NHS admits it is failing thousands suffering chronic pain
Thousands of patients living with incurable pain are being let down by the Scottish NHS, according to a hard-hitting report by the health service's own watchdog.
Despite four official investigations in the past 14 years highlighting worrying gaps in care, the research reveals there has been very little improvement.
Specialist support for people who suffer chronic pain is patchy and inadequate, patients are confused and clinicians are frustrated, say the authors.
They are demanding action from the Scottish Government and health boards to ensure patients, who can wait years for the treatment they need, get faster access to the right medical help.
It is estimated that 18% of the population, 900,000 people, suffer some form of chronic pain. This is discomfort from injury or disease which persists beyond the typical healing process.
One-quarter of people diagnosed are unable to continue working because of the condition, yet just 3% of sufferers are sent to the specialist clinics.
NHS Quality Improvement Scotland, which monitors standards in the health service, has published the latest report.
It notes the Scottish Office first described services as patchy in 1994 and further documents published by very experienced people in 2000, 2002 and 2004 raised the same issues.
"Despite all of this, very little progress has been made. Access to specialist services is poor."
NHS QIS found not one health board could accurately describe the services they did offer.
Dr Pete Mackenzie, who worked on the report, said: "There are major blackspots around the country where there is almost a complete lack of service. The chances of (being told there is no hope) are much greater if you live in an area like that."
Dr Mackenzie said, there was frustration about the pace of progress, adding: "It is fair to say many of us, and particularly the patients with chronic pain, feel reports come and go and nothing much happens."
A Scottish Government spokeswoman said: "We are considering the recommendations relating to the Scottish Government, and the Health Secretary will use her address to the national conference organised by the Pain Association Scotland on May 20 to set out her response.
"We have for a number of years been encouraging the development of a managed clinical
network approach to chronic pain."
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Posted by: subrosa on 12:17am Tue 25 Mar 08
Finally medical people admit there's no such thing as 'pain free pastoral care'. It's about time. So often people live in agony and they're told something will be done and it never is.
I watched my father die in agony with prostate cancer and was disgusted when the hospice staff told me he's been 'comfortable and pain free' during his stay with them.
Years ago the UK government said they would have pain clinics in every area of the country. Where are they?
Finally medical people admit there's no such thing as 'pain free pastoral care'. It's about time. So often people live in agony and they're told something will be done and it never is.
I watched my father die in agony with prostate cancer and was disgusted when the hospice staff told me he's been 'comfortable and pain free' during his stay with them.
Years ago the UK government said they would have pain clinics in every area of the country. Where are they?
Posted by: JBlackley, Florida on 12:23pm Tue 25 Mar 08
More third-world service from a second-rate health system.
The NHS is built on a model that was developed over sixty years ago and has had no fundamental redesign. What was intended to provide basic care through medical practices of the nineteen-forties has been squished, squashed and bolted-onto to try and keep up with advances in medical practice and more sophisticated demands from patients.
Who, in the nineteen-forties would have foreseen fertilisation treatment on demand? Who then might have predicted cosmetic surgery to heal 'self-image' issues? Who would even have predicted the advances in chemotherapy?
The system - designed in a Victorian mindset - is not fit for today's purpose and needs to be radically changed. Look to other countries and see better models - then begin to break down the protectionist barriers that keep this creaking, inadequate old system going. A modern country deserves a better healthcare system than the NHS.
More third-world service from a second-rate health system.
The NHS is built on a model that was developed over sixty years ago and has had no fundamental redesign. What was intended to provide basic care through medical practices of the nineteen-forties has been squished, squashed and bolted-onto to try and keep up with advances in medical practice and more sophisticated demands from patients.
Who, in the nineteen-forties would have foreseen fertilisation treatment on demand? Who then might have predicted cosmetic surgery to heal 'self-image' issues? Who would even have predicted the advances in chemotherapy?
The system - designed in a Victorian mindset - is not fit for today's purpose and needs to be radically changed. Look to other countries and see better models - then begin to break down the protectionist barriers that keep this creaking, inadequate old system going. A modern country deserves a better healthcare system than the NHS.
