, now is a good time to take stock of...
Christine Grahame (South of Scotland) (SNP)
SNP
I acknowledge the commitment to the issue of both Dorothy-Grace Elder and my colleague Mary Scanlon. As a pre-emptive strike, I beg a little flexibility from...
Cathie Craigie (Cumbernauld and Kilsyth) (Lab)
Lab
I am grateful for the opportunity to speak in the debate. I thank Mary Scanlon for bringing the subject to the chamber and I acknowledge her long involvement...
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
LD
It is a pleasure to join the debate. I congratulate Mary Scanlon on her motion and I salute the work that she has done with her cross-party group on chronic ...
Mary Scanlon
Con
I should bring some balance to the debate. Having quoted Dorothy-Grace Elder saying that NHS Highland was a disgrace in 2002, I should also say that we now h...
Jamie Stone
LD
The intervention is fair and I accept the point entirely. I do not wish to denigrate NHS Highland; I simply wish to question its policy decision on the futur...
Nanette Milne (North East Scotland) (Con)
Con
I apologise to you, Presiding Officer, and to colleagues for not being able to stay for the whole debate. I have commitments elsewhere in the building.Mary S...
Ian McKee (Lothians) (SNP)
SNP
I congratulate Mary Scanlon on obtaining this members’ business debate. It is, perhaps, the last time that I will be able to contribute to parliamentary proc...
Mary Scanlon
Con
I asked for an audit to be carried out across Scotland to see whether we could justify having here in Scotland a specialised service similar to that which ex...
Ian McKee
SNP
Knowledge of the problem that faces us can never be ignored. Therefore, an audit of chronic pain and other conditions is desirable.Although I do not know off...
The Deputy Presiding Officer
SNP
Thank you, Dr McKee.13:00
Rhoda Grant (Highlands and Islands) (Lab)
Lab
I congratulate Mary Scanlon on securing the debate. She was right to pay tribute to Dorothy-Grace Elder, but Mary has taken up the role of being an advocate ...
The Minister for Public Health and Sport (Shona Robison)
SNP
I congratulate Mary Scanlon on securing a debate on such an important topic as chronic pain. The issue has interested her since the establishment of the Parl...
Mary Scanlon
Con
The royal college and others have said that there is no clear referral pathway in Scotland, apart from through the managed clinical network in Glasgow. Consu...
Shona Robison
SNP
Mary Scanlon’s point about the patient pathway is important. The solution is a managed clinical network. Good evidence is emerging from Glasgow on the benefi...