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Information on how many nurses there are in multidisciplinary chronic pain teams in each NHS board area for (a) adult and (b) children services, is not held centrally. However, information on the number of Clinical Nurse Specialists with a specialty of pain can be found at the following link:

http://www.isdscotland.org/Health-Topics/Workforce/Publications/2011-11-29/Clinical_Nurse_Specialist_S2011.xls?62532551

It should be noted that the table contains data at the NHS board level and not at the (a) adult and (b) children services level.

I would also like to refer the member to the Benchmarking Report published by Healthcare Improvement Scotland on 26 October 2012. http://www.healthcareimprovementscotland.org/programmes/long_term_conditions/chronic_pain/chronic_pain_update_report.aspx

The audit has identified the current resources available in relation to NHS Board populations and provides up to date information on the provision of pain management services in each NHS Board area. This information will assist NHS Boards to identify any gaps and variation in local services and provides recommendations to inform planning and assist in the implementation of the Scottish Service Model for Chronic Pain.

Our Lead Clinician, on Chronic Pain and the National Chronic Pain Steering Group have been working with NHS National Services Division (NSD) to review the current provision of specialist residential pain management services. Options for the future provision of these services, including the potential for a service based in Scotland, will be considered at a meeting scheduled with NSD in early December.

The Public Services Reform (Scotland) Act 2010, which established the Care Inspectorate, came into force on 1 April 2011.

The Care Inspectorate has expedited powers, to apply to the sheriff, under s65 of the 2010 Act for cancellation of the registration of a care service (including care homes) on the basis that unless the order is made “there will be a serious risk to the life, health or wellbeing of persons”. An order to cancel a service would have the effect of closing the service.

The sheriff has the power to make an interim order, which may include an order suspending registration pending a full hearing. If necessary, the Care Inspectorate can also impose an emergency condition of registration, which becomes effective immediately and remains in place until removed or successfully challenged on appeal.

The Care Inspectorate has made one application to the sheriff under section 65. In this case interim suspension was sought by the Care Inspectorate but this was refused. A date for a full hearing was fixed by the court, however by the time the case called, the action was no longer necessary as the service had improved and the action was therefore dismissed.

Waiting time information is not available centrally for access to chronic pain clinics, as data is collected at specialty level.

The 18 weeks referral to treatment time target was due for delivery from
31 December 2011 and has a compliance rate of 90%. Since 31 December 2011 NHSScotland has delivered this target.

There are no plans to introduce a HEAT target in relation to chronic pain services this year. The Scottish Government reviews HEAT targets on an annual basis with decisions on new targets based on evidence and impact.

The Scottish Intercollegiate Guidelines Network (SIGN) are currently developing a guideline for the management of chronic pain, with a public consultation event scheduled in December 2012. Following publication of the SIGN guideline consideration can be given as to whether HEAT can support improvement / delivery.

The Care Inspectorate can cancel registration of a care service in a number of scenarios. It has the power to withdraw registration from care homes where it has served an Improvement Notice and this has not been complied with within the period specified in the Notice. It can also cancel registration of a service where the person providing the registered care service ceases to provide the service. Since1 April 2011, 1 registration of a care service was cancelled during the period 2011-12.

The National Chronic Pain Steering Group continues to make steady progress in taking forward an extensive work plan and is working with NHS boards to provide support in implementing the service model.

As part of the group’s work plan Healthcare Improvement Scotland recently published a benchmarking report on chronic pain services in Scotland. The purpose of the report was to provide an update on the provision of chronic pain services since the publication of the GRIPs report and provide recommendations to assist NHS Board in the planning of services. Findings from the audit show that there has been improvement in service provision since the GRIPS report of 2007.

The report is available on the Healthcare Improvement website at:

http://www.healthcareimprovementscotland.org/programmes/long_term_conditions/chronic_pain/chronic_pain_update_report.aspx.

The establishment of service improvement groups/Managed Clinical Networks are seen as a key way of implementing the Scottish Service Model for Chronic Pain. The National Chronic Pain Steering Group has been working with boards to support them to develop improvement plans. This has resulted in a number of successful bids to establish service improvement groups/managed clinical networks, most of which are in the early stages of development.

The GRIPS report (2007) published by Healthcare Improvement Scotland and revised in 2008, set out six priority actions aimed at improving service provision. The previous Cabinet Secretary addressed the first priority action by recognising chronic pain as a condition in its own right in May 2008.

Following the publication of the GRIPs report the Scottish Government appointed a Lead Clinician for Chronic Pain and established the National Chronic Pain Steering Group. The Scottish Government has proactively promoted the need to develop chronic pain services and implementation of the GRIPs actions will be achieved through the implementation of the Scottish Service Model for Chronic Pain in addition to the range of work being progressed by the National Steering Group.

In addition to funding the lead clinician the Scottish Government has also provided funding for three part time facilitator posts. The facilitators are employed by Healthcare Improvement Scotland and support the Lead Clinician to co-ordinate the various work streams within the National Chronic Pain Steering Group’s work plan for 2012-13.

The Scottish Government continues to advocate the role of managed clinical networks in improving the provision of services, including those for chronic pain. We are encouraging NHS boards who have not already done so to establish these.

Information on how many pain consultants there are in multidisciplinary chronic pain teams in each NHS board area for (a) adult and (b) children services, is not held centrally. However I would like to refer the member to the Benchmarking Report published by Healthcare Improvement Scotland on 26 October 2012:

http://www.healthcareimprovementscotland.org/programmes/long_term_conditions/chronic_pain/chronic_pain_update_report.aspx.

The audit has identified the current resources available in relation to NHS Board populations and provides up to date information on the provision of pain management services in each NHS Board area. This information will assist NHS Boards to identify any gaps and variation in local services and provides recommendations to inform planning and assist in the implementation of the Scottish Service Model for Chronic Pain.

The recently published benchmarking report on chronic pain services recognised there are gaps in the provision of children’s services for chronic pain. The Scottish Service Model for Chronic Pain applies to everyone living with chronic pain.

The National Chronic Pain Steering Group will continue to work with Boards to take forward implementation of the Scottish Service Model for Chronic Pain ensuring that plans reflect the needs of both adults and children. It is anticipated that any service improvement groups/Managed Clinical Networks established for Chronic Pain will work to improve services for all regardless of age.