Meeting of the Parliament [Draft]

Meeting date: Wednesday, December 20, 2023

Official Report 1026KB pdf

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Complex Regional Pain Syndrome Awareness Month

The final item of business is a members’ business debate on motion S6M-10702, in the name of Clare Adamson, on complex regional pain syndrome awareness month. The debate will be concluded without any question being put.

Motion debated,

That the Parliament marks Complex Regional Pain Syndrome (CRPS) Awareness Month; understands that CRPS is a debilitating chronic disorder, mostly affecting the limbs, which is characterised by severe pain, pathological changes of bones, joints and skin, swelling, temperature and colour changes, and motor dysfunction, which can cause a person to experience persistent, severe and debilitating pain; further understands that the condition may develop after an injury, surgery, stroke or heart attack, and that the pain can be out of proportion with the severity of the initial injury; notes that the 25th CRPS Awareness Month will be held during November 2023, a month where the chronic pain community and their families and supporters around the world come together to help raise awareness of the condition, and that, as part of the initiative, “Colour the World Orange Day” sees businesses, town halls and landmarks change their lights to orange in support of people living with CRPS; commends the volunteers and organisers at CRPS UK and Burning Nights CRPS Support for their efforts to raise awareness of what it sees as this poorly-understood condition; acknowledges that CRPS UK and Burning Nights are registered charities, with, it believes, the shared goals of raising awareness of CRPS symptoms, providing invaluable support to people with the condition, and advocating for more research development into it, and wishes all of the organisers, volunteers, and the wider CRPS community, including those in the Motherwell and Wishaw constituency, every success in their efforts to increase public awareness of this debilitating condition and to support people affected by CRPS.

17:29  

I thank colleagues across the chamber who will speak in the debate and all those who supported the motion.

Complex regional pain syndrome, or CRPS, is a rare neurological condition that I presume many in the chamber will never have heard of. If truth be told, I wish that that were the case for me, too. However, my son, Aidan, has CRPS. He is 26 and on the first steps of a professional career that he loves. I have never spoken about him in Parliament before—I felt that that would have been an intrusion into his privacy when he was younger—but I have his blessing to do so this evening.

Aidan loved rugby. He was a Dalziel dragon from the age of five and was a dedicated and talented hooker. In his first year at high school, he broke his wrist on the rugby field. That would be traumatic enough for any child or their parents, especially as it involved an operation and a pin, but we thought that it was mechanical, fixable and not threatening or life limiting. However, we were wrong.

Aidan complained of pain following the injury. Despite that, he continued to get on with rugby and karate, and he continued to play clarinet at school. He is a talented musician and, at the time, he hoped to study at the conservatoire.

Months after the stookie came off and the wound healed, Aidan came home with a strange swelling on his knuckle. The school had had the foresight to draw a circle around it—it was like a grape on his knuckle—to which Aidan had added a smiley face. Our general practitioner saw him and, within a few hours, Aidan was in accident and emergency with a suspected spider or insect bite or, in the worst case, sepsis.

That was the start of a medical pathway involving multiple disciplines, X-rays and MRI scans. It involved ups and downs, including a further visit to A and E, where he was—in my opinion and his own—coerced into saying that someone might possibly have bumped him in the corridor at some time in the school day and that that would have led to the swelling on his hand at the time. That did not happen—he had not had an accident.

A further low point was when an orthopaedic consultant suggested to him that he was having bad dreams at night and was banging his wrist on the wall while asleep. Can members imagine that teenage boy feeling that no one understood or believed him?

We tried everything, of course: physiotherapy; transcutaneous electrical nerve stimulation—or TENS—machines; acupuncture; wax baths; and icing. Icing was frequently recommended by clinicians and physiotherapists, but it is one of the worst things that can be done for someone suffering with CRPS. I am sure that we will hear that from other members.

Eventually, having waited for two years after his referral, Aidan saw a pain consultant, and was diagnosed on his first visit. Although his pain and challenges remained the same, the sense of relief and validation that he felt was overwhelming. Mirror box treatment with appropriate neurological treatment helped a little, but there is no cure or treatment for CRPS. We need more research into, and much more awareness of, the condition.

