Abstract
BackgroundChronic pain management services have historically been under-resourced in Ireland. There is no agreed model of care for chronic pain management services in Ireland. Previous studies have assessed the extent of services in Ireland without examining waiting times for access to services.AimsThis study aimed to quantify the extent of, geographical distribution of and waiting times for access to publicly funded chronic pain management services in Ireland.MethodsUsing the British Pain Society’s Core Standards for Pain Management Services in the UK (2015) and International Association for the Study of Pain (IASP) recommendations, a questionnaire was devised. Publically funded departments in Ireland were contacted and questionnaires completed. Waiting list data was publicly available and obtained from the National Treatment Purchase Fund website.ResultsThere was a 100% response rate. Sixteen publicly funded chronic pain management services were identified. There are 27 chronic pain management consultants (16.6 whole time equivalents (WTE)) practicing chronic pain management, amounting to 0.55 specialists (0.34 WTEs)/100,000 of the population. There are 21 WTE for non-consultant hospital doctors (NCHDs), 26.5 WTEs for nursing, 8 WTEs for physiotherapy and 6.2 WTEs for psychology, nationally. A percentage of 93.75% of departments (n = 15) provide interventional therapies, 37.5% (n = 6) provide advanced neuromodulation and 43.75% (n = 7) are managing intrathecal pump therapies. There are five pain management programmes nationally. As of January 2020, ~ 25% patients on waiting lists for outpatient appointments were waiting > 18 months, with ~ 17% patients on waiting lists for interventional treatments waiting > 12 months.ConclusionsShortage of multidisciplinary staff is of particular concern for Irish services. Patient access is limited as evidenced by significant waiting lists. In order to improve access to care and bring services in line with international recommendations, increased resources are needed.
Highlights
Chronic pain is estimated to affect between 13 and 36% of the Irish population [1, 2]
What followed was a series of national audits that sought to paint a clear picture of the extent and delivery of chronic pain management services in the UK [4]
We undertook a survey of chronic pain management services in all publicly funded hospitals in Ireland in an effort to quantify extent of services and their geographical distribution
Summary
Chronic pain is estimated to affect between 13 and 36% of the Irish population [1, 2]. The International Association for the Study of Pain (IASP) provides guidance on standards of care that include the approach, infrastructure and treatment content of such services, and recommended waiting times [4]. While details of Irish chronic pain management services have been published before [3, 6], we sought to conduct a comprehensive follow-up taking the IASP and BPS publications into consideration from an Irish perspective, while examining waiting times for access to said services. Previous studies have assessed the extent of services in Ireland without examining waiting times for access to services. Aims This study aimed to quantify the extent of, geographical distribution of and waiting times for access to publicly funded chronic pain management services in Ireland. In order to improve access to care and bring services in line with international recommendations, increased resources are needed
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