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

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.