Posted by: tris, scotland on 2:29pm Tue 25 Mar 08
[quote][bold]JBlackley[/bold] wrote:
More third-world service from a second-rate health system. The NHS is built on a model that was developed over sixty years ago and has had no fundamental redesign. What was intended to provide basic care through medical practices of the nineteen-forties has been squished, squashed and bolted-onto to try and keep up with advances in medical practice and more sophisticated demands from patients. Who, in the nineteen-forties would have foreseen fertilisation treatment on demand? Who then might have predicted cosmetic surgery to heal 'self-image' issues? Who would even have predicted the advances in chemotherapy? The system - designed in a Victorian mindset - is not fit for today's purpose and needs to be radically changed. Look to other countries and see better models - then begin to break down the protectionist barriers that keep this creaking, inadequate old system going. A modern country deserves a better healthcare system than the NHS.[/quote]
Yes,I agree with you. Yet Brown in his article for the Daily Telegraph counted the NHS as one of the proud achievements of the Union, of which we are all so fond.
.........or not
JBlackley wrote:
More third-world service from a second-rate health system. The NHS is built on a model that was developed over sixty years ago and has had no fundamental redesign. What was intended to provide basic care through medical practices of the nineteen-forties has been squished, squashed and bolted-onto to try and keep up with advances in medical practice and more sophisticated demands from patients. Who, in the nineteen-forties would have foreseen fertilisation treatment on demand? Who then might have predicted cosmetic surgery to heal 'self-image' issues? Who would even have predicted the advances in chemotherapy? The system - designed in a Victorian mindset - is not fit for today's purpose and needs to be radically changed. Look to other countries and see better models - then begin to break down the protectionist barriers that keep this creaking, inadequate old system going. A modern country deserves a better healthcare system than the NHS.
Yes,I agree with you. Yet Brown in his article for the Daily Telegraph counted the NHS as one of the proud achievements of the Union, of which we are all so fond.
.........or not
Posted by: JBlackley, Florida on 3:03pm Tue 25 Mar 08
tris, thanks for the agreement. I understand what Brown was talking about - politicians generally boast about the amount of public money they've spent, not the effect of spending it.
In this case, all the government was doing was putting lipstick on a pig.
tris, thanks for the agreement. I understand what Brown was talking about - politicians generally boast about the amount of public money they've spent, not the effect of spending it.
In this case, all the government was doing was putting lipstick on a pig.
Posted by: subrosa on 3:07pm Tue 25 Mar 08
Reducing or eliminating pain is surely fundamental to a health service is it not. Problem is that the people suffering such pain do not have the strength to lobby their MPs.
Reducing or eliminating pain is surely fundamental to a health service is it not. Problem is that the people suffering such pain do not have the strength to lobby their MPs.
Posted by: tris, scotland on 3:44pm Tue 25 Mar 08
Yes that's true, but the measure of a decent society is how it treats its weak, its old, its very young and its ill. In short people who can not fend well for themselves. (Despite Browns proclamations this morning, I'm not convinced that Britain does a good job of that.)
It is down to the rest of us to ensure that these people be taken care of, if not out of human decency, then at least out of the fact that we ourselves may one day be in that situation.
And it may not be caused by old age... so it is not necessarily way into the future.
Yes that's true, but the measure of a decent society is how it treats its weak, its old, its very young and its ill. In short people who can not fend well for themselves. (Despite Browns proclamations this morning, I'm not convinced that Britain does a good job of that.)
It is down to the rest of us to ensure that these people be taken care of, if not out of human decency, then at least out of the fact that we ourselves may one day be in that situation.
And it may not be caused by old age... so it is not necessarily way into the future.
Posted by: subrosa on 3:52pm Tue 25 Mar 08
Tris, pain is no respecter of age. Pain is an indication that something in the body is not functioning as it should. Of course the cause must be identified but, morally, the medics involved should be doing their best to alleviate the pain first and foremost.
I have listened for years to some medics saying the pastoral care of the ill in this country is second to none. That's drivel. Look around you and see the people, of all ages, who have little or no quality of life, all because of pain. Then again, you won't see many outside of their own front doors because they're so debilitated with pain.
