NHS: Pain Management Services

Baroness Emerton Excerpts

Wednesday 7th July 2010 Lords Chamber

[Baroness Emerton]

My Lords, I wish to add my thanks to my noble friend Lord Luce for initiating this short debate, following up his previous attempts to improve the multi-disciplinary approach to managing chronic pain. I declare an interest as a retired nurse and fully support multi-professional involvement. I certainly agree with the noble Baroness, Lady Pitkeathley, about the importance of care, compassion and communication as vital accompaniments. I also support my noble friend Lord Luce in urging the introduction of the fifth vital sign. It is extremely important that that is implemented.

There also appears to be a hold-up in extending the prescribing role of nurse consultants to patients suffering from chronic pain, although they are able to prescribe opiates to those suffering from acute pain or if they hold the role as a palliative care nurse. However, in a chronic pain clinic they have to refer the patient back to the GP. I understand that this causes great frustration to the patient, the GP and the nurse, and is wasteful of resources. I urge the Minister to look into this, please, to see whether it can be untangled.

I wish also to draw the Minister’s attention to an aspect of chronic pain that is preventable and very cost-effective. Reference has already been made to Dame Carol Black’s 2008 report, Working for a Healthier Tomorrow, which found that early intervention enables staff to return to work quickly, particularly where illness has the potential to become chronic and long-lasting, such as in the musculoskeletal disorders. Her report found that for employees with lower back pain, early intervention sees them return to work up to five weeks earlier than under normal care and reduces the recurrence of back pain in the following year by up to 40 per cent.

The Secretary for State for Health has made much of the need for an NHS that is focused on prevention and wider public health. Taking measures to safeguard nurses from back pain could be a tangible commitment to this. According to the Boorman review of November 2009, NHS Health and Wellbeing, which was acknowledged by the former Government, sickness among NHS staff in England currently accounts for 10.7 million lost work days at a cost of £1.7 billion. Some 30 per cent of the staff of the NHS are nurses. A national audit into clinical back pain management found that nurses and nurse support staff were more frequently absent than any other healthcare professionals with back pain caused by the level of manual handling in their jobs. It is not clear what the exact cost of back pain related nurse illness is to the NHS, but as nurses comprise the largest part of the workforce, it must make a significant contribution to the costs highlighted by Boorman. In addition, professional compensation awards can be significant. In recent years, awards of £800,000 and £400,000 have been made for work-related injuries. Early intervention to prevent nurse back pain related illness could help prevent a genuine risk to patient safety.

In the interests of ensuring patient safety, saving large sums of money as a result of preventive action and producing a healthier workforce, will the Minister add to the requests of other noble Lords my request for government action to encourage regular risk assessments, training in updated manual handling procedures and the supply of adequate equipment, especially in the community services, as well as a recognition of the need for early intervention in signs of lower back pain in nurses, support workers and other healthcare professionals? There is a saying that prevention is better than cure. Focus on prevention in this field would be of great benefit to patients, staff, management and the economy generally.