Pain management service delivery framework: implementation plan update

Governance Structure

Task Force

The implementation of the Framework for Pain Management Service Delivery in Scotland is overseen by the Pain Management Task Force who report directly to Scottish Government Ministers (see Annex x). The role and remit of the Task Force is focused on implementation of the Framework by utilising programme and risk management methodologies to ensure successful delivery of the aims and commitments. During our recent stakeholder engagement, we have heard feedback that more can be done concerning keeping all stakeholders involved and informed throughout the process (see Annex A (2)). Our Governance structure has built stronger links between the existing Clinical Networks, working groups and the Task Force to increase communication and collaborative working.

The permanent membership of the Task Force consists of Scottish Government Policy and Clinical Leads to provide clear lines of accountability and ensure rapid triaging, assessment and action against risks to delivery and implementation. Membership includes policy officials working in pain management, Realistic Medicine, Primary Care, Rehabilitation as well as our National Implementation Lead for Pain Management, the Centre for Sustainable Delivery and lived-experience representation. We have heard feedback calling for more lived experience representation on the Taskforce and will be appointing an additional member to represent people with chronic pain.

We are investing in the leadership required to help us, and the wider pain community, to identify, prioritise and agree activities at the pace that people with chronic pain have told us is required. A key element of this is the shift to working groups aligned to the Aims of the Framework with a clear mandate and responsibility to ensure appropriate engagement, consideration and recommendation of activities to drive progress. These Short-Life Working Groups (SLWGs) will be tasked with delivering the Actions for each of the specific Aims. The Chairs of the Groups will also be co-opted onto the Task Force whilst their groups are operational. Recruitment of Chairs and Group membership will reflect the expertise, experience and diversity of skills required to deliver the Actions for each Aim set out in this Plan.

Our Networks

This Governance Structure recognises the existing work programmes of each of the National Clinical Networks. We have also established a Service Manager Network, a third-sector network, a pain medic and Pain Management National Network Leads group. Individual Network leads will be paramount to aligning their work programmes to the Short Life Working Groups. This will ensure multi-disciplinary input across all professional groups working in pain management services throughout Scotland. We have heard feedback from stakeholders and will be facilitating better connections between our networks and people with chronic pain as required.

Involving people with lived experience

The ethos of Realistic Medicine is that the person receiving care should be at the centre of decision making through meaningful conversations about what matters most to them, with a shared understanding of what healthcare might realistically contribute to this. It is therefore vitally important that we place people with lived experience of chronic pain at the very centre of this Plan.

Lived experience inclusion to date.

Previous Governance models for Scottish Government chronic pain policy have involved people with lived experience in a variety of methods – including individual representation, a wider reference group of lived experience and elected representatives.

Public consultation on the draft Framework was carried out between December 2021 and February 2022. The Scottish Government commissioned independent analysis of the consultation responses which was been published alongside the initial Chronic Pain Implementation Plan.

During the first year of the Chronic Pain Implementation Plan we commissioned an independent organisation to recruit, support and engage a diverse cross-section of people with chronic pain across Scotland. The need to amplify the voices of groups of people who may be impacted by persistent pain but typically overlooked when it comes to engagement was highlighted in our Equality and Impact Assessment which showed people from socio-economic deprivation, older people, and certain ethnic minority backgrounds have been under-represented to date. The group looked at the services and information available for people living with chronic pain. A report outlining the work on services and a report outlining the work around information needs were published online.

Further, a HIS Gathering Views report gave a national perspective of the key issues of people with chronic pain and carers in their local area. This report helps inform national and local approaches to implementation that will increase the chances of successfully delivering meaningful improvement of local pain service delivery.

Graphic text below:

Dec 2021 - Draft Framework

Jul 2022 - Implementation Plan

Nov 2023 - Implementation Plan - Uptate

Next Steps - Going Forward

Informed by the Participation Framework we will look to understand what questions still need answers and the best engagement plan to do this to ensure we are continuing to include people with lived experience most effectively. See Annex A (3) for more information on how we will keep stakeholders informed.

We are also committed to monitoring and reviewing the performance of the Governance structures as they are delivered. This includes ensuring we are appropriately involving and engaging the views of all stakeholders through the proposed Networks, Groups and Lived Experience structures. In addition, we will take a risk-based approach to delivery of the Framework, with clear processes to escalate emerging issues or concerns raised by stakeholders through our Governance structure and Task Force.