We recognise the effect that poor health can have on economic inactivity and that the economy relies on a healthy population.

The 10-Year Health Plan will support people with musculoskeletal (MSK) conditions like arthritis to better manage their condition and access services and support through the three shifts: from hospital to community; from analogue to digital; and from sickness to prevention. For example, the shift from hospital to community will enable people with MSK conditions to access a range of additional services to support the management of their condition and treatment closer to home.

In line with this shift, the Government has funded NHS England’s Getting It Right First Time programme to deploy their proven Further Faster model for MSK community services. The programme has been designed to reduce waiting times for community MSK appointments and to enhance access to quality treatment, working with integrated care board leaders to improve data and metrics and referral pathways to wider support services.

We are working together to further develop the approach to better enable integrated care systems to commission the delivery of high quality MSK services in the community, which will benefit patients now and into the future.

Additionally, the Further Faster 20 scheme, which is an extension of the existing Further Faster Programme, is designed to help reduce waiting lists across multiple specialities at 20 targeted hospital trusts located in areas with the highest levels of economic inactivity.

The following table shows a breakdown of the Finished Admission Episodes (FAEs) in England with a primary diagnosis relevant to nerve pain, as well as the total number and proportion of FAEs with a primary diagnosis relevant to nerve pain, for 2023/24:

Source: Hospital Episode Statistics (HES), published by NHS England

Notes:

- FAEs refer to the first period of admitted patient care under one consultant within one healthcare provider, and are generally counted against the year or month in which the admission episode finishes, so do not represent the number of patients, as a person may have more than one admission within the period;

- the primary diagnosis is the first of up to 20 diagnosis fields in the HES data set and provides the main reason why the patient was admitted to hospital;

- the data is provisional and may be incomplete or contain errors for which no adjustments have been made, as counts produced from provisional data are likely to be lower than those generated for the same period in the final data set; and

- all counts have been rounded to the nearest five and values less than 10 have been supressed.

The commissioning of spinal cord stimulation (SCS) is the responsibility of clinical commissioning groups. The National Institute for Health and Care Excellence Technology Appraisal ‘Spinal cord stimulation for chronic pain of neuropathic or ischaemic origin’ reviewed in 2014, recommends SCS as a treatment option for adults with chronic pain of neuropathic of ischaemic origin. The guidance is available at the following link:

www.nice.org.uk/guidance/ta159

There are a wide range of SCS devices available, and centres can choose which type of device to implant. The Evoke device is available through the NHS Supply Chain.

We are aware of recent research looking at electrical stimulation of the vagus nerve to treat patients with rheumatoid arthritis. This was a small pilot study of 14 people, and therefore research remains at an early stage. In order to be suitable for routine National Health Service use, larger scale clinical trials demonstrating the safety and efficacy of this treatment approach would need to be undertaken, and assessments of its cost effectiveness would also need to be considered.

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 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.

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.

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

NHS England estimates that around 14 million people in the United Kingdom, both children and adults suffer with chronic pain. The vast majority of services for people are planned and paid for locally by clinical commissioning groups.

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. It is important that patients with the most serious pain management issues are able to access specialist care. A patient whose pain is particularly difficult to manage may be referred to a specialised pain management service. Under the care of an expert multidisciplinary team, patients may be offered specialised pain management programmes specifically and more complex drug treatments. Such services are commissioned nationally by NHS England as part of its remit to deliver specialised services.

To support clinicians in the management of pain, the National Institute for Health and Care Excellence has published several clinical guidelines on the treatment and management of different types of pain, such as migraine and back pain, as well as technical guidance on specific treatments, such as the use of opiates in palliative care and deep brain stimulation for chronic pain.

NHS England estimates that around 14 million people in the United Kingdom, both children and adults suffer with chronic pain. The vast majority of services for people are planned and paid for locally by clinical commissioning groups.

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. It is important that patients with the most serious pain management issues are able to access specialist care. A patient whose pain is particularly difficult to manage may be referred to a specialised pain management service. Under the care of an expert multidisciplinary team, patients may be offered specialised pain management programmes specifically and more complex drug treatments. Such services are commissioned nationally by NHS England as part of its remit to deliver specialised services.

To support clinicians in the management of pain, the National Institute for Health and Care Excellence has published several clinical guidelines on the treatment and management of different types of pain, such as migraine and back pain, as well as technical guidance on specific treatments, such as the use of opiates in palliative care and deep brain stimulation for chronic pain.

NHS England estimates that around 14 million people in the United Kingdom, both children and adults suffer with chronic pain. The vast majority of services for people are planned and paid for locally by clinical commissioning groups.

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. It is important that patients with the most serious pain management issues are able to access specialist care. A patient whose pain is particularly difficult to manage may be referred to a specialised pain management service. Under the care of an expert multidisciplinary team, patients may be offered specialised pain management programmes specifically and more complex drug treatments. Such services are commissioned nationally by NHS England as part of its remit to deliver specialised services.

To support clinicians in the management of pain, the National Institute for Health and Care Excellence has published several clinical guidelines on the treatment and management of different types of pain, such as migraine and back pain, as well as technical guidance on specific treatments, such as the use of opiates in palliative care and deep brain stimulation for chronic pain.

The information requested is not collected.

We have had no such discussions. Botox is not licensed in the United Kingdom for use as a painkiller.

The National Institute for Health and Care Excellence (NICE) published technology appraisal guidance for the National Health Service in May 2012 which recommends botulinum toxin type A as a possible treatment for preventing headaches in some adults with chronic migraine, subject to certain clinical criteria.

Patients have the right to drugs and treatments that have been recommended by NICE for use in the NHS, where their doctor believes they are clinically appropriate.