Recurring concern

Unreliable access to specialist pain care for people with chronic pain

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First reported 23 Sep 2013•Latest report 17 Jun 2022

Definition

What this concern includes

Includes deficiencies in the end-to-end specialist pain-care pathway, including referral guidance or thresholds, timely access, service capacity and provision of specialist pain-team or pain-clinic assessment, where these are directly related to chronic-pain management.

Not included

Excludes generic failures in pain assessment, prescribing, documentation or medication monitoring that are not explicitly tied to access to or provision of specialist pain care.
Excludes unrelated referral pathways, including mental-health, emergency, ambulance or general hospital referrals.
Excludes generic workforce or capacity deficiencies unless the report directly connects them to specialist pain-care access or provision.

Reports: 3
Individual concerns: 3
Date range: 2013–2022
Stated actions: 5

Reports over time

Reports about this concern issued each year.

* 2026 is projected from reports observed to 7 Sep 2026.

Most frequent recipients

Reports about this concern sent to each recipient.

Department of Health and Social Care2

Care Quality Commission1

Donneybrook Medical Centre1

Greater Manchester Health and Social Care Partnership1

Recipient name withheld1

Concerns and responses across reports

Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.

17 Jun2022
Manchester South
Concerns raised1
1. Inadequate specialist input for patients prescribed multiple analgesics on repeat prescription
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Respondent positions 1
1. Position
  ICBs are responsible for commissioning specialist pain clinic services appropriate to their populations.
  Stated by Department of Health and Social CareRedirects responsibility
AI-generated summary

Amanda Hesketh · Prevention of Future Deaths report

This summary was generated using AI from the published report. Please read the original report for the complete account.

Report summary

Amanda Hesketh, who had a complex health history and was prescribed multiple analgesic medicines, became unresponsive in the Emergency Department after presenting with diarrhoea and vomiting and could not be resuscitated. The report identified concerns about the lack of systematic reviews and individual plans for patients receiving multiple analgesics, limited specialist pain-clinic input, and inconsistent use of practice pharmacists.

Read the report on judiciary.uk
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Inadequate specialist input for patients prescribed multiple analgesics on repeat prescription
Wider context from the report
“The court heard evidence from a General Practitioner as to difficulties patients encounter in accessing services from specialist pain clinics with lengthy waiting lists often being experienced. It is a matter of concern that patients being prescribed multiple analgesics continue to receive such medicines on repeat prescription with often with little or no specialist input; ”
Source location
Amanda Hesketh · Prevention of Future Deaths report
Page 2 · concerns
Open source report
Source evidence

How this respondent position was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
ICBs are responsible for commissioning specialist pain clinic services appropriate to their populations.

Verbatim wording from the response
“Finally, it is within the remit of ICBs to commission services within their geographical area including specialist pain clinics and NHS England expects that ICBs commission appropriate pain clinic service provision to meet the needs of the population they serve.”

Source location
Response from Department of Health and Social Care
Page 2 · response
Published 20 September 2022
Open published response
15 Jun2022
Manchester South
Concerns raised1
1. Delays in accessing specialist pain clinics
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response 5
1. Action
  Deliver increased NHS staffing capacity and skills to support elective recovery and service transformation.
  Stated by Department of Health and Social CareStated in progress
2. Action
  Provide more than £8 billion in elective recovery funding from 2022–23 to 2024–25 to increase and protect elective activity.
  Stated by Department of Health and Social CareStated planned
3. Action
  Make £2 billion of Elective Recovery Fund and £700 million of Targeted Investment Fund support available to healthcare systems.
  Stated by Department of Health and Social CareStated completed
1. Action
  Invest £5.9 billion in capital for new beds, equipment and technology.
  Stated by Department of Health and Social CareStated planned
2. Action
  Continue working with NHS England to deliver the plan for tackling the COVID-19 elective care backlog and provide support and challenge.
  Stated by Department of Health and Social CareStated in progress
Respondent positions 1
1. Position
  ICBs commission local pain services; NHS England commissions only highly specialist pain services subject to eligibility criteria.
  Stated by Department of Health and Social CareRedirects responsibility
AI-generated summary

Marjorie Walker · Prevention of Future Deaths report

This summary was generated using AI from the published report. Please read the original report for the complete account.

Report summary

Marjorie Walker was found unresponsive in hospital on 27 May 2020 after receiving prescribed gabapentin, morphine and buprenorphine, with post-mortem toxicology finding gabapentin above the therapeutic level. The report describes concerns about an incorrectly completed DNA CPR form, delays in specialist pain-clinic access, and insufficient recognition and monitoring of kidney function when prescribing gabapentin and other pain medication.

Read the report on judiciary.uk
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Delays in accessing specialist pain clinics
Wider context from the report
“2. Mrs Walker had lived with significant chronic pain for many years. Evidence was heard that she would have benefited from an appointment with a pain clinic for specialist input and the risks around pain medication could have been reduced with specialist input. The inquest heard that there were significant delays in accessing specialist pain clinics due to demand and capacity issues across the NHS; ”
Source location
Marjorie Walker · Prevention of Future Deaths report
Page 2 · concerns
Open source report
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Deliver increased NHS staffing capacity and skills to support elective recovery and service transformation.

