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National Pain Audit

NPA

Overview

The First National Audit of Pain Services aimed to:

  • Improve the quality and effectiveness of care by measuring services against established national standards
  • Improve access to specialist pain services for patients and service users
  • Improve awareness of specialist pain services within the NHS among patients, commissioners and clinicians
  • Help close the gap in the variation of care
  • Accelerate the rate of improvement and development in both the organisation and delivery of care for people with chronic pain
  • Establish new standards relating to the delivery of a high quality pain service
    Outcomes
    National Standards were established for specialist outpatient pain services. These included:

Services

  • Every specialist pain service should be multidisciplinary and include, at a minimum, psychologist, physiotherapist or other rehabilitation professional, and a physician. Other professions should be included if the case mix is more complex (e.g. nursing staff). Only 40% of services reached these standards
  • Waiting time to treatment should adhere to 18-week waits with a more rapid time to assessment

Case mix

  • The case mix audit the quality of life for patients attending specialist services is very poor - on par with those with advanced senility. Most have spinal pain and are of working age

Patient reported outcomes

  • Small gains are made with treatment which may be linked to reduced healthcare resource use
  • Many patients struggle to grasp and accept that they have long term pain

Recommendations

  • A training framework and a competency framework for non-medical staff
  • Clinical coding needs to be simplified and some new codes introduced for diagnosis and treatment
  • Improved educational resources for patients and better to support to manage their pain
  • An inpatient audit to cover non-surgical cases