National Chronic Pain Improvement Group (NCPIG)

Transcription

1 National Chronic Pain Improvement Group (NCPIG) Minutes of the National Chronic Pain Improvement Group (NCPIG) Meeting Held on Friday 5 th December 2014 at 10.30am At Stirling Court Hotel, Stirling University Present: Dr Mary Harper, Chair NCPIG Ms Susan Archibald, Patient Representative Mr Adam Briggs, Policy Manager, Scottish Government Mr Paul Cameron, National Coordinator NCPSG Dr Aileen Clyde, NHS Ayrshire & Arran Ms Sonia Cottom, Director, Pain Association Scotland Dr David Craig, NHS GG&C, (deputising for Chair, Learning & Development Subgroup) Dr Lesley Colvin, NHS Lothian (deputising for Chairs of Research and Children s Subgroups) Mr Chris Doyle, The Alliance Ms Linda Frydrychova, NHS Forth Valley (plus Deputising for Chair, Self-Management Subgroup) Ms Heather Harrison, NHS GG&C (Chair, Primary Care Subgroup) Mr Sabu James, NHS Lanarkshire Ms Dorothy Kirkpatrick, NHS Dumfries & Galloway, (via Video Conferencing) Ms Emma Mair, NHS Ayrshire & Arran Dr Margaret Macleod, NHS Western Isles (via Video Conferencing) Dr Ravi Nagaraja, NHS Grampian (via Video Conferencing) Ms Lesley Platford, NHS Orkney (via Video Conferencing) Mrs Elizabeth Porterfield, Head, Strategy and Planning Team, Scottish Government Ms Judith Rafferty, NHS Tayside Ms Hazel Smith, NHS Highland Dr Shona Smith, NHS Borders (via Video Conferencing) Ms Linda Sparks, NHS GG&C (Chair, Website Subgroup) Mr John Wilson, Policy Officer, Scottish Government In Attendance: Dr Jackie Fearn, Clinical Psychology, NHS Fife (for item 5) Apologies: Prof Blair Smith, National Lead Clinician NCPIG and Chair, Research Subgroup Mr David Cline, Head, Clinical Priorities Team, Scottish Government Ms Etive Currie, Patient Representative Dr Michael Fascia, NHS Lothian Ms Lesley Giblin, NHS Shetland Dr Stephen Gilbert, NHS Fife (Chair, Learning and Development Subgroup) Mr Neil Hay, Patient Representative Ms Rachael Heaney, Patient Representative Ms Maureen McAlistair, Arthritis Care Scotland Dr John Muthiah, NHS D&G Ms Sheila Nicolson, NHS Western Isles Ms Frances Proctor, NHS Fife Dr Colin Rae, NHS GG&C Dr Mary Rose, NHS Lothian (Chair, Children s Services Subgroup) Mr Ian Semmons, Action on Pain Mr Andrew Strong, Policy & Information Manager, The Alliance Ms Norma Turvill, NHS Forth Valley (Chair, Self-Management Subgroup) Ms Heather Wallace, Chair of Board of Trustees, Pain Concern Produced by: John Wilson Page: 1 of 7 Review Date:

