Comment

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or ‘general’ for comments on the whole document

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 or ‘general’ for comments on the whole document

Comments

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3

55

The draft scope currently excludes people who have already been diagnosed. We feel this group should be included because….

1

general

general

BPS welcomes the development by NICE of guidelines for the management of 
persistent pain which will help to further the proper recognition, 
assessment and management of such conditions.

2

general

general

BPS emphasises the complexity of the lives of patients who have persistent 
pain including having high levels of psychological distress and previous 
difficult interactions with healthcare providers. Also, persistent pain problems 
frequently coexist with anxiety, distress and depression.

3

general

general

It should be recognised that there are pain conditions that are not already 
covered by separate NICE guidance on individual pain conditions that cannot 
be included in a general guideline for persistent pain because they require 
more condition specific guidance e.g. Ehlers-Danlos syndrome and 
post-stroke pain. Treating persistent pain as a single clinical condition 
will be inappropriate in many cases.

4

general

general

BPS agrees that treatments for persistent pain generally have low measured 
efficacy in controlled studies but are widely used with apparently greater 
benefit in the clinical setting - it welcomes the suggestion for better 
evaluation of these treatments together with their mechanisms of effect. 

5

general

general

BPS advises particular caution in designating pain treatments as having no 
clinical value on the basis of lack of published evidence of efficacy in 
trials that may have little relevance to the complex clinical situations 
that are often seen in pain clinics. The benefits of patients attending 
pain clinics usually go far beyond the effects of any specific treatments 
that they receive and include recognition of their persistent pain as a 
genuine phenomenon, insight into the mechanisms and effects of pain and an 
understanding of how best to approach living with the pain. In this 
context pain treatments and psychological interventions may act as much as a vehicle for change as the specific agent of change.

6

general

general

The document Core Standards for Pain Management Services UK (Royal College 
of Anaesthetists, 2015) should be central to further developments in or 
recommendations for the assessment and management of persistent pain in the 
UK. It was drawn up by representatives of the Faculty of Pain Medicine, 
the British Pain Society, the Royal College of Nursing, the Royal 
Pharmaceutical Society, the College of Occupational Therapists, the 
Chartered Society of Physiotherapy, the Royal College of General 
Practitioners, the British Psychological Society and patient groups.

7

general

general

There remains mixed views on the terms persistent and chronic pain, and we request that the Guideline Development Group debate these terms as part of their review