Pain Management Task Force minutes: February 2023

Attendees and apologies

Lynne Nicol, Deputy Director (Chair), Scottish Government
Nicci Motiang, Unit Head (deputy chair), Scottish Government
Stuart Stephen, Implementation Lead, Scottish Government
Moira Nelson, Team Leader, Scottish Government
James O'Malley, Senior Policy Manager, Scottish Government
Sharon Robertson, Policy Manager, Scottish Government
Nicola Rhind, National Clinical Lead
Lynn Railston, Public Health Scotland
Deborah Steven, Pharmacy Network Lead
Aline Williams, Service Manager Network Lead
Linda Sparks, Centre for Sustainable Delivery
Tracey Steedman, Public Health Scotland
Jacqueline Watson, Nurse Network Lead

Apologies

Martin Dunbar
Rory McKenzie
Helen Moores-Poole
Nina Cockton
Lois Lobban

Items and actions

Welcome and apologies

Apologies noted as above.

Approval of minutes from 23 November 2022

The minutes were agreed.

Implementation Progress

Action 5 – Third Sector Network

The Network has been established and has held three meetings held since 1 December. The Network have agreed who will sit on the other Networks and SLWGs. The Network were able to give the policy team feedback on the proposed section 10 fund. A draft workplan has been created and will be shared with the Network for approval in due course. 

Action 10 – Remote Health Pathway update

The Clinical Lead gave an update on the pilot project running in NHS Highland – evaluation now completed and available. Patients stated that it was a positive experience and would recommend to others – easy to use especially on mobile phone; questions condensed and relevant, digital approach, understood the resources shared with them. Barriers highlighted were not being able to save the data as they went along, which has been integrated with feedback on updated questions. Other Boards have indicated they are keen to test the pathway and a meeting of the steering group is due to be held March 2023 to agree next steps.

It was noted that this pilot was in line with the forthcoming digital health social care strategy and was quite far ahead of other specialities with using InHealthcare

Action 11 – SIGN Guideline

SIGN Board agreed to update the Pain Management guidelines and are meeting in March to confirm next steps including establishing a Guideline Development Group with input from existing Pain Clinical Networks. There is an opportunity to ensure the prescribing element of this work dovetails with the proposed update to the Chronic Pain Quality Prescribing Guide which is being developed by Scottish Government’s Effective Prescribing policy team. The Chronic Pain policy team will take forward these discussions and update the task force in due course.

Action 15 – Training Credentialling

The task force was provided with an update on this work by the Senior Policy Manager. It was highlighted that there has been a substantial change in approach by the General Medical Council, with the decision that each nations’ statutory education body would now take forward development of the specialist and multi-professional credentials, rather than the Faculty for Pain Medicine. This is a recent decision and the policy team are currently engaging with NHS Education for Scotland (NES) to understand what this entails and to establish new timeframes for delivery, including any expected costs.

Action 16 – Public Health Scotland review

Public Health Scotland (PHS) carried out a comprehensive review of pain management service data reporting and have developed a number of draft recommendations for action to improve the quality of the available information. A report has been produced to share with Health Board teams including analysts, and a request issued to identify members to join a Pain Data Working Group to develop and deliver the recommendations. Initially the Group will be focused on highly technical data reporting issues, but going forward will consider broader data needs, and membership will be widened as appropriate.

Finance and commissioning    

The Chair highlighted that it was still a challenging time with regards to Scottish Government budget – the Stage 3 debate on the budget took place the day after the Task Force meeting on 21 February. This means that more certainty on the availability of funding is expected to be confirmed shortly. The Policy Team Leader talked through the proposed ‘essential spend’ for the pain management Budget for 23/24. This included funding for the Scottish National Residential Pain Management Programme (SNRPMP), service level agreeemnts for the Implementation Lead, Clinical Lead and Network Leads, Public Health Scotland data reporting and delivery and improvement work delivered by the Centre for Sustainable Delivery (CfSD).

It was discussed that a public heath campaign on chronic pain should be considered essential to help change the public and clinical perception of chronic pain. It was discussed that some services including NHS Fife are delivering some elements of local work in this area, but a national campaign would be more effective. There was also discussion of how the Networks could build on existing evidence from previous campaigns e.g. Flippin’ Pain with a view towards informing an effective campaign once funds are available at the national level. 

23/24 Review and Update proposal    

The Policy Team Leader highlighted that there had been good progress against the 18 actions set out in the Implementation Plan, and thanked the stakeholders and supporters involved in this work.

The task force were thanked for sharing their views on a draft paper to inform proposals on how to report progress and update the plan which is intended to be shared with Ministers. It was highlighted that any update should consider actions or activity that required a longer timeframe for delivery given the challenges facing the NHS at present. The current proposal involves delivering a series of stakeholder engagements to secure their feedback and identify what updates and future priorities are required across the next 3 – 4 year horizon.

It was also highlighted that it was essential to ensure that the voice of lived experience heard and that any review would build on the recent lived experience activities delivered by Healthcare Improvement Scotland and the Pain Panel.

Stakeholder Involvement

Paper on Lived Experience – Health Improvement Scotland (HIS) Gathering Views

The HIS Gathering Views report  on the local barriers faced by people with chronic pain was published at the beginning of February 2023. As part of the response to the findings of the report, it has been identified that there is a need to develop tools to support pain services to engage people with chronic pain in planning, delivery and improvement to ensure they are meeting local needs. The Clinical Lead proposed developing a Framework or Toolkit which collated national guidance and resources and examples of existing approaches in services e.g. work already underway in NHS Fife and Greater Glasgow and Clyde pain services. This would be hosted on the national Chronic Pain TURAS Hub to facilitate accessibility and use of the resource.

The Chair of the task force highlighted that the Scottish Government team working on designing the National Care Service (NCS) would be a useful point of contact to help inform this work.

Communications 

The task force were asked to note that the first newsletter was sent out 27 January 2023 to 21 subscribers. As at 17 Feb – 68 subscribers (almost all are NHS email accounts). It was suggested that NES may be able to support increasing the reach of the newsletter.

Any other competent business 

The new Implementation Lead was introduced. Stuart Stephen has joined us from NHS Grampian secondment for 23 months to lead on implementation of the framework.

Dates of 2023 meetings

A written update will be provided to the task force in March 2023.

3rd May 2023
5th July 2023
6th September 2023
1st November 2023