Hansard

I welcome the opportunity to speak in this debate on the important issue of chronic pain. I am pleased to see so many people in the public gallery to listen to the debate.

Significant pain is reported to be experienced by 14 per cent of our population, with 6 per cent suffering severe chronic pain that has a major impact on their quality of life, employment, daily activities, mood, sleep and all aspects of their general health and wellbeing. Chronic pain is a sensitive and deeply personal subject for those who suffer it and for their loved ones, who often suffer with them and can feel powerless to help. I am therefore genuinely pleased to see the commitment that the Government has outlined to deliver high-quality chronic pain services at every level of care.

The Scottish service model for chronic pain, for example, will greatly assist patients’ understanding of what support is available and will give clinicians and healthcare professionals the knowledge and structure to direct patients and allow consistent care pathways to be followed. I further welcome the Government’s commitment to provide a highly specialised pain management service and today’s announcement of a public consultation on the options for the future delivery of the service.

The new service for Scotland will be a strong addition to the services that are necessary to meet the many and complex needs of those with a debilitating chronic condition that can devastate the lives of patients if appropriate support is not available.

I will highlight the progressive initiatives that are taking place in Dumfries and Galloway, which show how the Scottish service model for chronic pain is being implemented based on specific local needs and circumstances. Since its formation in April 2012, NHS Dumfries and Galloway’s chronic pain improvement group has worked well. Each of its five sub-groups has developed a range of projects to improve the chronic pain care pathway. An important element of the improvement work is the upskilling of local staff. Twenty physiotherapy staff have recently undergone a two-day cognitive behaviour training course and community pharmacies have participated in training sessions on chronic pain. Pharmacies have also circulated patient questionnaires to people who are prescribed medication for chronic pain, and the responses will be fed into the patient involvement sub-group.

NHS Dumfries and Galloway has agreed to create an additional health psychologist post, with two sessions a week for chronic pain. In addition to working with patients, the postholder will, crucially, cover the education of general practitioners and other clinicians. Arrangements are also in place for GPs and community physiotherapists to use the much-praised electronic referral system to refer patients directly to Pain Association Scotland, which has a funded service agreement with the health board.

It is key to assist people to manage chronic pain themselves not only by making sure that the necessary support and advice are there but by giving them the tools to do it themselves, when appropriate. That is as much about empowerment as it is about prescribing.

Such examples are being replicated across the country. Some boards are further forward than others in developing their local service delivery plans for implementing the model, but it is important to emphasise that progress is being made and that that is a significant step towards ensuring equity of access to chronic pain services and support across all levels of primary, secondary and tertiary care.

Prior to consultation, the NHS is working with partners, including patients and clinicians, to assess appropriate options. Addressing the needs of patients at the pinnacle of the Kaiser Permanente pyramid can be challenging. Consultation, especially with the small number of patients who have the most severe needs, is vital to ensure the most appropriate targeted use of resources and to deliver equity of service for that highly specialised group of patients.

Therefore, I especially welcome the Government’s decision to include appropriate residential accommodation in the options for the intensive pain management service. That is fundamental in ensuring that patients get the support that they need from the intensive service. It is vital that the service offers as non-medicalised a routine as possible and that any accommodation reflects normal aspects of daily living, because that helps patients to maintain progress when they return home.

Services need to be person centred. All the measures in the Government motion add focus and positive direction to chronic pain services, not only at the highly specialised intensive end of the spectrum but in prevention and secondary care. With the publication today of the Public Bodies (Joint Working) (Scotland) Bill, which is to integrate adult health and social care, that approach will help to reduce health inequalities and empower patients with chronic pain to have as full a life as possible.

I think that everyone in the chamber recognises the importance of delivering high-quality services for chronic pain sufferers—there can be nothing more personal than pain. Although improvements have been made in service provision since 2007, it is equally clear that the Government is resolute on the need to accelerate the delivery of further improvement throughout the spectrum of treatment. That is a work in progress, but I am confident that we are heading in the right direction.

I support the Government’s motion.

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