Verbatim wording from the response
“Regarding your concern about significant delays to access specialist pain clinics, the pandemic has put enormous pressures on the NHS with elective waiting lists growing to over 7 million patients, but we remain committed to ensuring people get the right care at the right time. That is why we are delivering record staffing numbers, and putting in record levels of funding, to help the NHS recover and transform services. Having virtually met our target to eliminate long waits of two years or more for elective procedures in July 2022, our next ambition is to eliminate waits of eighteen months or more by April 2023.”

Source location
Response from Department of Health and Social Care
Page 1 · response
Published 20 September 2022
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Provide more than £8 billion in elective recovery funding from 2022–23 to 2024–25 to increase and protect elective activity.

Verbatim wording from the response
“To support this elective recovery, the government plans to spend more than £8 billion from 2022-23 to 2024-25, in addition to the £2 billion Elective Recovery Fund and £700 million Targeted Investment Fund already made available to systems last financial year, to help drive up and protect elective activity. Taken together, this funding could deliver the equivalent of around nine million more checks and procedures and will mean the NHS in England can aim to deliver around 30% more elective activity by 2024-25 than before the pandemic.”

Source location
Response from Department of Health and Social Care
Page 1 · response
Published 20 September 2022
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Make £2 billion of Elective Recovery Fund and £700 million of Targeted Investment Fund support available to healthcare systems.

Verbatim wording from the response
“To support this elective recovery, the government plans to spend more than £8 billion from 2022-23 to 2024-25, in addition to the £2 billion Elective Recovery Fund and £700 million Targeted Investment Fund already made available to systems last financial year, to help drive up and protect elective activity. Taken together, this funding could deliver the equivalent of around nine million more checks and procedures and will mean the NHS in England can aim to deliver around 30% more elective activity by 2024-25 than before the pandemic.”

Source location
Response from Department of Health and Social Care
Page 1 · response
Published 20 September 2022
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Invest £5.9 billion in capital for new beds, equipment and technology.

Verbatim wording from the response
“A significant part of this funding will be invested in staff, both in terms of capacity and skills. However, the Department has also committed to a £5.9 billion investment in capital for new beds, equipment and technology. The Department will also continue to work closely with NHS England to deliver the ‘Delivery Plan for Tackling the COVID-19 Backlog of Elective Care’, providing the necessary support and challenge to make sure it benefits patients and delivers value for money.”

Source location
Response from Department of Health and Social Care
Page 1 · response
Published 20 September 2022
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Continue working with NHS England to deliver the plan for tackling the COVID-19 elective care backlog and provide support and challenge.

Verbatim wording from the response
“A significant part of this funding will be invested in staff, both in terms of capacity and skills. However, the Department has also committed to a £5.9 billion investment in capital for new beds, equipment and technology. The Department will also continue to work closely with NHS England to deliver the ‘Delivery Plan for Tackling the COVID-19 Backlog of Elective Care’, providing the necessary support and challenge to make sure it benefits patients and delivers value for money.”

Source location
Response from Department of Health and Social Care
Page 1 · response
Published 20 September 2022
Open published response
Source evidence

How this respondent position was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
ICBs commission local pain services; NHS England commissions only highly specialist pain services subject to eligibility criteria.

Verbatim wording from the response
“Turning specifically to pain clinics, it is within the remit of Integrated Care Boards (ICBs) to commission services within their geographical area and NHS England expects ICBs to commission appropriate services to meet the needs of the population they serve, including services that can”

Source location
Response from Department of Health and Social Care
Page 1 · response
Published 20 September 2022
Open published response
23 Sep2013
Milton Keynes
Concerns raised1
1. Failure to provide Pain Team assessment during hospital admission
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.

No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
AI-generated summary

Sally King · Prevention of Future Deaths report

This summary was generated using AI from the published report. Please read the original report for the complete account.

Report summary

Sally King was admitted to Milton Keynes Hospital after falling from her chairlift on 22 December 2012 and sustaining a fractured femur and ribs; the inquest concluded that she died as a result of an accident. Concerns included the failure of the Pain Team to see her during an admission of over three weeks and delays in transferring her to the Respiratory Team because of a lack of beds, with the transfer occurring on the day she died.

Read the report on judiciary.uk
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Failure to provide Pain Team assessment during hospital admission
Wider context from the report
“(1) Mrs. King was a patient in the hospital for over three weeks and despite numerous attempts to involve the Pain Team they proved unsuccessful and she was not seen by the team during her admission. ”
Source location
Sally King · Prevention of Future Deaths report
Page 1 · concerns
Open source report

Data last updated 7 September 2026

What this concern includes

Not included

Reports over time

Concerns raised1

Inadequate specialist input for patients prescribed multiple analgesics on repeat prescription

Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1

Concerns raised1

Delays in accessing specialist pain clinics

Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.5

Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1

Concerns raised1

Failure to provide Pain Team assessment during hospital admission

Respondent positions 1

Actions described in response 5

Respondent positions 1