Pain management - service delivery framework: implementation plan

Tackling the impact of chronic pain on Scotland

Chronic pain is pain that persists beyond normal injury healing time, or recurs for longer than three months. It is a separate condition in its own right, and frequently presents alongside other long-term health conditions. Chronic pain can have a substantial impact on general health and wellbeing, and is often described as a distressing experience.

The estimated existing high-prevalence of chronic pain in Scotland, and projected future increase in potential risk factors for the condition demand a response which is comprehensive, coordinated and collaborative.

Draft Framework for pain management service delivery

The Scottish Government set out an ambition to develop a new Framework for pain services to better meet the need of people living with chronic pain in Scotland. A draft Framework for Pain Management Service Delivery was developed across 2021 in consultation with the National Advisory Committee for Chronic Pain (NACCP), people with lived experience of the condition and other stakeholders.

The draft Framework set out a comprehensive summary of the evidence on the impact of chronic pain, including emerging evidence on its links to health inequalities and other social issues associated with poorer outcomes and reduced quality of life in Scotland. It also addressed the existing experience of patients in navigating and accessing appropriate support for chronic pain, and the challenges faced by existing services and organisations and frontline staff. It contained a series of proposed Aims and Commitments which were intended to drive discussion and engagement with stakeholders to inform our approach to service improvement.

Our response to public consultation on the draft Framework

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 has been published alongside this Implementation Plan.

We are grateful for the time that respondents took to contribute to the consultation and welcome the input towards shaping the Framework and this Implementation Plan. Analysis of the number of respondents shows that engagement with the consultation was similar to other similar long-term condition Frameworks published by the Scottish Government, and in line with the level of other topic-specific consultations carried out during the COVID-19 pandemic.

We welcome the very high level of support for the Aims and Commitments set out in the draft Framework which frequently exceeding 90% from both individual and organisational respondents. This clearly demonstrates the willingness and shared ambition to deliver the changes people with chronic pain have told us are needed to improve their quality of life and wellbeing. We also welcome the detailed and challenging feedback provided by respondents on both the barriers and opportunities to achieving this goal, which we have sought to address through this Implementation Plan.

A clear theme emerging from the consultation was that the draft Framework and Aims required greater focus, specificity and ambition. In response, this Implementation Plan sets out clear and realistic initial Actions to deliver the Framework with estimated timeframes for delivery.

Respondents also highlighted a need for effective and transparent leadership and engagement arrangements for the Framework to effectively deliver its ambitions, and to ensure meaningful stakeholder involvement in its implementation. We have set out a comprehensive Governance structure with clear lines of accountability to Scottish Government Ministers. We have also set out the ambition to establish a series of Networks to strengthen clinical, third-sector, lived-experience and other stakeholder input to deliver a Framework that is shared in its approach and delivery.

This Implementation Plan also provides a summary of the responses from the consultation against each of the Aims of the Framework. This has been used to review and inform the high level commitments and Actions for each Aim. For a number of the draft Aims and Commitments a significant proportion of the feedback related to specific ideas and approaches that could be used to inform their delivery. Where appropriate, this feedback will be considered by groups working to deliver the Framework or as potential future Actions are developed and implemented.