Future provision of specialist residential chronic pain management services in Scotland: consultation report

Chapter 1: Introduction and background

About this report

This report responds to the findings of the consultation as set out in the independent report 'The Provision of Residential Chronic Pain Services in Scotland: Analysis of Consultation Responses' and sets out the Scottish Government's proposals for taking forward the development of these services.

Chapter 2 of this report relates to our response to the main findings of the consultation with Chapter 3 setting out the planned next steps.

Detailed analysis of the consultation was conducted independently and the results published on 23 January 2014. A full report is available on the Scottish Government website at http://www.scotland.gov.uk/Publications/2014/01/7685. In addition, a separate analysis summary has also been published - http://www.scotland.gov.uk/Publications/2014/01/9795 - along with the consultation responses for which consent to publish had been provided.

Background to the Consultation

The consultation focused on those people who may benefit from treatment provided by the establishment of a specialist residential service in Scotland. This type of service is designed to improve quality of life, enable patients to better manage their chronic pain and reduce their disability.

This service is not currently available in Scotland. At present people for who it is considered may benefit from such a service are assessed and receive treatment outwith Scotland. Most commonly the service has been provided by the Bath Centre for Pain Services, at the Royal Hospital for Rheumatic Diseases.

In 2009 the National Chronic Pain Steering Group carried out a review of the provision of specialist pain management services and at that time concluded that there was insufficient evidence to support provision of such a service in Scotland. However, the group committed to review the position again in the future.

In keeping this commitment, National Specialist and Screening Services Directorate (NSD) of NHS National Services Scotland were asked to scope and assess options for the future provision of chronic pain services. An expert group was convened, comprising of professional providers of chronic pain services in Scotland, third sector organisations and patients. The group commenced work in March 2013.

During a debate in the Scottish Parliament on 29 May 2013, Mr Alex Neil, MSP, Cabinet Secretary for Health and Wellbeing pledged to establish the first specialist residential pain management service in Scotland. The Cabinet Secretary recognised that there were a number of ways in which a service in Scotland could be developed and acknowledged the importance of seeking a wide range of views to inform a decision on the most appropriate way to provide the service.

About the consultation

A public consultation was held to seek views of patients, their families, carers, clinicians and other stakeholders. National Services Division agreed to provide a report of their scoping and assessment of the various options for providing the service, which could be used to form the basis of a consultation paper. A consultation paper was launched initially on 3 July 2013, however, early feedback indicated that the consultation document was technical in nature and not as accessible as we would have wished. The Cabinet Secretary took the decision to suspend the consultation in order that it could be re-drafted to ensure as wide a range of views as possible would be received. A small review group was formed, which included external and third sector representation, to consider the feedback and re-draft the consultation document. The consultation was re-launched and was open for comment from 2 September to 27 October 2013.

The consultation set out three potential options for the future provision of specialist residential services in Scotland:

Option 1: A Centre of Excellence in a single location

Option 2: A service delivered by local chronic pain clinicians supported by other clinical advisors in another part of the country

Option 3: A service delivered in different locations by a team of chronic pain specialists (an outreach or roving service)

The consultation document included a Respondent Information Form and a consultation questionnaire, which explored 11 questions (the questions are provided at Annex C). In addition to seeking views on the options presented, the consultation questionnaire invited respondents to identify any other ideas and sought views on a range of issues including: barriers to services; components of a service; current service provision and personal experience of service use. Respondents also had the opportunity to comment on any aspect of chronic pain services in Scotland.

An electronic version of the questionnaire was available for download or in HTML format on the Scottish Government website, and hard copies and large print format versions of all documents were available on request. Information on the consultation and links to the documents were circulated via email to a wide stakeholder group (see Annex D).

To support the consultation, the Health and Social Care Alliance (The ALLIANCE) in conjunction with the Scottish Government organised a series of network events across Scotland. These events were widely publicised through the ALLIANCE and Scottish Government and were held in:

• Glasgow - 23 August 2013
• Inverness - 21 October 2013
• Dumfries - 23 October 2013
• Glenrothes - 24 October 2013

A total of 77 participants attended the stakeholder events. The comments from all of these events were summarised by the ALLIANCE and submitted to the Scottish Government as part of the ALLIANCE's consultation response.

We would like to thank the team at the ALLIANCE for their work and support in arranging and delivering these events.