Acute pain services in the United Kingdom

Nurse prescribing for inpatient pain in the United Kingdom: A national questionnaire survey

“…The development of APS in the United Kingdom (UK) began in the 1990's following an influential report by the Royal College of Surgeons and the College of Anaesthetists (1990), which identified low standards of care for postoperative pain and recommended the development of multidisciplinary teams to assume responsibility for pain management, staff training, audit and research. Since then, the number of APS has steadily increased (McDonnell et al, 2003, Nagi, 2004, Powell et al, 2004. While the remit of these pain services was initially to improve acute post-operative pain, in some areas this has expanded to include the management of other pain types such as cancer pain and chronic pain (Powell et al, 2004, Counsell, 2008.…”

“…Dedicated Acute Pain Services (APS) have been developed in the USA, Canada, New Zealand and across Europe (Nagi, 2004). The development of APS in the United Kingdom (UK) began in the 1990's following an influential report by the Royal College of Surgeons and the College of Anaesthetists (1990), which identified low standards of care for postoperative pain and recommended the development of multidisciplinary teams to assume responsibility for pain management, staff training, audit and research.…”

Understanding the challenges of service change – learning from acute pain services in the UK

“…Ten years after the publication of the first key policy document, 4 the majority of UK hospitals had set up an acute pain service. 5 However, these services have continued to struggle to implement necessary improvements in postoperative pain management. 6 Many acute pain services only focus on the care of selected patients, such as those in receipt of specialized forms of pain relief such as epidural or patient-controlled analgesia.…”

“…+ By 2002 the majority of hospitals did have an acute pain service in some form 5,6 but many services were struggling to embed the necessary improvements in postoperative pain management in routine practice across their hospitals. Deficits in basic care continued.…”

“…Thus postoperative pain management remains inadequate for many surgical patients. 5,6 We set out to understand these local implementation difficulties given the clear recognition of the problem and a national policy impetus for action. …”