Read Codes, a coded thesaurus of clinical terms, have been used in the National Health Service since 1985. However, they were confirmed for retirement in 2014 and updates to the system are no longer being provided.

SNOMED CT (Systematized Nomenclature of Medicine - Clinical Terms) is the clinical terminology that has replaced Read Codes within the NHS. It is a structured clinical vocabulary for use in an electronic health record and is the standard for communication of clinical information between providers of care. SNOMED CT is an approved information standard published under section 250 of the Health and Social Care Act 2012.

Within SNOMED CT, there are currently 87 concepts, which represent a unique clinical meaning, related to the recording of chronic pain, including chronic back pain, chronic neck pain and chronic pain control. These can be viewed using the NHS SNOMED CT browser at the following link:

https://termbrowser.nhs.uk

The routine assessment and management of pain is a required competency of all healthcare professionals. Many patients with chronic pain can be successfully supported and managed through routine primary and secondary care pain management services. Approaches to treatment are not all pharmacological; education in self-management techniques to aid symptom control may also be appropriate for some patients.

The National Institute for Health and Care Excellence (NICE) is currently developing guidance on the assessment and management of chronic pain aimed at all settings in which National Health Service and local authority commissioned care is provided. The guidance is expected to be published on 19 August 2020. Guidance scope for the NICE clinical guidance document in development can be found via the following link:

www.nice.org.uk/guidance/gid-ng10069/documents/final-scope

The routine assessment and management of pain is a required competency of all healthcare professionals. Many patients with chronic pain can be successfully supported and managed through routine primary and secondary care pain management services. Approaches to treatment are not all pharmacological; education in self-management techniques to aid symptom control may also be appropriate for some patients.

The National Institute for Health and Care Excellence (NICE) is currently developing guidance on the assessment and management of chronic pain aimed at all settings in which National Health Service and local authority commissioned care is provided. The guidance is expected to be published on 19 August 2020. Guidance scope for the NICE clinical guidance document in development can be found via the following link:

www.nice.org.uk/guidance/gid-ng10069/documents/final-scope

The routine assessment and management of pain is a required competency of all healthcare professionals. Many patients with chronic pain can be successfully supported and managed through routine primary and secondary care pain management services. Approaches to treatment are not all pharmacological; education in self-management techniques to aid symptom control may also be appropriate for some patients.

As set out in the NHS Long Term Plan, published on 7 January 2019, NHS England will expand the number of physiotherapists working in primary care networks, enabling people to see the right professional first time, without needing a general practitioner referral. NHS England will also expand access to support such as the online version of ESCAPE-pain (Enabling Self-management and Coping with Arthritic Pain through Exercise), a digital version of the well-established, face-to-face group programme.

The routine assessment and management of pain is a required competency of all healthcare professionals. Many patients with chronic pain can be successfully supported and managed through routine primary and secondary care pain management services. Approaches to treatment are not all pharmacological; education in self-management techniques to aid symptom control may also be appropriate for some patients.

As set out in the NHS Long Term Plan, published on 7 January 2019, low back and neck pain is the greatest cause of years lost to disability, with chronic joint pain or osteoarthritis affecting over 8.75 million people in the United Kingdom. In the Long Term Plan NHS England committed to build on work already undertaken to ensure patients will have direct access to musculoskeletal First Contact Practitioners (FCP). 98% of sustainability and transformation partnerships have confirmed pilot sites for FCP and 55% of pilots are already underway.

NHS England will expand the number of physiotherapists working in primary care networks, enabling people to see the right professional first time, without needing a general practitioner referral. NHS England will also expand access to support such as the online version of ESCAPE-pain, Enabling Self-management and Coping with Arthritic Pain through Exercise, a digital version of the well-established, face-to-face group programme.

The routine assessment and management of pain is a required competency of all healthcare professionals. Many patients with chronic pain can be successfully supported and managed through routine primary and secondary care pain management services. Approaches to treatment are not all pharmacological; education in self-management techniques to aid symptom control may also be appropriate for some patients.

As set out in the NHS Long Term Plan, published on 7 January 2019, low back and neck pain is the greatest cause of years lost to disability, with chronic joint pain or osteoarthritis affecting over 8.75 million people in the United Kingdom. In the Long Term Plan NHS England committed to build on work already undertaken to ensure patients will have direct access to musculoskeletal First Contact Practitioners (FCP). 98% of sustainability and transformation partnerships have confirmed pilot sites for FCP and 55% of pilots are already underway.

NHS England will expand the number of physiotherapists working in primary care networks, enabling people to see the right professional first time, without needing a general practitioner referral. NHS England will also expand access to support such as the online version of ESCAPE-pain, Enabling Self-management and Coping with Arthritic Pain through Exercise, a digital version of the well-established, face-to-face group programme.

