National Advisory Committee for Chronic Pain minutes: March 2020

Attendees and apologies

Attendees: 

• Prof Blair Smith (BS), National Lead Clinician for Chronic Pain (Chair(
• Prof Lesley Colvin (LS), University of Dundee 
• Dr Rachel Atherton (RA), Consultant Psychologist SNRPMP 
• Gregory Hill O’Connor (GHC) – (the ALLIANCE) 
• Sonia Cottom (SC), Pain Association Scotland (3rd Sector Rep) 
• Anita Stewart (AS), Scottish Government 
• Carolyn Chalmers (CC), Scottish Government 
• Paul Cameron, (PC) NHS Fife
• Kieran Dinwoodie (KD), NHS Lanarkshire
• Angela Donaldson-Bruce (ADB), Versus Arthritis
• Emma Mair (EM), NHS Ayrshire and Arran
• Peter Martin (PM), NHS ISD
• James OMalley (JOM), Versus Arthritis
• Patricia Roche (PR), Pain Concern
• Pauline Bennett (PB), Scottish Government
• Sharon Robertson (SR), Scottish Government

Items and actions

Welcome, Introductions and apologies

Apologies were received from Dr Gregor Smith, Marianne Hayward, Dr Gracy Bell and Aline Williams. BS Chaired the meeting in GS’s absence.

Introductions were made around the room. 

Review of previous actions 

BS reminded everyone that expression of interest forms were to be completed and returned the NACCP secretariat. Secretariat to send out a reminder. (Action).

• Secretariat to share minutes from the ISD steering group for chronic pain dataset with NACCP. Minutes have been circulated.
• CC to find out if an EQIA exists for the Modernising Patient Pathways Programme and/or Scottish Access Collaborative Programme. The Programme does not need an EQIA but individual projects/pieces of work will. There has been a recent PQ on this which provides information (S5W-27398)
• GF/CC agreed to follow up waiting time queries with ISD and Health Boards. Completed 
• The latest position on the promotion and education of the guidelines - Management of chronic pain in children and young people - were discussed. Secretariat to follow up with LC and others to agree the next steps. (Action)
• AS/CC advised that they were keen to put in place a “Policy Statement for chronic pain in Scotland and would start to meet with relevant policy areas and provide an update Ministers to seek views. The Committee endorsed this approach and are keen to see this implemented as it would set out a clear vision and provide clarity about relevant policy aims. (Action)

JOM advised the Arthritis and MSK Alliance were currently developing a chronic pain policy statement. It was agreed that would be an opportunity for this to feed into the Scottish document. 

Scottish Access Collaborative – data and measures

CC gave an update on the work of the Scottish Access Collaborative/Modern Patient Pathways Programme including welcoming EM and KD as new appointments who will lead on the implementation plan. First step is to start gathering views on the priorities from wider chronic pain community via a survey that is open until 9 March. To date there has been 160+ responses with about half of these from people with lived experience. CC recorded appreciation to the Cross Party Group for Chronic Pain and the NACCP for promoting it within their networks. The survey findings will be analysed and shared publically over the next few months. 

The emerging key themes to date are: 

• sustainable funding for chronic pain services
• development of strong links between primary and secondary care, as well as acute and chronic care and
• awareness of, availability and access to information on self-management

CC advised that Scottish Government is currently in discussion with NHS Inform to agree the process to update content on chronic pain. CC asked if the NACCP would support the creation of a SLWG or task and finish group to lead on this review and who should be involved. It was agreed with this proposal.

PR advised that Pain Concern had a navigation tool for people to use for discussions with primary care practitioners. 500 copies have been trialled so far.

ADB advised that Versus Arthritis is about to commence training for 30 health and wellbeing professionals through its Escape Pain programme in primary care (has been done in England) – 200 sites).  

The Committee recognised there is a wealth of resources available but not easily signposted through one location such as NHS Inform. It was highlighted that NHS Boards, (NHS Lanarkshire and NHS Ayrshire and Arran), are also in the process of developing their own local websites

There was a consensus that best practice and learning must be central to the review and more interactive content should be included in the content refresh such as short video clips from people with lived experience and health professionals.

BS agreed that people with lived experience should be substantially and meaningfully involved, and that we should plan for this to happen. RA also offered to discuss with the various clinical pain networks.

PM from ISD gave an overview of the CMD/QPI project. The ISD Steering Group for this work has met twice and Tracey Steedman has been appointed as the project lead 

TS is currently meeting with all Health Boards to discuss the purpose of the new dataset, the value at local/ national level and the practical steps to report it to ISD. The Committee were told that TS S has found variation in pathways and the way waiting times data is currently collected within Boards.

The Committee agreed that the new data will enable a focused approach to achieve better outcomes for people through quality improvement; waiting times measurement and service redesign.

JOM – felt this data development is important to measure outcomes. Versus Arthritis is holding its national MSK data conference in Edinburgh this June – and will circulate details shortly. Versus Arthritis commissioned the inclusion of a chronic pain question in the latest health survey in England. JOM will share findings when available. Versus Arthritis is also working with NHS 24 and ISD to support Scotland’s MSK helpline – this includes development of a triage tool to identify people that are already not working and to assist with supporting them return to employability.

AS asked what ISD is doing to move the classification of the quarterly 18 week referral to first treatment appointment statistics from experimental to official data. PM confirmed this is under consideration.

Chronic  Pain Management short life working group – draft report 

The Committee discussed and endorsed the report produced by the Short Life Working Group that was established in 2018 to explore available data sources and gather additional data via bespoke means about the current and historical number of specialists in relevant disciplines operating within level 3 pain clinics. The report also covers the current system of pain education and training for healthcare professionals and barriers affecting take up. Recommendations are included to address the need for a workforce that has the skills/ competency to support people living with chronic pain in different settings (community, primary, secondary and tertiary). 

 Work is underway to scope short-term and longer-term proposals to action these recommendations. In the short term, services are already considering ways to improve awareness and knowledge of the existing workforce. Longer-term the aim is to incorporate relevant training into under and post graduate training, plus develop CPD accredited training modules for medical and non-medical healthcare professionals in pain management.  

AOCB 

Lived experience group

AS shared feedback from Irene Oldfather (IO) about the first meeting of the chronic pain lived experience group (facilitated by the Health and Social Care Alliance) held on 27 February. ADB provided her reflections on the meeting too. The Committee emphasised the importance of involving people in policy production and service improvement. BS asked for IO to present at the next NACCP meeting to hear more about the group’s objectives and how it can contribute to the NACCP.  (Action) 

Date of next meeting 

The next meeting on 4 May was previously a UK bank holiday until it was changed to 8 May. As some Health Boards are still honouring the 4 May holiday, the meeting will be postponed and the Secretariat will advise NACCP of a new date. (Action) 

List of agreed actions

Number	What	Who
1	Declaration of interest - send out a reminder email and blank copy of the form	Secretariat
2	Management of chronic pain in children and young people	LC/PB
3	Chronic Pain Policy Statement – outline proposal to be shared for comment before submitting to Ministers in order to obtain consent to proceed	PB/AS
4	IO to present at the next meeting	IO
5	New date for May to be sourced	Secretariat