Health and Wellbeing Progress – Recommendation 12

Chronic pain management

The National Advisory Committee for Chronic Pain (NACCP) should consider veterans specifically as part of their work to improve chronic pain management in Scotland.

2019 SVC evaluation of status:

Partially implemented

2019 update provided by the Scottish Government:

The National Advisory Committee on Chronic Pain (NACCP) is taking forward work to inform policy development and support NHS Boards and Health and Social Care Partnerships (HSCPs) to improve the provision of pain services across Scotland. This includes a project to develop a core dataset and a set of Quality Performance Indicators (QPIs) to measure service outcomes and improvements for people living with chronic pain, including veterans. The Director of Pain Association Scotland (PAS), sits on NACCP and has been in discussion with the MOD Clinical Adviser for Veterans about the need to recognise veterans as a vulnerable group that would benefit from tailored support for chronic pain. The Pain Association has identified a gap in the quality of support services received on leaving the forces, in comparison to those received whilst serving. We are actively engaging with stakeholders to better understand experiences of veterans. PAS are piloting a programme in Scotland after securing funding from the Veterans Association. The programme offers veterans one-to-one self-management sessions via phone or skype to discuss personal needs and outcomes. This alleviates the need for the individual to attend clinics in person, recognising attendance may be difficult due to the nature of their pain. PAS will evaluate the project after 18 months and NACCP, chaired by the Deputy Chief Medical Officer, will consider outcomes and findings of the pilot.

2020 SVC evaluation of status:

Implemented, but work should continue

2020 update provided by the Scottish Government:

The Pain Association Scotland (PAS) ran a very successful pilot from 2018 to 2019 on chronic pain self-management for 41 veterans. This was in the format of group meetings at Erskine House and through 1:1 sessions with 11 veterans. The pilot received excellent feedback from participants, with some describing the course as “informative, educational and interesting”, and commenting that the course has “taught me to accept, manage and deal with” pain. PAS has secured a further 18 months of funding as of March 2020, and will put the pilot findings before the National Advisory Committee for Chronic Pain with the aim of embedding the services provided.

2021 SVC evaluation of status:

Fully implemented

2021 update provided by the Scottish Government:

Pain Association Scotland (PAS) state that as the challenges of COVID-19 have continued, more and more people have been suffering from increased anxiety and fear, the curtailment of their usual socialising, as well as the difficulties that long-COVID now presents. PAS support for veterans has been mainly by phone on a one-to-one basis and they have a regular cohort of 36 veterans whom they provide support for their chronic pain. They are delighted to have been able to offer continued help and re-assurance during difficult times. Initially, PAS had planned that the project would involve short-term self-management training for up to 5 sessions, but during this last year they have found that some people accessing the service have very complex needs that reach beyond the pain. This cohort, often with adjustment issues and trauma, have required a different approach in which PAS have continued to work longer term looking to improve life in general, often focussing on helping them to cope better with day-to-day life.

Following feedback from some veterans and those who support them, PAS have been delighted to offer an online 5 week self-management group programme. The first course started in July 2021 and they had 12 people sign up and complete the course. Due to the success of this group based programme, they have launched another 5 week course starting on 18th October 2021. Sign-up is available online.

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