The National Institute for Health and Care Excellence (NICE) provides guidance on ‘Spinal cord stimulation for chronic pain of neuropathic or ischaemic origin’. NICE is currently developing guidance on the assessment and management of chronic pain, with an expected publication date of 19 August 2020. Further information can be found via the following links:

www.nice.org.uk/guidance/ta159

www.nice.org.uk/guidance/gid-ng10069/documents/final-scope

As with the majority of NHS services, local commissioners are responsible for provision of treatment and support for patients with chronic pain conditions. Patients with chronic pain can be well managed in the community or local hospitals by appropriately trained members of interdisciplinary Pain Management Services. Patients may be treated in a Specialised Pain Management Centre where appropriate. When considering what services should be made available we would expect clinical commissioning groups to consider the best practice available guidance.

No estimate has been made. The National Institute for Health and Care Excellence states the prevalence of chronic pain has been difficult to define. A recent systematic review has reported prevalence rates of between 8.7% to 64.4%, with a pooled mean of 31%. An earlier review suggested that chronic pain affects between one-third and one-half of the population.

The following table provided by the NHS Business Services Authority (NHS BSA), shows the number of people prescribed GnRH analogue treatment by the National Health Service in England in a primary care setting. Figures are provided for the last three years as patient information for prescribing is only available from April 2015 onwards.

Note:

Care should be taken when interpreting the patient counts as some patients could appear in the results for multiple time periods. Therefore, the patient numbers should not be combined and reported at any other levels than as provided in the dataset.

NHS numbers are not captured for every prescription and hence the NHS BSA has included the number of patients who could be identified along with the proportion of applicable prescription items for which the patient data could be identified.

NHS England has advised that it does not hold this information.

ESCAPE-Pain is a group-based, six week rehabilitation programme which combines exercise and education to help patients manage chronic joint pain using exercise and coping techniques. The programme is endorsed by the National Institute for Health and Care Excellence, and has received Best Practice Awards from the British Society of Rheumatology and Royal Society of Public Health.

The programme, which is running at over 30 sites across England, can be provided in physiotherapy departments, the community and places of work, and lessons can also be accessed via an app that is free to download. Commissioning of self-management and rehabilitation programmes, such as ESCAPE-Pain, is a local matter.

Health is a devolved matter, and decisions about use of the ESCAPE-Pain programme in Wales, Northern Ireland and Scotland would be a matter for the devolved administrations of those countries.

ESCAPE-Pain is a group-based, six week rehabilitation programme which combines exercise and education to help patients manage chronic joint pain using exercise and coping techniques. The programme is endorsed by the National Institute for Health and Care Excellence, and has received Best Practice Awards from the British Society of Rheumatology and Royal Society of Public Health.

The programme, which is running at over 30 sites across England, can be provided in physiotherapy departments, the community and places of work, and lessons can also be accessed via an app that is free to download. Commissioning of self-management and rehabilitation programmes, such as ESCAPE-Pain, is a local matter.

Health is a devolved matter, and decisions about use of the ESCAPE-Pain programme in Wales, Northern Ireland and Scotland would be a matter for the devolved administrations of those countries.

Health is a devolved matter, and no discussions have taken place between ministers and the devolved administrations of Wales, Northern Ireland and Scotland about the Escape Pain programme.

Escape Pain is a group-based, six week rehabilitation programme which combines exercise and education to help patients manage chronic joint pain using exercise and coping techniques. The programme is endorsed by the National Institute for Health and Care Excellence, and has received Best Practice Awards from the British Society of Rheumatology and Royal Society of Public Health.

The programme, which is running at over 30 sites across England, can be provided in physiotherapy departments, the community and places of work, and lessons can also be accessed via an app that is free to download.

Health is a devolved matter, and no discussions have taken place between ministers and the devolved administrations of Wales, Northern Ireland and Scotland about the Escape Pain programme.

Escape Pain is a group-based, six week rehabilitation programme which combines exercise and education to help patients manage chronic joint pain using exercise and coping techniques. The programme is endorsed by the National Institute for Health and Care Excellence, and has received Best Practice Awards from the British Society of Rheumatology and Royal Society of Public Health.

The programme, which is running at over 30 sites across England, can be provided in physiotherapy departments, the community and places of work, and lessons can also be accessed via an app that is free to download.

The information requested is in the attached tables.

NHS England is committed to transforming cancer services across the country and ensuring every patient has access to the care and treatment they need. The management of pain through drugs such as fentanyl is a clinical decision and should be considered on an individual basis, in line with patients’ clinical needs and in line with guidance from the National Institute for Health and Care Excellence.

Data on the number of people diagnosed with chronic stomach pains is not collected.