By: 28 September 2015
Plymouth anaesthetics department accredited by RCoA

Plymouth anaesthetics department accredited by RCoA

The anaesthetics department at Derriford Hospital in Plymouth has been accredited by the Royal College of Anaesthetists (RCoA) as one of the first in the UK to receive Anaesthesia Clinical Services Accreditation (ACSA).

Jeremy Langton, consultant anaesthetist at Derriford Hospital and vice president elect of the RCoA, presented the department with the commemorative plaque.

ACSA is a unique scheme for anaesthetic departments in the NHS and independent sector that enables departments to measure their performance against defined standards and clinical guidelines with the aim to become accredited for their quality of patient care and service delivery following an external peer review visit.

Since the scheme’s launch in 2013, it has received acclaim from national regulators and, to date, more than 56 NHS anaesthetic departments have begun working towards meeting the ACSA standards.

Sophia Wrigley, anaesthetics consultant and department ACSA lead, said: “The Royal College of Anaesthetists ACSA has recently been launched nationally and is a voluntary scheme for NHS and independent sector organisations, which offers quality improvement through peer review.

“The anaesthetic department in Plymouth is delighted to be the first large NHS Trust to achieve these standards and the first in the south west. To become accredited, the department demonstrated to an external review team that we met more than 170 standards related to high-quality and safe patient care. It is a huge achievement, to which every member of the department contributed.”

Richard Struthers, anaesthetics service line lead, said: “The formal commitment to ACSA motivated all members of the department to work towards a common goal – enabling demonstration of the high standards of clinical care, teaching, research and organisational tasks already delivered within our cohesive department. The external recognition by the review team affirms our position to stakeholders, such as patients, commissioners, clinical colleagues and the executive team, that we put patients’ safety and delivery of all aspects of quality care at the centre of our work.”

Battle against chronic pain must be given higher priority, say health policy experts

Approximately 20 per cent of Europe’s adult population – more than 80 million people – suffer from chronic pain. Some 9 per cent of Europeans experience pain on a daily basis. Back pain is especially common, reported by 63 per cent of all pain patients, followed by joint and rheumatic pain. The total direct and indirect costs of chronic pain amount to an estimated 1.5–3 per cent of total European GDP. These alarming figures were the subject of discussion at the European Pain Federation EFIC’s Pain in Europe IX Congress in Vienna, in September.

Chronic pain: an enormous economic burden

“Our objective is to increase the visibility of chronic pain as a medical, economic and social problem, since it affects quality of life more than most other illnesses,” commented Chris Wells, president of EFIC. With the economy stagnating, and health and social services under pressure due to cost-cutting measures, he pointed out that it is all the more important to draw attention to the economic impact of chronic pain. “We are not just talking about the huge burden the treatment of chronic pain places on health budgets, but all the indirect costs arising from lost productivity and incapacity for work,” Wells said. Although two-thirds of chronic pain patients in Europe are technically still in work, their conditions account for 500 million sick days a year. Chronic pain is the most frequent cause of early retirement and incapacity for work. The risk of being forced to leave employment is seven times higher for pain patients than for the population as a whole.

Inadequate treatment despite medical advances

A particularly worrying factor, Wells explained, is that a considerable part of the negative impact on society is the result of inadequate treatment of pain, despite major advances in therapy. “More than half of chronic pain patients suffer from the condition for two years or more before they receive adequate treatment. A third of patients get no treatment at all, and around 38 per cent say that the treatment received was insufficient,” he added. The prevalence of chronic pain, its social and economic impact and the clear deficiencies in the level of care being provided amount to a wake-up call for EU and national health policymakers, Wells believes. “We need investment in pain research, pain therapy training and most of all in specialist facilities for chronic pain prevention, treatment and rehabilitation. Less chronic pain, less suffering, greater productivity – we can achieve it, but it won’t come for free.”

European pain diploma

For the EFIC president, an especially important issue is training and education. “One of our key priorities is to raise the standard of pain medicine and care provided throughout Europe. That is why we are involved in harmonising education and training in pain medicine across the continent,” Wells explained.

There are exams and degrees available in some European countries, but by no means in all. To counter this problem, EFIC is planning a pain knowledge curriculum leading to an examination and certification, to be known as the European Pain Federation Diploma in Pain Medicine, which will be recognised across Europe. EFIC hopes to publish the curriculum later this year, and to hold the first exam next year. 

Chronic pain to be recognised as a condition in its own right

EFIC’s commitment to improving care for chronic pain has borne fruit. As a result of concerted efforts by EFIC and the International Association for the Study of Pain (IASP), chronic pain will soon be defined as a condition in its own right in the World Health Organization’s International Classification of Diseases (ICD). Chronic pain is included in the beta version of the ICD’s 11th revision, which will be tested in practice until August 2016, with subcategories such as chronic primary pain, chronic postsurgical pain, chronic neuropathic pain, and chronic headache and orofacial pain. “This represents a very important step forward towards chronic pain being afforded the significance it deserves. Its classification will certainly lead to changes in health policy,” said the EFIC president.