I accept that not all pain can be eliminated but it can be controlled. That's not being done.
Tris, pain is no respecter of age. Pain is an indication that something in the body is not functioning as it should. Of course the cause must be identified but, morally, the medics involved should be doing their best to alleviate the pain first and foremost.
I have listened for years to some medics saying the pastoral care of the ill in this country is second to none. That's drivel. Look around you and see the people, of all ages, who have little or no quality of life, all because of pain. Then again, you won't see many outside of their own front doors because they're so debilitated with pain.
I accept that not all pain can be eliminated but it can be controlled. That's not being done.
Posted by: tris, scotland on 4:04pm Tue 25 Mar 08
I agree Subrosa. A few years ago I was in a local community centre, when a woman came in to get help from one of the workers. It was heart wrenching to see the agony she was in from some sort of joint pain. It turned out she was in her 50s but looked over 70. The lines of pain were etched on her face. She, as you say, had no quality of life, every day was just a mass of pain. And maybe 30 years still to live.
I agree that not all pain can be totally illiminated; rather from my limited understanding I appreciate that its effective alleviation may mean so much morphine that death is the result, and that doctors are frightened, particularly since Shipman, to be seen to doze as highly as once they did.
We need to remedy this. Could we not at least in Scotland, have a commission of top doctors looking into the responsibilities of health care workers to ensure that pain is not all that some people can look forward to?
I agree Subrosa. A few years ago I was in a local community centre, when a woman came in to get help from one of the workers. It was heart wrenching to see the agony she was in from some sort of joint pain. It turned out she was in her 50s but looked over 70. The lines of pain were etched on her face. She, as you say, had no quality of life, every day was just a mass of pain. And maybe 30 years still to live.
I agree that not all pain can be totally illiminated; rather from my limited understanding I appreciate that its effective alleviation may mean so much morphine that death is the result, and that doctors are frightened, particularly since Shipman, to be seen to doze as highly as once they did.
We need to remedy this. Could we not at least in Scotland, have a commission of top doctors looking into the responsibilities of health care workers to ensure that pain is not all that some people can look forward to?
Posted by: fat tam, new zealand on 6:01pm Tue 25 Mar 08
The UK is not out of step here. Other countries i have practiced have similar gaps; even when there are different models of health care delivery. So perhaps denigrating the whole NHS is slighty catastrophising.
The issue is that there are huge shortages in specialist anaethetists and psychiatrists interested in pain. Both those professions are essential to a specialist pain clinic according to the proffesional pain bodies. It is an area, as one commenter states, that is hard to recruit to, due to Shipman, the concerns over litigation ( see the US)
and the inherent frustrations of the job.
Given the epidemiology of chronic pain and the fact that pain is universal it is a condition which is rarely curable in a conventional sense- just like most chronic medical conditions- and thus management in a recovery framework ie how do you live a normal as possible life in the presence of symptoms , is the most realistic approach. Such an approach requires not only the medical proffesion, particularly primary care but also social services and the public themselves to alter their expectations.
The UK is not out of step here. Other countries i have practiced have similar gaps; even when there are different models of health care delivery. So perhaps denigrating the whole NHS is slighty catastrophising.
The issue is that there are huge shortages in specialist anaethetists and psychiatrists interested in pain. Both those professions are essential to a specialist pain clinic according to the proffesional pain bodies. It is an area, as one commenter states, that is hard to recruit to, due to Shipman, the concerns over litigation ( see the US)
and the inherent frustrations of the job.
Given the epidemiology of chronic pain and the fact that pain is universal it is a condition which is rarely curable in a conventional sense- just like most chronic medical conditions- and thus management in a recovery framework ie how do you live a normal as possible life in the presence of symptoms , is the most realistic approach. Such an approach requires not only the medical proffesion, particularly primary care but also social services and the public themselves to alter their expectations.
Posted by: JBlackley, Florida on 6:23pm Tue 25 Mar 08
fat tam, pain management is a thriving speciality in the US with many clinical centres - and even offices in malls - offering focused regimens to help those with chronic pain.