Aidan is in a relatively good place. He could not put in the practice to achieve his clarinet and bass clarinet goals and become a professional musician. Nonetheless, he won the music prize in sixth year, he has studied for a music degree, and he is now on his future pathway. That was despite being told by a guidance teacher after his standard grade results that he had been a disappointment and that he should have done much better and got all As. His dad and I were very proud of him. Unknown to the teacher—despite the condition being disclosed—I had had to sit up with him in tears at night, with him begging me to cut off his wrist and hand.

That might sound like a teenage drama until it is understood that, for CRPS sufferers, elective amputation is a common route. We first saw that reported in the news in 2019, when a promising Welsh athlete, Helena Stone, had her leg amputated at the age of 22 following a kayaking accident when she was 16. CRPS is usually, but not exclusively, triggered by an injury.

CRPS has always been in the news. Recently, it has been in the news because of the Netflix documentary “Take Care of Maya”. The title comes from the suicide note of Maya Kowalski’s mother, Beata, after she was accused by clinicians of Munchausen syndrome by proxy and her daughter was taken into care in the US. That is a tragedy in the true sense of the word, with a family losing a loved one in horrific circumstances. Indeed, a Florida court has just awarded the family damages of $261 million to the family against John Hopkins all children’s hospital in St Petersburg. The documentary has raised awareness and understanding of CRPS.

A number of charities, including CRPS UK and Burning Nights CRPS Support, provide support. Through Burning Nights, I met another pupil from Aidan’s school, Kiera McAdam, who is just a few years older than him, is also in a professional educational role and is a champion fundraiser for the charity. Her experiences of grappling with CRPS as a teenager and adult resonate with Aidan’s.

In 2022, Burning Nights held its annual conference in Scotland. I was delighted to attend with Aidan and know that it was a profound and inspirational experience for him to meet and talk to other young people coping with CRPS. I also met Victoria Abbott-Fleming in person; I had been working with her for a number of years and was honoured to be asked to open, and to speak at, the conference. Victoria was a successful barrister until a fall at work in 2003 triggered CRPS. During the time that she has had the condition, she has had both legs amputated above the knee, not through the type of elective surgery that I mentioned earlier but due to life-threatening, aggressive and extreme CRPS symptoms. You can read Victoria’s story on her founder’s page on the Burning Nights website.

Throughout November, which was CRPS awareness month, Burning Nights posted daily tweets informing people of the condition. The tweets are incredibly informative, and I urge anyone interested in learning more about the CRPS to look at them, and at the charity’s tweets in general.

I have just about managed to get through my speech without crying, but I have cried about CRPS in this place. At an event here in Parliament, I met a truly inspirational academic from the University of Glasgow, Dr Jennifer Corns, who came here with a brain—not the incredible one that she herself has but a plastic one. I know that many people will remember her from having their photograph taken with that brain in the garden lobby. She is an expert on chronic pain. When I mentioned Aidan’s diagnosis, her first question to me was, “Did he have an accident?” and I knew that she understood. There was no need for an explanation or for the same questions. I had met someone who understood what I had gone through—and I am just a parent, not a sufferer.

Today is about raising awareness. There is work to be done in general practice surgeries, in accident and emergency and in our schools to foster understanding and empathy. There is also a need for access to pain condition nurses and consultants, and waiting times, especially for young people, must be improved. Aidan, Kiera and Victoria, and all those across the globe living with CRPS day in, day out, are all heroes in my eyes. [Applause.]

17:37  

I thank my friend and colleague Clare Adamson for bringing this important debate to the chamber and for her personal interest in raising awareness of complex regional pain syndrome. Her story was very moving, and I know that it must have been difficult to tell. I wish her son Aidan well.

I have a confession to make. I have been co-convener of the cross-party group on chronic pain since 2016, but, until Clare Adamson brought the condition to my—and the group’s—attention, I was unaware of CRPS. That is why awareness raising and debates such as this one are so important. Until there is greater understanding of the condition, sufferers will not benefit from the research and medical knowledge that they deserve.

As Clare Adamson’s motion states, CRPS is a debilitating and chronic disorder, mostly affecting the limbs. It is characterised by severe pain, pathological changes to bones, joints and skin, swelling, temperature and colour changes and motor dysfunction, and it can cause people to experience persistent burning, severe and debilitating pain.

The three clinical stages of type 1 complex regional pain syndrome are?acute, subacute, and chronic. The acute form lasts approximately three months. Pain, often burning in nature, is one of the first symptoms that initially limits function and chronic pain is a lifelong and debilitating condition. As Clare Adamson explained, the condition can develop after an injury, surgery, stroke or heart attack, and the pain is often very much out of proportion with the severity of the initial injury. It is a truly awful condition to be afflicted with.

