NATIONAL PROVISION OF ACUTE PAIN SERVICES

In order to determine the degree to which the recommendations of the r eport of the joint working party on 'Pain after Surgery' by the Royal College of Surgeons of England and the College of Anaesthetists have b een implemented, a postal survey was conducted of all hospitals in the United Kingdom where surgery is performed. The number of hospitals wi th a multidisciplinary acute pain service had significantly increased from 2.8% before September 1990 to 42.7% at the end of 1994. Over the same period there has been an increase in the number of hospitals with a named clinician responsible for acute pain management, from 20 befo re 1990 to 230 (65.2%) and the number of hospitals with an acute pain nurse has increased from 8 (2.3%) prior to 1990 to 139 (39.3%). Routin e assessment of pain and sedation occurs in 82% of hospitals with esta blished acute pain services and in less than 50% of hospitals without an acute pain service. The use of written protocols, the provision of out-of-hours cover and regular training for all staff have increased w ith time. Research and audit activity related to acute pain management has also improved since 1990.