In fact, denigrating the whole NHS is not catastrophising, it's a legitimate criticism for a Victorian-era approach to healthcare.
fat tam, pain management is a thriving speciality in the US with many clinical centres - and even offices in malls - offering focused regimens to help those with chronic pain.
In fact, denigrating the whole NHS is not catastrophising, it's a legitimate criticism for a Victorian-era approach to healthcare.
Posted by: fat tam, new zealand on 6:53pm Tue 25 Mar 08
Yes you are correct the pain system is flourishing as are the arrest and trial of pain physicians for their practices- hardly a week goes by without a high profile case. This has led to serious misgivings about the use of opioids in pain practice- the risk of diversion, addiction and overdose are real and balancing this with pain management is complex-as a result many are frightened to enter this area. Many non medical treatment centres in the US have opened up with the best of intentions but the standard is questionable. More litigation will result.
We now have a situation in the states wereby licit prescription abuse of opioids is more prevalent and deadly than all illicit drugs combined. Oxycodone is the prinicipal suspect in the US.,
For more info check out DEA ARCOS data and DAWN and DEPT OF HEALTH AND HUMAN SCIENCES.
Yes you are correct the pain system is flourishing as are the arrest and trial of pain physicians for their practices- hardly a week goes by without a high profile case. This has led to serious misgivings about the use of opioids in pain practice- the risk of diversion, addiction and overdose are real and balancing this with pain management is complex-as a result many are frightened to enter this area. Many non medical treatment centres in the US have opened up with the best of intentions but the standard is questionable. More litigation will result.
We now have a situation in the states wereby licit prescription abuse of opioids is more prevalent and deadly than all illicit drugs combined. Oxycodone is the prinicipal suspect in the US.,
For more info check out DEA ARCOS data and DAWN and DEPT OF HEALTH AND HUMAN SCIENCES.
Posted by: fat tam, new zealand on 7:11pm Tue 25 Mar 08
Forgot to comment on your understanding of the Victorians.
Compare if you will a failed but essentially idealistic service which is raised by tax across the populace and delivers health care free at the point of access with a system of short term intervention driven by insurance led managed care which excludes the poor and thus most needy. Which one is Victorian?
UK readers experience health care in other countries outside of Europe and then be thankful for our system.
Forgot to comment on your understanding of the Victorians.
Compare if you will a failed but essentially idealistic service which is raised by tax across the populace and delivers health care free at the point of access with a system of short term intervention driven by insurance led managed care which excludes the poor and thus most needy. Which one is Victorian?
UK readers experience health care in other countries outside of Europe and then be thankful for our system.
Posted by: ubergeek, glasgow on 7:12pm Tue 25 Mar 08
You may consider it Victorian, but I consider a healthcare system which cannot provide for 40 million of its people wholy unsatisfactory. There are problems within the UK, but we have an integrated system which supports preventative medicine far better than the US model. It has been shown time and time again that the US system delivers a poor deal in this type of provision.
You may consider it Victorian, but I consider a healthcare system which cannot provide for 40 million of its people wholy unsatisfactory. There are problems within the UK, but we have an integrated system which supports preventative medicine far better than the US model. It has been shown time and time again that the US system delivers a poor deal in this type of provision.
Posted by: rod8, Argyll on 10:50pm Tue 25 Mar 08
Nice Guidelines are a joke. We do not give enough resource i.e. money, to the care of the sick.
It is how you see the priorities. An independant nuclear deterrant to support a world force or more local cat scans to identify early signs of cancer.
Support our boys in the armed forces, or give them a good reason to not to sign up, give them a good alternative to stay at home.
I live on the Clyde. I see these submarines coming and going.
I know people who need someone to help to get them out of bed in the mornong. Someone to get them back at night. maybe even someone to put the food in their mouth. They are living in Britain. To-day. Well you can't posture at an international conference if you are putting your ain folk first
We (UK) are a major player in the international scene. ?
Well see NUT have at last thought that their 5 year effort is not best served by sending their pupils to join the royal family in the ARMED forces.
