A few thoughts on the draft NICE guideline for managing primary chronic pain. I'll preface this by saying that I am on a NICE guideline committee myself - all membership is publicly available. Before you get thoroughly outraged about it - answer a few questions.

Does this guidance apply in my country? (i.e. do you live in England or Wales?). If no, then maybe consider sending irate tweets about something else today. There's a lot to choose from, poverty, the handling of coronavirus - guidance that really won't affect you? Not so much.

Next question. Have I read the guidance? The whole thing, not the headlines on twitter but the actual guidance. What about the background stuff and all the explanations for how the recommendations were drawn and the numerous shortcomings of the evidence available? No? Do it.

Do I know how NICE operates and how they decide what evidence can be considered? No? All of this information is available on their website. NICE does not claim to be perfect, it doesn't claim its guidance is perfect. It has a method and it has limitations. It is GUIDANCE.

Do I know what primary chronic pain is? This is not all forms of long-term pain. NICE have other guidelines on low back pain, osteoarthritis, rheumatoid arthritis etc etc - they recommend medicines, if that is what you want. NICE direct you to them, throughout the guideline.

Finally, because I'm boring myself now. This is guidance. NICE cannot stop people prescribing, they cannot force CCGs or Health Boards to ensure that services provide what people with pain will most benefit from. They state, within parameters, what current evidence best supports.

Actually, I'm not done. Anyone furiously tweeting 'Who are these people writing the guideline?'. Why? What are you going to do? Have a word with yourself and refer back to my earlier tweet about how NICE works. And if you're in the UK - maybe put yourself forward.

If you have knowledge and experience, are prepared to give up a significant amount of your own time, for no remuneration whatsoever, in order to represent your profession or specialism - please apply when you can. But do not go after individuals - respond to the consultation.