Who is providing pain care? Mapping chronic pain services across Scotland using freedom of information requests

Abstract

Background The Scottish Service Model for Chronic Pain advocates multidisciplinary provision of care, stratified across sectors. However, there is lack of transparency over staffing capacities and provisions. Method We submitted Freedom of Information requests to the 14 regional Scottish Health Boards in September 2024. We conducted descriptive quantitative and qualitative analysis of responses. Findings We received 13 responses from 14 Health Boards with varying levels of detail. We found that staff groups most commonly reported to provide dedicated care for chronic pain are: medicine, physiotherapy, psychology and nursing, with lower levels of occupational therapy and pharmacy provision. Six Boards reported at least 1.0 whole-time equivalent medical, physiotherapy and psychology staffing capacity per 500,000 population, with sparse provisions by some populous Boards, showing considerable variation. A variety of pain groups were reported. Boards with higher levels of multidisciplinary staffing and group provision tended to report a dedicated management resource. We found several examples of cross-sectoral connections, potentially improving access to pain care according to need at the local level. The most variable and least well-developed responses were to the question on equitable delivery of care, demonstrating need to improve delivery of equitable approaches and strategies to pain care. Conclusions We used FOI requests to collect data on chronic pain staffing capacity showing considerable variation across Scotland. There are limitations to this method; it is likely that our findings do not show a complete picture, rather useful insights into activities and provisions of services for pain care across Scotland.