Agenda item

(To receive a report from the NHS Lincolnshire Clinical Commissioning Group (LCCG), which provides the Committee with an update on the Community Pain Management Service.  Sarah-Jane Mills, (Chief Operating Officer, LCCG) and Tim Fowler, (Assistant Director of Contracting and Performance, LCCG) will be in attendance for this item)

The Chairman invited Tim Fowler, Assistant Director of Contracting and Performance, Lincolnshire CCG and Sarah-Jane Mills, Chief Operating Officer (West Locality), Lincolnshire CCG to update the Committee on the Community Pain Management Service. 

The report for the item was shown on pages 91 to 95 of the report pack.

The Committee was reminded that the service had been awarded in November 2018 to Connect Health and that the service had commenced on 1 April 2019.  The service was commissioned as an end to end chronic pain management service throughout the pain pathway from GP referral through assessment and treatment to discharge.  It was highlighted that in accordance with best practice the service had also moved away from a traditional model of pain management largely focussed around injections to a 'holistic bio psychosocial' model of care.

The Committee noted that Covid-19 had presented a significant number of challenges to the pain management service. These challenges were generally well responded to and a number of actions had been put in place to allow the service to continue during Covid-19 i.e. virtual appointments.

The Committee noted further that the most significant issue had been the suspension of hospital based elective pain management treatment, which during Covid-19 had been largely cancelled in line with national guidance.  It was highlighted that patient's whose assessment or treatment had been cancelled were being kept under review by Connect Health.

It was reported that Connect Health had now restored all services and were working to reduce the backlog of assessments and treatments, and that plans were in place to have normalised waiting times to those pre-Covid-19 by the end of December 2020.

The Committee noted that patient satisfaction with the service had been largely positive; and that comments received from patients whether positive or negative had been reviewed with Connect Health.  Some negative comments received were contained on page 93 of the report.

Appendix A to the report provided the Committee with a KPI Performance Summary - April 2020 to August 2020.  It was noted that performance across the KPIs was variable, with some indicators showing good performance despite Covid-19 impact.  Reassurance was given that action was being taken to consistently improve performance where below target levels.

During discussion, the Committee raised the following points:

·       Patient expectations not being met. The Committee noted that this was a complicated issue as to what meets the needs of an individual.  The contracted service was the nationally recommended approach to help people manage their pain; and for a significant number of people that approach helped; and enabled some patients to come off their medication.  However, there were some individuals who needed their medication, and the service provided a person centred approach;

·       Some concern was expressed that the transfer of some patients to the service had not been managed as well as it could have been and that going forward there needed to be reassurance that patients' needs were dealt with in a sympathetic way.  The Committee noted the service was all about working with an individual to find out what was right for them as an individual; and in some cases the patient needed to continue with their medication.  Reassurance was given that an injection was never ruled out, but this was part of an assessment process with a pain consultant.  Representatives from the CCG invited feedback from the Healthwatch representative regarding the pain management service;

·       How much progress had been made by Connect Health in establishing sites on the East Coast for patients unable to access the Internet.  The Committee noted that during Covid-19 there had been a scaling back on the East Coast. Connect Health was starting to re-open sites and was currently looking for new sites;

·       Page 93 of the report pack advised that the CCG was working with Connect Health to address a series of negative comments, such as long waiting times.  The CCG was asked to explain what measures had been put in place by Connect Health.  The Committee was advised that the CCG had lots of discussion with Connect Health regarding the long waiting times; Connect Health had recruited extra staff; and the CCG was regularly monitoring the situation.  It was noted that in June 2020 there had been 700 on the 'long waiters' list; this was now down to 300; and confirmation was given that this would be back to normal by December 2020; and

·       KPI performance on Page 95 highlighted poor performance on KPI 4 and 5.  A question was asked as to what the reasons were for this, and what actions were going to be taken to improve them.  The Committee was advised that initial assessments were improving with additional capacity and by the use of virtual appointments where appropriate. For the service users starting treatment, there would be a dip in figures as long waiters were treated, but this would improve as this was linked into the action plan for improvement for December 2020;

·       Reference was made to page 92 which stated that some patients would be expected to travel further for face to face appointments during the pandemic.  The Committee was advised that where patients were eligible they would have been able to use patient transport, as the eligibility criteria had been suspended during Covid-19.  The Committee noted further details could be provided for members of the Committee;

·       The Committee requested being able to see a copy of the friends and family test results. The CCG advised that this would be made available to members of the Committee. 

The Chairman on behalf of the Committee extended his thanks to the presenters.

RESOLVED

1.    That the Lincolnshire Clinical Commissioning Group be urged to continue its work with Connect Health, the provider of the community pain management service in Lincolnshire, on reducing negative comments from patients.

2.    That information on the Friends and Family test, the sites being used by Connect Health in the east of the county; and the number of patients using the service be provided to the Committee.

3.    That a further update on the Community Pain Management Service be received in 6 months.