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Nurses 'integral' to pain management services

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Services for sufferers of chronic pain vary hugely across the country with a fifth of primary care trusts not providing any services at all, new research has shown.

The Pain Audit is the first ever comprehensive assessment of services available in England and Wales to the 6.4% of the population estimated to suffer from chronic pain.

It found there were 214 pain clinics in England, 136 of which were based in acute trusts, 31 in community settings and 37 where the location was unclear. In total 28 PCT areas did not appear to have any pain mangement services while in Wales there were 10 clinics across seven health boards.

The audit results were revealed at the Pain Summit 2011, an event bringing together nurses, medics, commissioners and policy makers with the aim of reaching a consensus on how chronic pain services could be improved.

Speaking at the event, health minister Earl Howe called on clinicians, including nurses, to take the lead in designing and develop new services.

He said: “Sadly patients in many parts of the country are still unable to access even the most basic standards of multidisciplinary care [for chronic pain]. The NHS needs to promote standards of the highest quality [and] over centralised management doesn’t work.”

The audit found only 40% of services in England and 60% in Wales had multidisciplinary teams that included a medical consultant, specialist psychologist and a physiotherapist, as well as nurses.

Only two thirds of services in England said they had the capacity to train new nurses or provide professional development for existing nursing staff. This was 80% in Wales, while in both countries only about half trained medical students. The report warned this threatened the future viability of services.

Chronic pain can be caused by a range of conditions including arthritis and musculoskeletal pain, although the root cause can often be extremely difficult to diagnose.

NHS medical director Bruce Keogh told the summit it took on average 2.8 years for sufferers to get a satisfactory diagnosis in the UK, compared to 1.9 years in Europe.

He said variation in treatment of pain in an acute setting suggested healthcare professionals did not get enough education about pain. However, he said there were also legal issues that professionals needed help to understand and could complicate working relationships between doctors and nurses.

He added: “The Shipman inquiry introduced a level of fear in the way GPs deal with pain in the community.”

The Pain Audit was carried out jointly by Dr Foster Intelligence, the Healthcare Quality Improvement Partnership and the British Pain Society.

British Pain Society secretary and nurse Pat Schofield told Nursing Times it was important to raise the profile of pain management.

She said: “Nurses are integral to pain management services… [they] need to be involved in the process of developing services.”

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  • Nurses are integral to every service in the NHS.

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