Adjournment debate held to discuss chronic pain

The adjournment debate concerning the pain management services in England, proposed by the chair of the All Party Parliamentary Group for Chronic Pain Anne Begg MP, took place on the 20th April 2009 – appropriately the start of Arthritis Care awareness week. The debate was arranged to draw attention to the staggering number of people affected by pain on a daily basis, estimated to be around 7.8 million.

In support of the Chief Medical Officer’s report and recommendations, Anne Begg drew the House’s attention to the lack of effectively co-ordinated services designed to deal with pain management, and that tackling this ‘means making improving pain services a priority for the Department of Health and for every strategic health authority, primary care trust and provider to the NHS trusts’.

Anne Begg stressed the importance of expert knowledge in dealing with pain, ‘training on chronic pain should be included in the curriculum for all health professionals who deal with patients’. Particular importance was put on GPs, who she suggested should have pain training as part of their undergraduate course, providing them with the knowledge to properly deal with the problem and providing patients with easy access to someone who understands the condition. She also voiced her support for Sir Liam Donaldson’s recommendation for a ‘model’ pain service of pathways, providing patients with increased access opportunities and offering a standard of treatment at a high level to all.

Central to the debate was the recommended inclusion of an assessment of pain in the quality and outcomes framework (QOF). Anne Begg stated: ‘A recent report on osteoarthritis found that 50 per cent of people said that they would need to be in frequently unbearable pain before considering seeing their GP—clearly this is a significant barrier.’ By introducing a pain assessment into the QOF, health professionals will be encouraged to enquire about a patient’s health, rather than relying on the patient to bring up the issue. Part of this recommendation includes the proposed use of a pain score as part of the vital signs monitored in hospitals, something the Chronic Pain Policy Coalition have been campaigning for to help health professionals initiate discourse with their patients about the pain they suffer.

The Parliamentary Under-Secretary of State for Health, Ann Keen responded by thanking the Chronic Pain Policy Coalition and Anne Begg for their involvement with chronic pain, and that she had made a persuasive argument regarding the recommendation for pain indicators in the QOF. She said: ‘the next opportunity to submit suggestions for new indicators to NICE will be this summer. I hope that the chronic pain policy coalition will take the opportunity to suggest specific indicators at that stage.

With chronic pain being so prevalent, the recommendations made during the debate have the potential to not only improve the quality of life of many but also reduce public expenditure on health, social care and incapacity benefits as the patients become more able to manage with their condition.