2 1. Welcome and Introductions / Apologies The Chair, Mary Harper, welcomed everyone to the meeting. Apologies were noted as above. Mary apologised for the last minute problems with some VC connections, such that Borders and Dumfries & Galloway could not link in. 2. Minutes of Previous Meeting The minutes of the meeting held on 5 September 2014 were accepted as being an accurate record. 3. Matters Arising/Progress on Action Points Mary Harper ran through each item detailed on the Action Template (circulated with the agenda) and progress was noted. 4. Future Arrangements supporting chronic pain improvement Mary Harper welcomed Elizabeth Porterfield to the meeting who updated on developments. Elizabeth Porterfield set out the background to the establishment of the Chronic Pain Ministerial Steering Group. Mr Michael Matheson, the then Minister for Public Health, supported by Mr Alex Neil the former Cabinet Secretary for Health and Wellbeing, had requested that a Ministerial Group be formed to provide leadership and direction to support improvement in NHSScotland chronic pain services. Following the Cabinet reshuffle, new Ministers had been appointed and it was expected that Ms Maureen Watt, Minister for Public Health, would hold the policy responsibility for chronic pain and a working assumption was that Ms Watt would Chair the Ministerial Group. A first meeting was expected to be scheduled for the end of January / beginning of February. Membership had not yet been agreed but Mary Harper as Chair of the now renamed National Chronic Pain Improvement Group (NCPIG) would be one of the members along with Blair Smith in his role as Clinical Lead. Future meetings would be scheduled to follow NCPIG meetings to allow a review of, in particular, the waiting times data supplied by ISD and the Health Board monitoring reports. Elizabeth Porterfield informed the group she would work with Mary Harper and Paul Cameron to develop an appropriate reporting framework for the Ministerial Group. Elizabeth emphasised that the role and remit of the Improvement Group would remain the same with only the name change taking effect. The group noted concerns that the new reporting of waiting times data may not fully reflect challenges that Boards have with their waiting lists. It was emphasised that Ministers had been clear regarding the aspects of waiting times requested but that these reflected a starting point to begin a way forward. Others topics touched on were different IT systems within Boards, the role played by primary care in treating chronic pain, the wider aspects of care for people with chronic pain including inequalities, mental health and wellness that could be brought to the Minister s attention, and resource constraints in the current financial climate on councils and support services. Mary Harper directed members attention to the circulated updated Role and Remit, which incorporated changes relating to the Ministerial Steering Group discussed above, but was otherwise as approved at the meeting in September. Mary also requested that members ensure that only one nominated representative from each Board / Group / Third Sector organisation attend future meetings to reflect the membership as set out in Appendix 1 of the Role and Remit. The Group approved the updated role and remit. 5. Data for Chronic Pain Produced by: John Wilson Page: 2 of 7 Review Date:

3 Lesley Colvin tabled a paper (circulated with minutes) to update the group on progress regarding a national core outcomes dataset. Lesley emphasised that the aim was to have a national system that would be quick to collect, i.e. easy and not labour intensive. She referred to a pilot underway in Tayside, which Judith Rafferty described in more detail. Extraction of raw data was taking place using the MiDIS (Multi-Disciplinary Information System), which was used in some other Boards but not all, which raised the query as to how easy it would be to roll out. It was suggested that the Scottish Government might support a national move to the TRAK system. Lesley Colvin also updated the group on elements of the EQ5DL data collection tool. Although EQ5DL was user friendly, a compatibility issue regarding calculations with MiDIS was outlined. In addition, administrative support options / licencing were being looked at. After further discussion, it was agreed that to help the national core dataset work stream, the SIGs would provide background information to Secretariat on the type of IT system used within their Board and on the outcomes already being routinely collected. Jackie Fearn attended the meeting to update the group on progress with a data-set for psychology. Working with Martin Dunbar and representatives from various Boards, the first steps had been taken through a meeting in September to discuss different outcome measures. These had included items grouped under domain, disability, illness and psychopathology. Types of measures also looked at included brief pain, disability questionnaire, lower back pain, MSK questionnaire and the Hospital and Anxiety Depression scale (HADS) score. Some measures such as the pain catastrophising scale had not been recommended. The consensus document would contain some recommendations and actions for further investigation. Jackie reported an editing process was taking place and that, following agreement, the document and questionnaire would be circulated for comment by Secretariat. The group discussed aspects of using a psychology data-set and it was noted it would be a good tool to use as well as presenting challenges to patients who would need support through the process. Action Point(s): Service Improvement Groups Provide Secretariat with background information that answers the following questions; What system(s) does each Health Board use e.g.trak, MIDAS etc and is there any imminent plan to change? What (if any) outcomes are being collected currently within the Pain Service? Action Point(s): Secretariat Circulate finalised draft of psychology data-set and questionnaire for comment 6. Reports from Subgroups The circulated remits and workplans from the subgroups were noted. Mary Harper introduced the Subgroup Chairs (or their deputies) who updated the meeting on progress, summarised below: Chronic Pain in Children subgroup (Chair Dr Mary Rose / Dr Lesley Colvin deputising) Development of a Paediatric Pain Guideline with Scottish Medical and Scientific Advisory Committee (SMASAC) was to be taken forward and SIGN had offered Produced by: John Wilson Page: 3 of 7 Review Date:

