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Agenda: Chronic pain sufferers have waited too long for a centre of excellence

Scotland's epidemic of chronic pain harms 800,000 people to varying degrees, wrecking lives and jobs.

A new report shows that most of Scotland's 14 health boards have failed to provide enough staff to cope with an avalanche of need.

Some areas have outpatient waiting lists of more than one year to see clinical psychologists, who are essential for depression caused by constant pain: suicide risk territory.

The report by Healthcare Improvement Scotland (HIS) blows the myth that chronic pain, triggered by scores of conditions and accidents, is about old people.

Some 77% of new patients at day clinics are from working age groups. Only 33.2% are still employed, many continuing with difficulty.

Aside from this report, the first Scottish residential service is to be established. That is due to intervention by Holyrood. For years, some NHS officials have supported a bizarre "solution" for severe cases: sending some sufferers on two 800 to 1000-mile return journeys to a Bath hospital instead of creating a Scottish inpatient centre. Even Wales has its own residential centre.

Alex Neil is the first health secretary pledging to end these agonising journeys, backed unanimously by the Scottish Parliament in a rare consensual move. Soon, he'll announce where the first Scottish centre of excellence will be sited.

There have been 13 years of campaigning with patients by Holyrood's Cross Party Group on Chronic Pain, led by MSP stalwarts Jackie Baillie, Jackson Carlaw and John Wilson. Annually, about 27 Scots patients go to Bath but 120 Welsh sufferers are helped at Wales's residential centre.

Many Scots refuse to go to Somerset because they can't afford upfront travel (repaid later) or endure marathon journeys.

In a four-year period, Scotland paid £1.1 million to have 107 patients treated at Bath, costing up to £11,847 each.

In four years, Wales treated 480 patients at half the individual cost. What about Scottish day clinics, often overwhelmed by patients? Mr Neil has told health boards to report to him and has appointed a new lead clinician, Professor Blair Smith, to speed progress.

In 2012, a report by HIS was damned as a whitewash by campaigners. That report stated: "All NHS boards reported they have pain management services."

But the health watchdog's new survey found only six out of 14 boards had pain management programmes. Mr Neil demanded transparency and has had that from HIS's Dr Lesley Holdsworth.

Thousands of sufferers visited Scottish day clinics more than 57,000 times last year, many returning several times. I calculate from HIS figures that there were only 104 whole-time equivalent staff coping with that number of visits. Most pain work is part-time and some staff work for only a few hours each week.

A postcode lottery remains, despite past boasts of improvements. The average wait is 10 weeks for a first clinic appointment but, in Grampian, patients waited 31 weeks. Second appointments are a critical area.

In Ayrshire and Arran, patients waited 63 weeks to see a pain psychologist; in the Borders, waits were nearly two years, at 86 weeks.Even in Glasgow and Forth Valley, it took 36 weeks to reach psychology. Patients' comments to HIS repeatedly highlighted a shortage of doctors, nurses, physiotherapists and psychologists, all pleading for more staff to cut waiting times.

But, after negotiating the slow lane, 95% rated treatment as either good or excellent, with much praise for staff skills and attitudes; proof of the valuable job overstretched experts do.

Pain becomes chronic after three months. But 89% of new patients had suffered for more than a year (some for years) before being referred to specialists by GPs.

The NHS agenda is predictable: create more committees. Local service improvement groups could succeed long term. But the urgent agenda of patients is: cut talk and increase staff.

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