Overview of the National Audit of Pain Services

Two government reports have called for better assessment practices. In response The National Audit of Pain Services has been initiated to collect detailed data on pain services. The three year study aims to improve NHS services for people affected by chronic pain and will establish a national data collection system which will enable services to monitor performance, share data, feedback and consensus of interested parties. Areas of data collection will include, patient case mix, demographics, diagnosis, treatments, assessment of condition severity and patient outcomes.

The audit is funded by the Health Improvement Partnership (HQIP) and is being carried out by a partnership of the British Pain Society and Dr Foster Research Ltd.

• To improve the quality and effectiveness of care by measuring services against established national standards.
• To improve access to specialist pain services for patients and services users.
• To improve awareness of specialist pain services within the NHS amongst patients, commissioners and clinicians.
• To help close the gap in the variation of care
• To accelerate the rate of improvement and development in both the organisation and delivery of care for people with chronic pain.
• To establish the new standards relating to the delivery of a high quality pain service.

Phase one of the audit will focus on the provision and distribution of NHS pain services, within both primary and secondary care, across England and Wales. Data will be collected on the staffing levels, level of multi disciplinary care provided, facilities, treatments and waiting times for new patients at each individual clinic. Where possible the information requested will be based upon guidelines produced by the Royal College of Anaesthetists and the Department of Health¹. The completion of this phase will establish a national data-base of pain services with all individual clinics mapped to their parent NHS Trusts and Strategic Health Authorities. This data-set will allow us to conduct a proper analysis of the pain services currently available to patients and look at the variation between different providers and regions.

Phase two of the audit will then focus on the continuous collection of patient case mix data from all participating pain clinics. Data collected from clinics will include age, sex, diagnosis, treatment(s), type of pain, severity of the condition, duration of the pain and the NHS patient ID number. A continuous collection process will allow us to capture a true representation of the patients treated at all participating clinics and will avoid factors such as seasonal variance affecting the analysis of the data collected.

During phase three of the audit outcomes data will be recorded by patients either through a secure online system or via a paper based questionnaire. The data collected will be based upon the Brief Pain Inventory Short form which is well established through clinical trials as an effective means of collecting patient outcomes in this area. Patients will be recruited to participate in the audit by their clinicians when visiting a specialist pain clinic and will be required to sign a consent form prior to submitting any data. All data will be submitted privately and not in the presence clinicians to ensure the honesty of answers and the overall accuracy of the data collected.