Clare Adamson referred to Burning Nights. At a recent meeting of the cross-party group on chronic pain, the founder of that UK-wide charity, Victoria Abbott-Fleming, gave a moving account of her condition. As Clare said, Victoria is a barrister and was a healthy young woman until 2013, when she experienced an accident at work. She is now a double amputee, due to the severity of her CRPS. Burning Nights is a small, not-for-profit charity that does an amazing job of raising awareness of the condition, and it is a great source of comfort to and advice for sufferers.

Shortly after being elected in 2016, I was a member of the Public Petitions Committee in the Parliament. One memorable petition sought to raise awareness of sepsis as a potentially fatal condition; it still is but, at that time, that was not universally understood or acknowledged. Following the petition, the Scottish Government mounted a successful awareness campaign, and much more is now known about sepsis. I sincerely hope that that can be the outcome for CRPS sufferers, too.

As ever, hearing from someone with experience of any illness, such as Clare’s account of what her son Aidan is going through, is the most powerful way of understanding it. The same goes for the many brave and literally long-suffering members of the chronic pain cross-party group, many of whom have battled to get the treatment that they need. I hear about their suffering once every three months, but they have to endure their pain every day, and my heart goes out to them.

Last month was CRPS awareness month, during which members of the chronic pain community and their families and supporters around the world came together to help to raise awareness of the condition. Slowly, but through their determination, that is beginning to happen. As part of the initiative, colour the world orange day involved businesses, town halls and landmarks changing their lights to orange in support of people who live with CRPS.

The volunteers and organisers of CRPS UK and the Burning Nights campaign group should be praised for their great efforts to raise awareness of this little-understood condition. If this debate helps open the gateway to more understanding and research into CRPS, the time spent in the chamber will have been well worth it.

I thank Clare Adamson again for bringing the debate to the chamber, and I wish her son Aidan well.

17:42  

I start by thanking Clare Adamson for bringing the debate to the chamber. I did not know much about the subject until I looked into it a wee bit more, but she made a truly emotional, personal and brave contribution, and I wish her, her family and her son Aidan well.

CRPS is an uncommon neurological disorder. It plagues those who have it with chronic pain that is felt mostly in the limbs, although it can affect the whole body. It is believed that 16,000 people across the UK suffer from the condition, which is poorly understood despite having been medically recognised in some form for more than 150 years.

Notably, the condition can affect anyone, regardless of their age. As we have heard, it can be brought on by an accident or an injury. According to NHS Scotland, CRPS often improves incrementally over time in some people; however, in others, the pain lasts for years. Often, that pain can be intense and debilitating, affecting everything from motor functions to the overall quality of someone’s life.

Because of our limited understanding of the complexity that surrounds CRPS, treatment requires a multidisciplinary plan. According to NHS Scotland, there are four main types of treatment option, which, typically, involve multiple physicians because of CRPS’s complexity: psychological support; pain relief; physical rehabilitation; and self-education and management. Although they do not offer a complete solution, the treatments that are available today offer some relief, as the understanding of and research into CRPS continue to improve.

Raising awareness of CRPS is key to better understanding the disorder and improving the quality of life for the people whom it plagues. As is set out by Burning Nights, individuals who live with CRPS should follow the guidelines of the Royal College of Physicians.

As we have heard, November each year is CRPS awareness month, which the Scottish Parliament has celebrated for years. Likewise, there is no better place to help to shed light on the disorder than here at the Scottish Parliament.

Apart from helping to raise awareness, I also take the opportunity to highlight the wonderful work that is done by volunteers and people working across Scotland in service of this cause, including groups such as Burning Nights and CRPS UK. I thank them for the invaluable work that they do to offer community-oriented support. These groups provide education and empathetic spaces, and they put patients at the heart of everything that they do. Not only are patients behind their work, but the groups are also actively led by patients, along with care givers. That approach allows for those who suffer from CRPS to improve their own lives and those of others from a position of first-hand experience.

CRPS is poorly understood, and many people are not even aware that the disorder exists. Despite that, treatment and support have been able to make a positive difference for some sufferers. Keeping individuals with the disorder at the heart of treatment is crucial to any conversation that is had on the topic. Patient-led consultations and community spaces are central to treatment approaches and to increasing CRPS awareness among the public.

