NHS clinics were still seeing just two thirds of the number of chronic pain patients they normally would by the end of last year, with some patients having waited a year or more.

In Ayrshire and Arran, 94 of the 112 chronic pain patients seen between October and December - equivalent to nearly 84% - had been on the waiting list for their first appointment for 52 weeks or longer.

Only nine were seen within the 18-week target.

This was by far the worst performance for any health board in Scotland.

HeraldScotland: A higher percentage of chronic pain patients were being seen within three weeks by the end of 2020, compared to the previous quarter, but there were also increases in those who had been waiting a year or moreA higher percentage of chronic pain patients were being seen within three weeks by the end of 2020, compared to the previous quarter, but there were also increases in those who had been waiting a year or more

Pain relief clinics across NHS Scotland were paused for four months at the beginning of the pandemic, leading to reports that some patients with problems such as nerve damage and arthritis were paying thousands of pounds to travel to private facilities in England for medical infusions or injections to ease their symptoms.

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In a statement at the end of last year, Joanne Edwards, the director of acute service at NHS Ayrshire and Arran, apologised for the delays, saying the coronavirus pandemic "has had a significant impact on the capacity of the chronic pain service".

Ms Edwards said the health board was increasing the number of face to face and telephone clinics that the chronic pain team can undertake, adding that an "enhanced clinical review" of the waiting list was also being carried out to prioritise patients for appointment based on clinical need.

In Grampian, which had the second worst performance in Scotland, 70 of the 240 patients (29%) seen at a chronic pain clinic in the final quarter of 2020 had been waiting at least a year.

Like Ayrshire and Arran - whose waiting times performance was blasted as "verging on scandalous" back in 2018 - Grampian was already struggling before Covid hit.

At the end of 2019, it had the worst waiting times in Scotland and had begun recruiting additional physiotherapists and a psychologist to try to speed up how quickly patients could be treated.

Despite the pandemic, this appears to have made some difference with the proportion of chronic pain patients seen within 18 weeks rising to 57% in the final quarter of 2020, compared to 52% at the end of 2019.

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Between them, however, NHS Grampian and NHS Ayrshire and Arran accounted for 87% of all the chronic pain patients in Scotland who had waited at least a year for their first appointment: 164 out of a total of 189.

There were also 11 in NHS Greater Glasgow and Clyde; 11 in NHS Highland; and three in NHS Forth Valley.

HeraldScotland: Mairi Gougeon, Minister for Public HealthMairi Gougeon, Minister for Public Health

Across Scotland as a whole, the total number of patients seen at a chronic pain clinic between October and December last year was 2,108 - 33% lower than during the same quarter in 2019, but up from 1,397 between July and September.

By the end of 2020, there were also 3,334 people still on chronic pain waiting lists, of whom 233 had been waiting 52 weeks or longer for their first appointment.

Scottish Conservative health spokesman Donald Cameron said: “While the picture for chronic pain patients is slowly improving, there are still far too many who are having to wait in pain for vital treatment.

“We’ve seen before that patients have had to travel down south for procedures, which is unacceptable.”

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Public Health Minister Mairi Gougeon welcomed the evidence that more patients are now being seen in pain clinics as the NHS remobilises.

She added: “Chronic pain services remain a priority for the Scottish Government and we continue to work with health boards to implement the Recovery Framework for NHS pain management services we published in September 2020.

"However, we know that there is need for improvement and this year we will publish a new Framework for chronic pain service delivery which is intended to improve access to care for people with chronic pain and deliver better health outcomes.”