Chronic Pain - FOI Response Register

1. How much staffing capacity (WTE) does your health board provide for dedicated management of chronic pain (including secondary care chronic pain services, in-patient or primary care clinics), for the following disciplines: medicine, nursing, physiotherapy, psychology, pharmacy, occupational therapy? (as of 19th September 2024)

NHS Shetland is an Island Health Board and as such employs generalists as part of multi-professional teams. We do not have specific primary care clinics because the number of patients presenting is small. Consultant Anaesthetists with a specialist interest in chronic pain, provide OP clinics and some treatment interventions. It is not possible to provide a WTE as the chronic pain activity is part of the wider delivery of the anaesthetic service.

2. What is your vacancy rate for each of these capacities as of 19th September 2024?

N/A See above

3. What capacity does the chronic pain service manager have dedicated to chronic pain services (in WTE)?

NHS Shetland do not have a Chronic Pain Service Manager

Provision of Pain Groups

Please give details (including staffing and duration) of any groups for management of chronic pain that your board provides or funds, for patients. These groups may treat chronic pain as either as a stand-alone condition, or as part of general long-term condition management.

There are no third sector groups established in Shetland that specifically focus on chronic pain. Voluntary Action Shetland has a community directory of support groups please see link: Voluntary Action Shetland | Shetland Community Directory

Chronic pain support for generalist services

4. The recent Scottish health survey (2023) found that people with chronic pain mainly received healthcare support from their GP, and after that from a physiotherapist for chronic pain. What staff support/ education does your board provide or fund for these staffing groups, for chronic pain management?

Staff will identify through their appraisal process their learning needs and/or requirements which may include chronic pain management. Generalists in Shetland can access decision making support via the Consultant Anaesthetists or specialist services at NHS Grampian as needed.

5. What, if any, healthcare is provided directly by physiotherapists and GPs to patients for treatment of chronic pain?

We do not have a dedicated MDT integrated chronic pain service in Shetland, hence patients are currently seen within the musculoskeletal (MSK) pathway for physiotherapy by MSK generalists.

Equitable delivery of care

6. The Scottish health survey (2023) found that chronic pain is a condition that is experienced unequally, with 29% prevalence in the least deprived decile in Scotland, ranging to 50% prevalence in the most deprived decile. Does your board have any strategies or policies, to address equitable delivery of care, providing resources according to level of need in more deprived areas?

Shetland is a rural island community and does not have distinct areas of deprivation.  Deprivation is experienced by individuals and families who live across the isles and it is difficult to take a targeted approach, but we have joined up working between primary, secondary, community and social care – with GPs as care co-ordinators. There is an ANP employed to help support people who are more vulnerable and may need additional support.  We also have living well hubs in our communities to bring services together to reduce inequity of access.