4 to provide support for this work stream. Local SIGs workplans would incorporate this piece of evidence based work. Progress would continue to be reported. Research (Chair Prof Blair Smith / Dr Lesley Colvin deputising) Had updated on data collection earlier, at agenda item 5. Development of Scottish Pain Research Community (SPaRC) group and annual scientific meeting were being taken forward. Support was being provided by the Association of the British Pharmaceutical Industry (ABPI). The fifth annual scientific meeting had been scheduled for Friday 27 March 2015 at the West Park Conference Centre, Dundee. Dr Colvin canvassed requests for abstract papers for the meeting to be submitted. Implementation of SIGN Guideline was being progressed through the SIGs. Learning and Development subgroup (Chair - Steve Gilbert / Dr David Craig deputising) Five main areas of focus were reported regarding identification and mapping of resources; Post and Undergraduate education, education for patients, education for the public and the Journal Club. The capture and collation of this information had been taken forward for postgraduate courses. Other areas reported as a work in motion with NHS NES playing a role in identifying specific courses and resources. Practice based small group learning had been developed by NES. Mapping of university courses still to be done before identification of gaps. A survey of undergraduate medical and AHP education was expected to be completed towards the end of A meeting had been scheduled with Professor Philip Cachia from NES to take forward patient safety aspects. Maureen McAllistair was conducting a survey of self-management material. The last piece of work, Journal Club was intended as a one stop shop on the literature covering all aspects of pain management. Primary Care subgroup (Chair - Heather Harrison) The top three priorities had been identified; a) three work streams that were working to develop a template with outcome measures, b) A pilot of education classes and c) the development of clearer pathways. Three meetings had taken place and had produced a positive sharing of ideas and established the different stages that members had reached regarding testing, tools and pathways. Four challenges had been identified; bringing GPs on board, Patient Safety, EQ5DL and the lack of a specific Read code for chronic pain. The next step would be to confirm the status of care standards for primary care and whether this is an item the Improvement Group would support. Supported Self-Management subgroup (Chair - Norma Turvill / Linda Frydrychova deputising ) Three meetings had taken place with good representation from across the service. Work was continuing on resources and related activities. A template was to be circulated to support compiling of resources. Work around signposting activity and wellbeing resources was also being taken forward. A further meeting of the Subgroup was scheduled for later in the year. Website subgroup (Chair - Linda Sparks) A WebEx meeting had taken place in November. Produced by: John Wilson Page: 4 of 7 Review Date:

5 The Quality & Assurance (Q&A) process for new and old resources was progressing with the Q&A steps being piloted using the NHS Inform chronic pain leaflets. Tools such as the AHP Scotblog and Twitter were being focussed on to raise the profile and functioning of the website. Paul Cameron had drafted updated guidance and Mary Harper, liaising with Neil Gammage from Dumfries & Galloway and Barry Brown, website developer from Roots Creative, would take this forward. The group discussed aspects of the subgroup updates. Jackie Fearn raised the issue of multidisciplinary training and education in relation to the new National Chronic Pain Programme in Glasgow. David Craig confirmed that, at present, this was not one of the major business items of the Learning and Development Subgroup and there was agreement that the Subgroup raise it for discussion. The group were informed that regarding the survey of self-management material that Maureen McAllistair was progressing, a meeting between Steve Gilbert and Norma Turvill had yet to take place. The NCPIG agreed the content of the Subgroups Roles and Remits. Action Point(s): All Send suggestions / proposals for abstract papers to Lesley Colvin for the SPaRC meeting scheduled for Friday 27 March 2015 Action Point(s): David Craig / Steve Gilbert Add multidisciplinary education and training at the National Chronic Pain Programme in Glasgow to the agenda of the Learning & Development Subgroup for discussion. 7. Monitoring Reports a. Coordinator s Report Paul Cameron confirmed that if there were specific items resulting from the monitoring reports he would contact SIGs to schedule one to one meetings. Prescribing trends were highlighted as a theme emerging from the reports and it was suggested arranging a presentation on prescriber trends for the next meeting. (Note following meeting - due to speaker availability, this would be scheduled for the June 2015 meeting.) b. Board Reports The circulated Board reports were noted. Paul Cameron noted that in future Ministers would need short, succinct reporting. Once a clearer understanding of what Ministers expected he would redraft the monitoring template and map them against what is being collected. Elizabeth Porterfield discussed the format of update papers to the Minister, which should aim for one page with a frontispiece setting out the rationale and what actions are being asked of the Ministerial Group. The level 4 services (the National Chronic Pain Programme and the Spinal Cord Stimulation service) would be the responsibility of the Scottish Government colleagues to take forward, with the Improvement Group progressing levels 1-3. Following discussion, Elizabeth confirmed that QPIs (Quality Performance Indicators) would be the preferred route to service improvement rather than through the development of standards. e.g. for primary care. Judith Rafferty asked that if QPIs were developed what mechanism was open to encourage use by GPs, as there was no Produced by: John Wilson Page: 5 of 7 Review Date:

