NHS needs to improve chronic pain management

 NHS services for management of chronic pain are inadequate to the needs of many patients, according to a report following the first UK ‘pain summit’.

The report, produced by a coalition of medical experts, identifies lack of clear guidelines, delayed referrals, long waiting times and suboptimal medication as problems affecting pain management services.

It recommends that the planned NICE quality standard on pain management include nationally agreed commissioning guidelines and a data strategy.

According to Beverly Collett, chair of the coalition, “chronic pain is not being taken seriously” though it impacts powerfully on general health.

Collett also argued that the conventional “analgesia staircase” was developed primarily for cancer patients and is less effective in patients with other types of chronic pain, who would benefit from a wider range of drug and non-drug therapies.

The report was produced by the Royal College of General Practitioners and the Faculty of Pain Medicine of the Royal College of Anaesthetists, together with the British Pain Society (a professional organisation) and the Chronic Pain Policy Coalition (an industry-sponsored group).

Chronic pain (persisting for more than three months) affects one in eight people in the UK, and has many causes.

According to the report, patients who would benefit from early intervention are often not referred to a specialist or face long waits for treatment, with reliance on suboptimal medication being the norm.

The report calls for:

• Clear national standards for the identification, assessment and initial management of chronic pain, forming the basis of the NICE quality standard.

• Nationally agreed commissioning guidelines to reduce service variation.

• A data strategy to collect and share information about the extent, severity and medical impact of chronic pain.

• Better education of medical students, clinicians and the public in pain management.