NCAPOP: First National Pain Audit reports

22 November 2011

National Pain Audit news release

First National Pain Audit finds many people accross England and Wales have no access to specialist pain services

Dr Foster Intelligence and the British Pain Society have, for the first time, audited the availability of specialist centres for the diagnosis and management of complex chronic pain disorders. The three year study was commissioned by the Health Quality Improvement Partnership (HQIP) in September 2009 and has a year left to run.

Read the Phase 1 Report here >>

The National Pain Audit aims to improve information on and awareness of pain services in England and Wales for patients with chronic pain. Prior to this auditlittle has been known of the population served, the services offered and outcomes from them. The audit also aims to improve the quality and effectiveness of care by measuring services against established national standards.

To deliver this over a three year cycle the audit is divided into three phases:

Phase 1:  an organisational audit based upon key standards.
Phase 2:  is case mix collection from both clinicians and patients
Phase 3:  looks at outcomes of care from the patients' perspective.

The audit has been led by the British Pain Society which is multi-professional in its remit and has significant patient involvement in its activities.

The National Pain Audit has reported organisational data for the years 2010 - 2011 against a wide range of standards set by the Faculty of Pain Medicine, British Pain Society and International Association for the Study of Pain.

Dr Cathy Price, Clinical Lead for the National Pain Audit said: "It is hoped that by improving the management of people with difficult chronic pain the consequences will be ameliorated, with obvious benefits both to the patient and to society. Patients should be afforded better knowledge of the services that are provided and how they compare with others."

Interim Findings:

• 209 services have been identified in the two countries. Most English Primary Care Trusts (PCT) and Welsh Local Health Boards (LHB) provided between one and three services for their population. Some PCT's had multiple providers within the same locality. 28 PCT's did not appear to have services available for their patients.
• Most English services (73% of PCT's) appeared to meet government waiting time target of 18 weeks until first appointment in a pain service. 11% of PCT's did not. International research indicates that more rapid access is often needed
• 71 % of clinics provide multidisciplinary care 40% of clinics in England meet multidisciplinary standard, and 63% in Wales. There is a wide geographical variation; in some areas patients need to travel great distances to receive multidisciplinary care as key personnel are often patchily available. Shortages of specialist psychologists, physiotherapists, occupational therapists and pharmacists hinder a multi-disciplinary approach.
• Only around half of all clinics offer psychologically-based treatments and have a specialist clinical psychologist. A quarter of those offering medical treatments for pain did not have consultant cover. Given that these are specialist services and patients, will, by definition, have failed generalist care, the lack of appropriately trained senior staff in to supervise and support treatment is concerning
• Many services do not have good access to technological support to provide good information about patients
• Few services are able to train staff which may impact on the sustainability of the service. 81 per cent of clinics had recently tried to obtain additional funding but 63 per cent had been unsuccessful.

A copy of the report can be downloaded from www.nationalpainaudit.org and www.britishpainsociety.org.