Once again, I take the opportunity to thank Clare Adamson for bringing the issue to the chamber.

17:46  

I, too, thank Clare Adamson for bringing this important debate to the chamber and for her heartfelt and honest speech about the reality for patients and their families. It was well received and I appreciate her doing that.

On behalf of Scottish Labour, I mark complex regional pain syndrome awareness month, which, as we have noted, was in November. I pay tribute to all those who work to raise awareness of CRPS and the impact that it can have on individuals and their families. As the motion states, CRPS is a debilitating chronic disorder that mostly affects the limbs and is characterised by severe pain, changes of bones, joints and skin, swelling, temperature and colour changes and motor dysfunction. Like other members, I was totally unaware of the effects and the presentation of symptoms.

As we have heard, those characteristics are debilitating and are often not recognised—that was clear from the speeches of Clare Adamson and other members—but we know that approximately 15,000 people across the United Kingdom live with the condition.

At this juncture, as Clare Adamson and others have done, I pay tribute to CRPS UK and Burning Nights, which are registered charities in the UK and do tremendous work not only to increase awareness of CRPS but to support those who live with it and to help them to improve their lives through advice, information, briefings and the development of research in this important area. From the briefings that we were kindly sent, I gather that we need to make sure that we are resourcing research into the condition on behalf of people who are suffering.

We have heard that Burning Nights holds an annual conference to bring together in a formal forum people who are impacted to enable them to discuss matters pertaining to the condition, and CRPS UK also holds regular events that raise awareness, inform people of the condition and encourage them to think about the importance of research in the area.

We have heard tonight that what is really important is that sufferers of CRPS are helped by the charities, families and loved ones and, often, volunteers who are keen to publicise the impact of the disorder on individuals. The latter is a key point. CRPS is so poorly understood that we need engagement from our clinicians to make sure that it is seen as an important area to research. I am keen to hear from the minister whether the Scottish Government understands that and whether it can see the need to progress research in that area on behalf of individuals. I am sure that we can do that through the work of the charities and the families.

I will make one final point about research. I often mention allied health professionals, because I have worked in that area previously. I know that they have been looking to come forward with ideas for research, because a multidisciplinary approach can be helpful. They recognised that there was not enough research in the work that they did, so they have put a lot of effort into doing that. Any time that I get an opportunity to speak with them, as I often do, I will ask how that is going and about what they have done.

I thank the national health service and the charities, but mostly I thank the patients and their families for being so committed to moving forward with this poorly understood condition, which causes a lot of pain and distress to the families that are involved. I thank Clare Adamson again for bringing the debate to the chamber.

17:50  

I, too, thank Clare Adamson for securing such a vital debate on complex regional pain syndrome, which we refer to as CRPS. It is essential to recognise that CRPS can happen to any of us, yet it remains a silent struggle for so many people. I am grateful to be part of the debate to help to break the silence that surrounds CRPS and to shine a light on the immense challenges that those who live with the condition face. I learned only this week—it seems that it was the same for other members—that CRPS is one of the most painful conditions that we know of, that it is often triggered by a seemingly minor injury, such as a sprain or a bone fracture, and that it can even appear spontaneously, with no known cause.

I have heard the enduring chronic pain associated with CRPS described as being much more painful than any initial injury and that it is a pain so severe that it can be described as

“being burnt alive from head to toe”.

That is a really scary thought.

In addition, CRPS causes pathological changes to the bones, along with intense swelling, heat and skin discolouration, as we have heard already. It is no surprise to learn that those symptoms can disrupt daily life and affect overall wellbeing.

One example that captured me was Ruby’s story. Ruby is a resilient individual who was diagnosed with CRPS in childhood and who faced a challenging shift in symptoms during her time at university. Ruby’s first couple of years at uni went really well, but then her pain escalated, and it reached the point at which sitting upright for more than a few minutes became unbearable.

Ruby’s exciting university life petered out and she had to leave her work placement and rely on essential support back at her parents’ home. That was devastating, especially for someone who describes themselves as a determined individual. The impact on her mental health was profound, not only because of the high level of pain that she was living with but from losing the ability to do the everyday tasks that we often take for granted.