Nice Guidelines are a joke. We do not give enough resource i.e. money, to the care of the sick.
It is how you see the priorities. An independant nuclear deterrant to support a world force or more local cat scans to identify early signs of cancer.
Support our boys in the armed forces, or give them a good reason to not to sign up, give them a good alternative to stay at home.
I live on the Clyde. I see these submarines coming and going.
I know people who need someone to help to get them out of bed in the mornong. Someone to get them back at night. maybe even someone to put the food in their mouth. They are living in Britain. To-day. Well you can't posture at an international conference if you are putting your ain folk first
We (UK) are a major player in the international scene. ?
Well see NUT have at last thought that their 5 year effort is not best served by sending their pupils to join the royal family in the ARMED forces.
Posted by: rod8, Argyll on 10:55pm Tue 25 Mar 08
Who says we get rid of parades, flags, army insignia, and military bands?
Who says we get rid of parades, flags, army insignia, and military bands?
Posted by: Dexter St. Clair, Langley on 1:50am Wed 26 Mar 08
[quote]Look to other countries and see better models - then begin to break down the protectionist barriers that keep this creaking, inadequate old system going. A modern country deserves a better healthcare system than the NHS.[/quote]
Ah yes it's all very well for immigrants living in Florida to look at Cuba and its health service but if you looked inward at Florida. you may gather that where's there a buck to be made you'll find
[quote]pain management is a thriving speciality in the US with many clinical centres - and even offices in malls - offering focused regimens to help those with chronic pain.
[/quote]
[quote]In fact, denigrating the whole NHS is not catastrophising, it's a legitimate criticism for a Victorian-era approach to healthcare."[/quote]
Is there not a zee (as you would say) in that conjugated word. I do so admire your country's adherence to old English and your enthusiasm for words that anywhere else in the English speaking world would mark you out as over ardently in love with your own verbiage, Or would you say verbage?
Look to other countries and see better models - then begin to break down the protectionist barriers that keep this creaking, inadequate old system going. A modern country deserves a better healthcare system than the NHS.
Ah yes it's all very well for immigrants living in Florida to look at Cuba and its health service but if you looked inward at Florida. you may gather that where's there a buck to be made you'll find
pain management is a thriving speciality in the US with many clinical centres - and even offices in malls - offering focused regimens to help those with chronic pain.
In fact, denigrating the whole NHS is not catastrophising, it's a legitimate criticism for a Victorian-era approach to healthcare."
Is there not a zee (as you would say) in that conjugated word. I do so admire your country's adherence to old English and your enthusiasm for words that anywhere else in the English speaking world would mark you out as over ardently in love with your own verbiage, Or would you say verbage?
Posted by: PAINBUSTER, Glasgow, Scotland on 2:27am Sun 30 Mar 08
I have suffered from a condition called Ankylosing Spondylitis from the age of 19 years old but was not diagnosed until the age of 36,
In that 17 year gap it was thought I had ARTHRITIS, SLIPPED DISC, LUMBAGO and all sorts of ailments eventually I was bedridden riddled with pain from my neck down my spine into my hips and down both legs my head was so far forward that it almost touched my breast bone unable to lift my head up. It was only then was I eventually diagnosed with Ankylosing Spondylitis.
I received a mixture of anti-inflamatory and painkilling drugs also hydro and phyisiotherapy, The help and care from the staff I must say was excellent in slowing down this condition although I still have different levels of stiffness aches and pains every waking minute to this day, for all I am going through people forget chronic pain not only has an affect on me but my family and friends who see me struggle to do simplest of things.
I ask myself only if better services had been available at the time how much less damage could have been prevented.
Whilst I was attending the hospitaal I had met another chronic pain sufferer a man from the east end of Glasgow and became great friends and after some time realised the only thing we had in common was a Chronic Pain condition and as it turned out he had approached his local MSP Dorothy Grace Elder to discuss the lack of sevices and care for people with Chronic Pain the outcome was Dorothy Grace Elder and my new found friend Mr John Thomson had become founders of the Scottish Parliament cross party group on Chronic Pain and now includes politicians, medical professionals and patients all seeking to have delivered better services for Chronic Pain conditions.
