Agenda item

Community Pain Management Service - Update

(To receive a report which provides an update from NHS Lincolnshire Clinical Commissioning Group on the Community Pain Management Service. Sarah-Jane Mills, Chief Operating Officer, West Locality, Lincolnshire Clinical Commissioning Group)

 

Minutes:

The Committee gave consideration to a report from NHS Lincolnshire Clinical Commissioning Group, which provided the Committee with an update on the Community Pain Management Service (CPMS).

 

The Chairman invited Sarah-Jane Mills, Chief Operating Officer (West Locality), to remotely present the report to the Committee.

 

The Committee had previously received an update on the Community Pain Management Service at its March 2021 meeting.

 

It was reported that the CPMS had made good progress in the last six months in improving referral to assessment waiting time performance, whilst continuing to operate in a Covid-19 safe working environment.

 

The Committee was advised that the CPMS expected to have 100% of clinic locations operating face to face appointments by the end of September, improving capacity and convenience for patients, where it was clinically appropriate to do so, or at the wish of the patient.

 

It was highlighted that the Care Quality Commission (CQC) had rated Connect Health, the organisation which provided the CPMS in May 2021 as 'good' overall.

 

The Committee noted that the latest CPMS Quarterly Quality Report up to June 2021 had not highlighted any areas of concern.  It was highlighted that the report had shown an improvement as positive feedback had been received by patients completing and returning a patient satisfaction survey and that there had been a reduction in negative feedback compared to the previous quarter.

 

The report also provided a summary of the time taken for the CCG to make decisions where pain management treatment had been requested through the CCG individual Funding request process and further commentary on the use of opioids, a medicine which traditionally had been used for the treatment of chronic pain.

 

Appendix A to the report provided a Key Performance Indicator Performance Summary for the period January to June 2021 for the Committee's consideration.

 

The Committee was asked to consider the information presented.  During discussion, the following comments were raised:

 

·       The impact of chronic pain on an individual.  Some concern was expressed to the length of time patients were waiting to be seen and to the minimum targets.  The Committee was advised that the targets were national targets.  Reassurance was given that Connect Health would ensure that patients were signposted to other support services to help them manage their pain.  The Committee noted that it was the aspiration of the service to exceed the national targets;

·       Some concern was expressed that delays in obtaining a GP appointment were also an issue for patients accessing the service; 

·       Whether the service was effective in dealing with pain management.  Reassurance was given that the treatment prescribed matched the needs of the individual.  It was noted that the use of the public health management system, would enable the service to better understand needs at a local level, highlight trends and help shape the service to meet needs better;

·       Some concern was raised at to how pain management services were provided in Lincolnshire compared with other areas.  Particular reference was made to the pathway into the CPMS; and to the service's reluctant use of opioids.  The Committee was advised that the model adopted in Lincolnshire was in line with NICE guidance and the British Pain Society recommendations, which had been adopted as best practice.  The Committee was advised further that it was the case in Lincolnshire that patients were able to receive injections.  Injections would be administered where it was clinically appropriate to do so.  It was noted that the pain management service looked at the whole person, as opioids were very addictive, and that clinicians worked with patients to find other ways of managing their pain;

·       Clarification was sought as to the start of the assessment process.  The Committee as advised that the start of the process was when the patient was review and assessed;

·       Clarification as to the provision of the CPMS to Stamford residents.  The Committee was advised that Stamford had not been omitted from the initial commissioning of the service.  Due to closeness of Stamford to the border, it had been originally agreed that both Peterborough and Stamford should have their own local clinic;

·       Concern was expressed that the follow up system did not appear to be working very effectively and needed to be reviewed.  The representative agreed to look into this matter further;

·       Referral into the service – The Committee was advised that referrals could be made by consultants as well as primary care;

·       Some concern was expressed that there would be no provision for a pain management clinic in Louth until October.  Reassurance was given that the clinic would be open as soon as possible;  and

·       The problems encountered by some patients accessing the CMPS via their GP.  The Committee was advised that the CCG could review this information, to identify if some practices were not accessing the service via the clinical pathway, or not utilising the service, as their referral rates would be lower. 

 

The Chairman extended thanks on behalf of the Committee to Sarah-Jane Mills for her presentation.

 

RESOLVED

 

1.    That the information presented on the Community Pain Management Service, including the rating of good by the Care Quality Commission in June 2021 and the actions taken to the high level review of complaints in June 2021 be noted.

 

2.    That the positive direction of travel of the service be noted, but with three of the key performance indicators still not reaching their targets, a further report be received in six months' time, and that a copy of the action plan also be made available for consideration by the Committee.

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