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Rhetoric and reality on acute pain services in the UK: a national postal questionnaire survey

Rhetoric and reality on acute pain services in the UK: a national postal questionnaire survey,10.1093/bja/aeh130,British Journal of Anaesthesia,A. E.

Rhetoric and reality on acute pain services in the UK: a national postal questionnaire survey   (Citations: 21)
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Background. The study aimed to explore the extent to which NHS acute pain services (APSs) have been established in accordance with national guidance, and to assess the degree to which clinicians in acute pain management believe that these services are fulfilling their role. Methods. A postal questionnaire survey addressed to the head of the acute pain service was sent to 403 National Health Service hospitals each carrying out more than 1000 operative procedures a year. Results. Completed questionnaires were received from 81% (325) of the hospitals, of which 83% (270) had an established acute pain service. Most of these (86%) described their service as Monday-Friday with a reduced service at other times; only 5% described their service as covering 24 hours, 7 days a week. In the majority of hospitals (68%), the on-call anaesthetist was the sole provider of out of hours services. Services were categorized by respondents as thriving (30%), struggling to manage (52%) or non-existent (17%). There was widespread agreement (>85%) on the principles that should underpin acute pain services, and similar agreement on the need for better organizational approaches (95%) rather than new treatments and delivery techniques (19%). Conclusions. More than a decade since the 1990 report Pain after Surgery, national coverage of comprehensive acute pain services is still far from being achieved. Despite wide consensus about the problems, concrete solutions are proving hard to implement. There is strong support for a two-fold response: securing greater political commitment to pain services and using organizational approaches to address current deficits. Br J Anaesth 2004: 92: 689-93
Journal: British Journal of Anaesthesia - BRIT J ANAESTH , vol. 92, no. 5, pp. 689-693, 2004
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    • ...In a climate of cost-driven health services, many hospitals have in recent years achieved important improvements in postoperative pain management [4]...

    Donna Brownet al. Developing the practice context to enable more effective pain manageme...

    • ...Hospitals vary widely in the ways they deliver pain care. Some have a comprehensive, interdisciplinary inpatient and outpatient pain service, while others subdivide into acute/postoperative/chronic services. Some still have a single-handed doctor doing a few injections, while a few have no access to services at all. Much more attention needs to be paid to the implementation of these services in the most patient-centred way....

    William Notcuttet al. Inadequate pain management: myth, stigma and professional fear

    • ...In the United Kingdom, 88% of all hospitals in 2004 had APS [11] while a survey in 2003 of 105 hospitals in 17 European countries by Rawal [12] showed that only 34% had an organised APS...

    P. Huet al. A survey of acute pain services in teaching hospitals in the Republic ...

    • ...We need to pay attention to the cultural and organisational factors that prevent patients receiving good peri-operative pain management as well as the technical medical ones (66, 68) and to challenge attitudes and current practices...

    W Macrae. Chronic Post-surgical Pain

    • ...En países con políticas nacionales para el manejo del dolor agudo, como es el caso del Reino Unido, se continúa presentando un déficit en las facilidades para la adecuada prestación del servicio (3); solamente el 5% de los servicios tiene capacidad de brindar atención 24 horas, 86% de ellos solo brindan atención de lunes a viernes y después de estas horas, la atención es brindada en un 68% ...

    C. E. Restrepo-Garcéset al. 432 ■ DOLOR Y MEDICINA BASADA EN LA EVIDENCIA

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