My message for Chronic Pain sufferers is YES we have a voice that can be heard so don't despair please write to your MP and ask what he or she intends to do to improve services in Scotland.
Thank you.
I have suffered from a condition called Ankylosing Spondylitis from the age of 19 years old but was not diagnosed until the age of 36,
In that 17 year gap it was thought I had ARTHRITIS, SLIPPED DISC, LUMBAGO and all sorts of ailments eventually I was bedridden riddled with pain from my neck down my spine into my hips and down both legs my head was so far forward that it almost touched my breast bone unable to lift my head up. It was only then was I eventually diagnosed with Ankylosing Spondylitis.
I received a mixture of anti-inflamatory and painkilling drugs also hydro and phyisiotherapy, The help and care from the staff I must say was excellent in slowing down this condition although I still have different levels of stiffness aches and pains every waking minute to this day, for all I am going through people forget chronic pain not only has an affect on me but my family and friends who see me struggle to do simplest of things.
I ask myself only if better services had been available at the time how much less damage could have been prevented.
Whilst I was attending the hospitaal I had met another chronic pain sufferer a man from the east end of Glasgow and became great friends and after some time realised the only thing we had in common was a Chronic Pain condition and as it turned out he had approached his local MSP Dorothy Grace Elder to discuss the lack of sevices and care for people with Chronic Pain the outcome was Dorothy Grace Elder and my new found friend Mr John Thomson had become founders of the Scottish Parliament cross party group on Chronic Pain and now includes politicians, medical professionals and patients all seeking to have delivered better services for Chronic Pain conditions.
My message for Chronic Pain sufferers is YES we have a voice that can be heard so don't despair please write to your MP and ask what he or she intends to do to improve services in Scotland.
Thank you.
Posted by: missleight, Glasgow on 11:44am Sun 30 Mar 08
As a sufferer of chronic pain, I monitor and support all chronic pain movements. However, with regards to the parliament being proactive, that statement bewilders me. To reach where we are just now has taken years of campaigning. Within the chronic pain cross party working group there has been numerous reports compiled. This has been followed by reports, more reports and even more reports. In order to move forward, there must be action!!! Stop timewaisting and help the sufferers of chronic pain.
As a sufferer of chronic pain, I monitor and support all chronic pain movements. However, with regards to the parliament being proactive, that statement bewilders me. To reach where we are just now has taken years of campaigning. Within the chronic pain cross party working group there has been numerous reports compiled. This has been followed by reports, more reports and even more reports. In order to move forward, there must be action!!! Stop timewaisting and help the sufferers of chronic pain.
Posted by: PAINBUSTER, Glasgow, Scotland on 5:52pm Mon 31 Mar 08
The Scottish Parliament is here to make a difference to your life, but they can only do so if our MSP'S are made aware of any concerns we the Scottish public may have.
I would strongly advice Chronic pain sufferers their families and friends whom directly or indiretly are affected by Chronic pay,infact when you look at the big picture we the Scottish tax payers are paying in so many ways because of the lack of care and services, how do we have our voice heard ? contact an MSP and express concerns about the lack of recognition and services on Chronic Pain.
You can contact an MSP @ http://www.scottish.
parliament.uk/msp/me
mbersPages/index.htm
Get your voice put into action by our MSP'S and help those of us suffering from Chronic Pain.
The Scottish Parliament is here to make a difference to your life, but they can only do so if our MSP'S are made aware of any concerns we the Scottish public may have.
I would strongly advice Chronic pain sufferers their families and friends whom directly or indiretly are affected by Chronic pay,infact when you look at the big picture we the Scottish tax payers are paying in so many ways because of the lack of care and services, how do we have our voice heard ? contact an MSP and express concerns about the lack of recognition and services on Chronic Pain.
You can contact an MSP @ http://www.scottish.
parliament.uk/msp/me
mbersPages/index.htm
Get your voice put into action by our MSP'S and help those of us suffering from Chronic Pain.
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