I also point out that we need to increase awareness of the condition. When hearing Ruby’s experience, I was a bit taken aback by the misconceptions that were voiced by her peers, such as, “How lucky you are to rest at home.” Those comments are unhelpful and undermine the intense agony that Ruby was enduring, so we need to make sure that we have compassion in mind.

I also stress the significance of increasing awareness from a medical perspective. CRPS is challenging to diagnose and treat. There is no specific clinical test for a definitive positive result, and patients’ symptoms can vary. The NHS website states that CRPS is a condition that is “poorly understood”, and patients’ symptoms are sometimes dismissed, as we have heard. It would be helpful if the minister could reflect on any steps that the Scottish Government might take to raise awareness.

I have been a registered nurse for 30 years and I have never heard of complex regional pain syndrome. Would it be worth exploring what the nursing universities can do to raise awareness when they are teaching our future nurses?

Yes, absolutely. I hope that we can hear something more on that tonight.

In closing, I am keen to put on the record my thanks to Burning Nights, CRPS UK and others for raising awareness, providing invaluable support and education and spearheading much-needed research into CRPS. I also thank Clare Adamson for bravely sharing her family experience of CRPS and for bringing the syndrome to my attention. I hope that the debate will bring CRPS to the attention of many other people.

17:55  

I thank Clare Adamson not just for bringing the debate to the chamber but for sharing her personal story. Like her, I had never heard of CRPS before 2010. At that time, my daughter was nine years old. Like Clare Adamson, I have not spoken about this in public before.

My daughter had a sports day. Nothing obvious happened—we did not think that she got injured at all. Perhaps she took a little bit of a tumble, but kids of that age are always taking a tumble. The next day, she woke up with the most severe pain in her lower leg and foot. Her foot was a little bit red. The pain was almost indescribable. We could not even touch her slightly because she would scream in pain.

We were in hospital for tests, MRIs and X-rays, but most of the doctors told us that nothing obvious was wrong. However, as her parents, we knew that something was wrong. We spent days in hospital. Doctors were in touch with colleagues at other hospitals, and it was suggested that she had CRPS.

That was 13 years ago. Not much was known about the condition then, and it sounds as though awareness has not progressed much. There was no support at all. We did a lot of investigation on the internet, as most parents do. Because we were desperate, we reached out to a family in the United States whose daughter had a similar story and who were going through the same as us. We even bought a DVD that came from the States on possible treatments.

For my daughter, CRPS was almost like a nervous condition that was tricking the brain into thinking that something was seriously wrong. However, physically, nothing might have been wrong at all. I am not trying to say that it is all in the head—it is certainly not all in the head. People feel real pain, but the pain felt is almost out of control and not comparable to the original injury.

For my daughter, treatment consisted of two things: medicine—gabapentin, which always sticks in my mind—and a course of intense physiotherapy. I will never forget the physiotherapy. It was almost like we were torturing her. We knew that we had to break the cycle somehow, so we were trying to get her to walk again. She was screaming in pain, and the physiotherapist was almost forcing her to put her foot on the ground, even though that must have been hellish for her. We felt that we had to do something.

A little bit more help is available nowadays. I applaud all the charities that have been mentioned and are helping in relation to CRPS. What my daughter went through was horrendous, but her outcome was a lot better than that of most people with the condition. I hope that, with more awareness, diagnosis can be quicker and easier. As awareness grows, I hope that there will also be better treatments.

I thank Clare Adamson for telling her story. I hope that we can improve the situation for many people for years to come.

17:59  

I, too, thank Clare Adamson for her speech. Annie Wells wrote down the same words as I did: brave, emotional and personal. That is absolutely right. I also thank Douglas Lumsden for sharing his story.

As others have done, I acknowledge that November 2023 was the 25th complex regional pain syndrome awareness month. That is an incredibly important event across the world to mark this serious but poorly understood condition.

I will also take this opportunity to commend all of the volunteers, organisations and communities for their hard work in raising awareness of CRPS. I commend in particular CRPS UK and Burning Nights CRPS Support for all the important work that they do for the CRPS community and beyond.

Today’s debate has provided us with a chance to highlight the impact of CRPS and to reflect on the challenges that are faced by people living with the condition. The Scottish Government is committed to ensuring that people with CRPS can access the right care in the right place at the right time. As Rona Mackay said, hearing stories such as those that we have heard tonight makes such a difference. I also commend the work of the cross-party group on chronic pain, which helps us to establish and understand the impact.

