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Parallel Session 1.6.4 Managed Clinical Networks and Quality Improvement: A Distinctively Scottish Approach
1. Greater Glasgow and Clyde
Managed Clinical Network
for Chronic Pain
Dr. C olin P Rae
.
C onsultant in Anaesthesia and Pain Management
North Glasgow Pain Service
Lead C linician GG&C MC N
2. Chronic Pain
• C ommon problem
• Estimated prevalence 1 in 5 of general
population
• Pain part of many different chronic
conditions/illnesses
• C hronic pain often not recognised and
difficult to manage
• Increasing incidence
• Big medical, social and political cost
3. Chronic Pain Management
Service in GG&C
• Small secondary care based service based at 3
sites in GG&C
• C onsultant Anaesthetist/Pain specialist led with
Multidisciplinary team
• Little awareness in primary and secondary care
of service or principles of chronic pain
management
• Historically under resourced and very variable
provision between sites
5. GRIPs report Recommendations
July 2008
Priority Action 1
Scottish Government to designate chronic pain as
a condition in its own right, welcome the inclusion
of chronic pain on the agenda of the Long Term
Conditions Alliance and support uptake of
Managed Clinical Networks (MCN) in Chronic
Pain
6. GRIPs report Recommendation
July 2008
Priority Action 2
NHS Boards to develop core secondary services, clear
referral pathways from primary care to secondary care
chronic pain services, and for tertiary services such as
Spinal Cord Stimulators (SCS), Intrathecal Drug Delivery
(IDD) and Pain Management Programmes (PMP). These
should take into account the administrative reforms
recommended by the McEwen Report, Chronic Pain
Services in Scotland, 2004 and will support the
development of chronic pain services at Managed Clinical
Network and Community Health Partnership (CHP) level
7.
8. What were the issues for the chronic pain service in
GG&C?
• How to reduce inequalities in service provision
• How best to provide pain management services in secondary
care?
• How to improve management in primary care?
• How to improve ‘patient journey’and improve patient
information
• How to improve communication and information?
- primary and secondary care
- patient and health care professionals
• How to encourage and promote self management?
• How best to link with other existing services
9. Managed Clinical Networks
• Streamlining patient journey and improving quality of service
• Making most effective use of resources
• Patient involvement / Multi-professional
• Planning forum
• Education and training
• Quality assurance programme
• Annual report and work plan
10. C hronic Pain MC N Structure
• Lead C linician(s)
• Administrator
• Executive group
• Steering Group
• Standards sub group
• Pathways sub group
• Education sub group
• Audit and Research sub group
• IT sub group
11. Other functions of the MC N
• Representation on GG&C Long Term C onditions Group
• Learning from other MC Ns
• Representation on C hronic Pain National Steering group
• C ross Party Working Group
• Involving clinicians, patients and third sector groups
• Area Drugs and Therapeutics committee
• Examining inequalities
• IT developments
12. Chronic Pain MCN Achievements
• Primary C are guidelines developed and updated
• Standardisation of patient information and drug information
• Development of regional chronic pain website
http://www.knowledge.scot.nhs.uk/pain.aspx
• Development of referral criteria
• Development of standards for chronic pain service
13. Chronic Pain MCN Achievements
• Training needs assessment undertaken of primary care professionals in
GG&C and secondary care nurses and physiotherapists
• Survey of needs of patients with chronic pain
• Rolling education programme started
• Increased access to pain clinics for advice
• Pilot of Specialist Nurse led local access chronic pain clinic in Paisley and
C lydebank
• Improving data collection
14. Work in progress
• Improving chronic pain management pathways in primary
care
• Improving data collection
• Development of chronic pain management ‘app’
• Further development of chronic pain web site
• Development of elearning modules
• Improving prescribing and monitoring of analgesic
medications (opioids)
• Monitoring of quality of care
• Examining health inequalities
15. Summary
GG&C MC N for chronic pain
- C heap!
- Good planning vehicle for service
- Provides continuing focus for improvement in
service quality and efficiency
- Patient and third sector key involvement
- Tangible achievements