6 specific Read code for chronic pain and it did not feature in QoF. Elizabeth Porterfield agreed to liaise with Scottish Government colleagues who had responsibility for the GP contract. c. Third Sector Reports The circulated paper, containing reports from the ALLIANCE and Pain Association Scotland, was noted. It was noted that Heather Wallace had submitted apologies and asked that the following section be added by way of an update for Pain Concern; Pain Concern have completed first stage of 2 year research programme into barriers to pain management in primary care, with a report on research findings. In addition they have also published a CD booklet aimed at young people who care for someone living with chronic pain. d. Waiting Times Report The group discussed the Waiting Times report produced by ISD from information submitted by Boards, the data, and its significance and gaps such as primary care data. David Craig informed the group that the profile of the 18 week wait was available and NHS GGC reported this on a monthly basis under the HEAT target. Paul Cameron noted that Grampian was looking at reporting issues. The group acknowledged that different Boards would have different approaches and where there were substantive differences, these could be illuminated over time. Mary Harper highlighted that the paper was for noting at this stage and asked that SIG Leads provide feedback to ISD colleagues on the process and findings, as this was the first use of these reports. Action Point(s): Secretariat Arrange presentation on prescriber trends for June meeting. Action Point(s): Elizabeth Porterfield Liaise with Scottish Government colleagues who have responsibility for the GP contract regarding possible mechanism to encourage QPI use by GPs. Action Point(s): SIG Leads Feedback to Fiona Mackenzie and colleagues at ISD regarding the Waiting Times reporting arrangements. 8. National Chronic Pain Management Programme Update Elizabeth Porterfield reported on progress. Allander House on the Gartnavel Hospital site in Glasgow had been identified as the temporary site of the national service from January The first patient assessments for suitability would take place at Stobhill, Glasgow. Future arrangements will depend on the number of referrals and location suitability as the service becomes embedded. 9. AOCB No further items of business were raised by the group. However the Chair requested members to confirm their attendance for future meetings timeously and, if sending apologies, to please nominate someone to deputise in their place if possible. Mary Harper introduced John Wilson and Adam Briggs who would be taking forward Secretariat duties following the invaluable support provided by Emma Graham. Mary also informed the group that Blair Smith was still off sick, but that he wished everyone well and passed on his best wishes. In turn, Mary had conveyed best wishes to Blair on behalf of the NCPIG. 10. Date of Next Meeting Produced by: John Wilson Page: 6 of 7 Review Date:

7 The next meeting of the National Chronic Pain Improvement Group (NCPIG) will take place on Friday 6 th March 2015 at am at the Beardmore Hotel and Conference Centre, Clydebank, G81 4SA. Future Meetings Friday 5 th June 2015 at Scottish Health Service Centre, Edinburgh, EH4 2LF Produced by: John Wilson Page: 7 of 7 Review Date: