GRIPS report

Getting to GRIPS with chronic pain

The overall aim of the report is to establish the current adult Chronic Pain Services provision across primary, secondary and tertiary care in each NHS Board area.

This work has been carried out over a short timescale to maintain momentum. We used a three tier approach based on feedback from:

  • NHS Boards on their arrangements for planning and providing chronic pain services
  • healthcare professionals of chronic pain services on what they provide
  • those using these services on what they receive.

The collective findings from these three perspectives provides a powerful three dimensional analysis of current service provision that has several key themes running through and across each tier. Further, the findings have informed the development of practical solutions to address the themes, gaps and priorities we identified

Findings

  • Despite four nationally commissioned reports in the last ten years and data from surveys indicating high prevalence (18% of Scottish population), chronic pain is not recognised as a 'condition' and is not currently included in the key long-term conditions to be addressed by the Long Term Conditions Alliance. As a result, it is not regarded as a priority by Scottish Government Health Directorates (SGHD) or by NHS Boards.
  • The provision of chronic pain services within Scotland is patchy and fragmented particularly for core secondary services. Service provision and access to services varies considerably between and within NHS Boards and we found little evidence of needs assessment or strategic planning for chronic pain services. Very few NHS Boards have dedicated funding streams for these services. The quality and effectiveness of these services is rarely monitored.
  • None of the NHS Boards could provide a complete or accurate description of the chronic pain services provided, or of the resources available to provide them.
  • There are significant discrepancies between the descriptions of available services as reported by NHS Boards and services actually provided, as reported by healthcare professionals and service users. In the main, clinicians providing services did not recognise and could not reconcile actual service provision with the service provision reported by NHS Boards.
  • Some information was available on services provided in the secondary care sector but very little feedback was
    provided on primary and community healthcare services although we are aware that most patients are cared for in this setting.
  • Access to specialist services is limited, with GPs often reluctant to refer and waiting times are long.
  • There is a general lack of knowledge about chronic pain and awareness of treatment options and services in NHSScotland.
  • Very few Boards offer pain management programmes (PMP) and very few patients have access to these.

Published Date: 10 December 2007