As has been illustrated tonight, when talking about CRPS, we must remember that everyone’s experience of pain and the condition is unique. People need support that addresses their individual needs. I understand how distressing the condition can be, but I also understand how people can regain control of their lives and improve the quality of their lives with the right information and support.

However, many do not feel that they have access to the support that they need, which is why, in November, we published the updated framework for the pain management service delivery implementation plan. The plan sets out priorities for improvement of care and services. It has been informed by people with chronic pain—including those with CRPS—and it outlines actions that we will take to support people with pain to live well. The framework was developed through extensive engagement with people with chronic pain, our services, clinicians and the third sector, and it includes a public consultation on the draft of the framework.

We understand that the majority of people with CRPS access support in community settings, and we recognise that there are opportunities for improvement. Given the varying impact that CRPS has on general health and wellbeing, different people require different levels of support that are tailored to their unique circumstances. We need to promote new approaches to delivery so that specialist services are more accessible and sustainable for the future. We will continue to work with service managers, our clinical networks and the centre for sustainable delivery to include and introduce new ways of delivering care, create additional capacity and redesign pathways into specialist pain services.

We have heard about the variation in management and treatment options across Scotland. My officials have taken note of some of the points and suggestions that have been made, and we will look into them—specifically those on meeting CRPS UK and Burning Nights CRPS Support.

I want to be clear that it is our expectation that every person with CRPS has access to high-quality, evidence-based and effective support to help them to manage the impact of their condition, no matter where they live. Together, the actions in our framework will provide a better experience of services for people, improved co-ordination of care between community-based and specialist services, and better outcomes for care and treatment.

Clare Adamson and Carol Mochan mentioned issues related to research. NHS Research Scotland’s pain network, which is funded by the Scottish Government through the chief scientist office, brings together around 200 researchers across multiple disciplines to promote collaboration and to share pain research activity and findings. The chief scientist office directly funds research projects, so any projects on underlying causes, treatment or management of pain are very welcome.

Tonight’s debate has informed us that many people who live with complex regional pain syndrome feel that the impact of their condition is often overlooked or ignored by society. People with CRPS also need services that recognise pain and offer effective support for the challenges that they face in their daily life. That is why we are taking action to embed awareness and skills in management of chronic pain and associated conditions at all levels of the NHS workforce through a pain-informed approach. However, I note some of the other points that have been made, and we will also look at other options around those.

I recognise the work that third sector organisations are doing in this area. We have heard how challenging it can be to find clear and consistent information. In response, we have established a pain management national working group, which is dedicated to overseeing improvement in the co-ordination of information and resources at the national and local levels. That is to ensure that we deliver more useful and appropriate national advice about chronic pain and associated conditions, as well as better information on the steps that people can take to manage its impact and how they can access further support and services when they need it. I am pleased to say that, this year, as a result of that work, the chronic pain pages on the NHS Inform website were updated.

People with CRPS are already experts on their condition, but we know that many benefits from additional supported self-management are offered by our partners in the third sector. We have established a dedicated third sector network to improve partnership working in our public services so that people can access a wider range of options for support. The network includes stakeholders such as Versus Arthritis and Pain Concern, which provide support for people with people with CRPS, and I am grateful for their contribution and the important work that they continue to do.

We also understand that people who are living with CRPS face challenges in accessing local services when they need them, and that that has an impact on their wellbeing and opportunities for earlier and more effective intervention. Our framework includes an aim on accessible care, with specific actions to improve how local and national services are delivered to provide a more co-ordinated and consistent experience. We will do that by sharing best practice, promoting innovative new approaches to service delivery and improving how services understand the needs of their local populations. That supports the approach that we have taken to date to improve how specialist pain services work in partnership and share expertise with primary care colleagues.

I thank members for their contributions. As I said earlier, my officials and I have noted suggestions and we would be happy to meet members and the charities. We have been improving referrals and access to the Scottish national residential pain management programme, which provides the highest level of care for people who have chronic pain. The Scottish Government funds the programme to the value of about £630,000 a year.

I reiterate the Scottish Government’s commitment to increasing awareness of complex regional pain syndrome and its impact or, as Rona Mackay said, to opening the gate to improving everyone’s understanding. We will continue to listen, learn and act to make sure that people who are living with CRPS can access safe, effective and person-centred support to help them to manage their condition and live well.

Meeting closed at 18:07.