Dear NHS Wirral Clinical Commissioning Group,

Thank you for your initial response. We have fine-tuned our questions in order to gain more clarity. Please may you answer the following:

1) How many consultations are there per year in each of the following care settings for chronic pain. Please provide us with the financial years of 2018-2019, 2019-2020 and 2020-2021.

- How many consultations are there in Community services?
- How many consultations are there in Primary care (general practice)?
- How many consultations are there in Secondary Care (Acute Hospitals)

2) How many patients per year does that represent? In each care setting for each of the following financial years (2018-2019), (2019-2020) and (2020-2021).

- Primary care (general practice) - in the years (2018-2019), (2019-2020) and (2020-21).
- Community Services - in the years (2018-2019), (2019-2020) and (2020-2021).
- Secondary care (acute hospitals) - in the years (2018-2019), (2019-2020) and (2020-21).

3) What is the total cost of medication per year for Chronic Pain?
Please give us the total cost for providing the following analgesics on prescription in each of the following care-settings: ( Primary = GP and Community Services ) and (Secondary = Acute Hospital Settings) for the following years: 2018-19, 2019-20 and 2020-21. Please note, we recognise that it may be impossible to dissociate the prescription of these drugs for pain or for other indication. In that case, please just provide us with the total cost irrespective of indication. Please consider referring to the BNF analgesics chapter.

5) Do you have a secondary care pain unit in the CCG? If so, how many referrals are made to this unit per year? For the following financial years: (2018-19), (2019-20) and (2020-21).

6) Do you have community pain services? If so, how many consultations are made to these services per year? For the following financial years: (2018-19), (2019-20) and (2020-21). How are these services commissioned?

7) What is the total cost of care per year for Chronic Pain? ​In each setting for each financial year.

- Primary care (general practice) - in the years (2018-2019), (2019-2020) and (2020-2021).
- Community Services - in the years (2018-2019), (2019-2020) and (2020-21).
- Secondary care (acute hospitals) - in the years (2018-2019), (2019-2020) and (2020-21).

Yours faithfully,

Dr Benjamin Viaris De Lesegno and Sabrina Khaloon