Research Projects

Managing postoperative pain in adults: the role of acute pain services in the UK

Researchers

Huw Davies, Professor of Health Care Policy & Management, Director of Centre for Public Policy & Management (University of St Andrews), and Associate Director of Social Dimensions of Health Institute (Universities of Dundee and St Andrews).
Alison Powell, Centre for Public Policy & Management, University of St Andrews
Jonathan Bannister, Tayside Pain Service, Ninewells Hospital
Bill Macrae, Tayside Pain Service, Ninewells Hospital

Contact for more information: Alison Powell (aep2@st-and.ac.uk)

Background

Effective control of postoperative pain is valued highly by patients and carries significant clinical, economic and social benefits. Recognition that postoperative pain management in the NHS (as elsewhere) had been deficient for many years led to the introduction of "acute pain services" from the early 1990s. The majority of NHS hospitals providing surgery now have some form of acute pain service. However, successive studies have shown that good practice in postoperative pain management remains patchy, and that the deficiencies are largely attributed to organisational and cultural factors.

Aims of study

• To update and supplement existing national data on
  • the extent to which UK acute pain services (APSs) are set up in alignment with national guidance
  • the degree to which clinical leaders in acute pain management believe that APSs are fulfilling the role asked of them
• To use concepts of organisational culture to explore why some hospitals have been relatively successful in implementing the national recommendations on acute pain services and the management of postoperative pain in adults and others have not.

Methods of working

In 2002, a postal questionnaire survey addressed to the head of the acute pain service was sent to 403 NHS hospitals each carrying out more than 1000 operative procedures a year; this achieved a response rate of 81%. Detailed case studies comprising semi-structured interviews with key medical, nursing and managerial staff and documentary review are in progress at three NHS trusts across the UK.

Funding

This project is funded by a grant from an educational and research trust managed through Tayside University Hospitals Trust.