Workshop 5: Establishing multi-stakeholder pain platforms in Europe Hiltrud Liedgens Gitte Handberg

Objectives Share experience on how far the “Road Map for Action” resulting from the previous SIP symposia has evolved within various countries in Europe and share best practice. Ten years on from the EFIC Declaration on Pain, national and EU policy action has been very limited. At the same time, basic and clinical science have demonstrated the feasibility of pathways out of pain for many types of acute and chronic pain, but health care systems currently do not guarantee general access to these. So far national action plans at governmental level exist in Portugal, France, Italy, Scotland and Wales.

Road Map for Action We call on European governments to: 1. Acknowledge that pain is an important factor limiting the quality of life and should be a top priority of the national health care system. 2. Activate patients, their family, relatives and care-givers through the availability of information and access to pain diagnosis and management. 3. Raise awareness of the medical, financial and social impact that pain and its management has on the patients, their family, care-givers, employers, and the healthcare system. 4. Raise awareness of the importance of prevention, diagnosis and management of pain amongst all healthcare professionals, notably through further education. 5. Strengthen pain research (basic science, clinical, epidemiological) as a priority in … research road maps at national … level, addressing the societal impact of pain and the burden of chronic pain on the health, social, and employment sectors. 6. Establish an EU platform for the exchange, comparison and benchmarking of best practices between member states on pain management and its impact on society. 7. Use the EU platform to monitor trends in pain management, services, and outcomes and provide guidelines to harmonize effective levels of pain management to improve the quality of life of European Citizens. Presented by Prof. Treede

Country presentations England: Beverly ColletEngland: Beverly Collet “Bringing people together.” The Chronic Pain Policy Coalition“Bringing people together.” The Chronic Pain Policy Coalition Slovenia: Nevenka KrcevskiSlovenia: Nevenka Krcevski No national plan for pain treatment exists, no multidisciplinary pain centers.No national plan for pain treatment exists, no multidisciplinary pain centers. Netherlands: Frank HuygenNetherlands: Frank Huygen Pain is on the agenda of the Dutch Council for the quality of health carePain is on the agenda of the Dutch Council for the quality of health care Denmark: Gitte HandbergDenmark: Gitte Handberg Multidisciplinary pain clinics exist, but too few resulting in long waiting listsMultidisciplinary pain clinics exist, but too few resulting in long waiting lists Northern Ireland: Pamela BellNorthern Ireland: Pamela Bell Same approach as in England has startedSame approach as in England has started France: Michel Lanteri-MinetFrance: Michel Lanteri-Minet 4th national program for pain management has started4th national program for pain management has started Romania: Viorica CursaruRomania: Viorica Cursaru Low priority of health in the public sectorLow priority of health in the public sector Spain: Jaime EspinSpain: Jaime Espin New ways of financing health care: No cure, no pay!New ways of financing health care: No cure, no pay!

Outcomes and Summary of Discussion Many countries made good success since the last SIPMany countries made good success since the last SIP To improve quality of pain treatment a national strategy is necessary in each country.To improve quality of pain treatment a national strategy is necessary in each country. It is important to identify the stakeholders that really matter (it might be more supportive to identify the right civil servants than to approach a member of a ministry as politicians can change quickly).It is important to identify the stakeholders that really matter (it might be more supportive to identify the right civil servants than to approach a member of a ministry as politicians can change quickly). Bring the right team together: find your friends and connect the dotsBring the right team together: find your friends and connect the dots There is no golden way how to approach health authorities. This has to be adapted to the individual country situation.There is no golden way how to approach health authorities. This has to be adapted to the individual country situation. Treatment of pain at GP level is wanted because the majority of pain patients are best treated by GPs. However GPs are sometimes hesitant to this approach.Treatment of pain at GP level is wanted because the majority of pain patients are best treated by GPs. However GPs are sometimes hesitant to this approach. Extra payment for GPs involved in pain treatment should be considered (positive example: Quality outcomes Frame from UK)Extra payment for GPs involved in pain treatment should be considered (positive example: Quality outcomes Frame from UK) Better education in pain treatment at all levels is necessary.Better education in pain treatment at all levels is necessary. EFIC should lead a pain education grogram (establish a EU pain university)

Outcomes and Summary of Discussion Costs of pain treatment has to be presented in a holistic way including indirect costs like work absenteeism. Should be one of the main arguments to employers and policy makers.Costs of pain treatment has to be presented in a holistic way including indirect costs like work absenteeism. Should be one of the main arguments to employers and policy makers. Identify how to monitor progress in each country:Identify how to monitor progress in each country: A discussion is necessary about a structured process and outcomes to identify progress in pain treatment. StructureStructure ProcessProcess OutcomesOutcomes