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
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
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
- 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
- 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