The annual Care Quality Commission (CQC) State of Care report has consistently highlighted significant sustainability challenges in England’s social care system, primarily driven by workforce shortages, rising demand and financial pressures.
While often overlooked, effective pain management can be central to person-centred care and prioritising this can significantly help to improve outcomes and resilience of health and care systems.
The CQC emphasises that care should be responsive and effective, something that can be improved with accurate pain ratings and management. When pain is well managed:
- Individuals experience better physical functioning and independence
- Mental health is improved, with a reduction in anxiety, depression and distress
- There is increased ability for those in care to engage in rehabilitation, self-care and daily activities
- Quality of life improves, particularly for those with long-term conditions, disabilities and receiving end-of-life care
Benefits for the whole system
Prioritising pain can benefit the whole healthcare system and ensure that limited time, resources and capacity are spent in the most efficient ways. The CQC State of Care report consistently highlights system pressures and capacity challenges, two areas which can be improved with effective pain management. Focusing on pain can result in:
1. Eased pressure on the healthcare system
By being able to monitor and manage pain consistently and objectively, healthcare staff will be able to reduce the number of incidents such as falls resulting in fewer ambulance call-outs and subsequent avoidable hospital admissions – things that previously may have been frequent with patients who exhibit distress but cannot voice their pain. It can also lead to shorter hospital stays and fewer readmissions when the area of pain is easily identified and managed early.
Being able to determine whether a resident is in pain and the causes of pain can also be useful for reducing long-term spend on medications that may not be the most effective causes of treatment. Often, an individual who cannot voice their pain may show signs of distress and agitation and be given medication to help calm them, such as benzodiazepines. Treating their pain would actually be a more beneficial solution with sustainable, longer-term results.
2. Support for staff
Effective pain management can support staff by reducing stress and distress and resistance to care linked to unmanaged pain, lowering caregiver burden. Being able to treat residents who cannot voice their pain – something particularly prevalent in those living with dementia – can reduce the risk of injuries to both staff and the residents themselves when they become distressed. Residents typically become less resistant in higher acuity care once their needs are met and this ultimately reduces stress levels in staff and make it easier for them to provide the care their residents’ need.
Being able to accurately monitor and identify pain with tools such as PainChek can also improve staff confidence as they will be able to determine the cause of discomfort for residents and implement clear procedures in order to treat this.
The CQC report highlights the increased levels of workforce shortages and burnout within the healthcare industry, with vacancy levels for adult social care staff currently 3 times higher than those of the wider job market, and the number of qualified district nurses per 10,000 people aged 65 and over has dropped by 50% in the last 14 years. Prioritising pain management through training, multidisciplinary working and clear guidance can help staff to deliver high-quality care despite these challenges.
3. Improved safety and quality of care
Pain is a key clinical indicator. It should be considered with every individual and monitored alongside all other routine observations to ensure the best quality of care. Identifying and managing pain can lead to more person-centred care and decisions, which is in the best interests of residents and can significantly improve their quality of life. Managing pain can also reduce reliance on inappropriate medicines and ensure that only the necessary ones are being administered – this will benefit both the residents being treated and healthcare staff.
Addressing inequalities through pain management
Pain management is a matter of equality and dignity, particularly so for:
- Older people
- Those with learning difficulties, Autism and/or other communication difficulties associated with cognitive impairments
- Individuals receiving palliative care
Pain is often under-recognised in these groups and the CQC has raised concerns in its reports about inequalities in access and outcomes for these individuals. Prioritising pain management helps to address these gaps, ensuring that pain is recognised, assessed and treated consistently across settings.
Pain management as a driver of sustainability
From a sustainability perspective, effective pain management can:
- Prevent deterioration that leads to costly interventions
- Support early intervention and prevention, rather than crisis-driven care
- Encourage the use of non-pharmacological approaches (e.g. physiotherapy and psychological support) rather than over-reliance on medication
- Support long-term management of chronic conditions in community settings
This aligns with the CQC’s focus on system sustainability, integration and prevention, as outlined in the recent State of Care report.
How reliable pain management tools can help
Prioritising pain management benefits health and social care systems by improving individual outcomes, reducing service pressures, supporting staff, addressing inequalities and promoting sustainability. In line with the CQC State of Care reports, it strengthens quality, safety and person-centred care while helping systems to cope with increasing demand and limited resources. Pain management is therefore not only a clinical priority but a strategic one for the future of health and social care.
Historical pain assessment tools rely on clinical observations of behaviours. They should be considered as assessment tools only, as they do not meet medical device grade. Evidence demonstrates that PainChek® as a medical device, now FDA De Novo cleared, increases pain assessment rates significantly and surpasses traditional methods in terms of performance, including high interrater reliability. This means all carers can deliver consistent pain management that improves care for their residents.
Using a medical device, like PainChek®, is an effective way to assess individuals with medical conditions and to discover whether they are in pain or not. Being able to identify and manage this pain significantly improves outcomes and resilience of health and care systems.
To find out more about PainChek® and how it works to accurately assess pain, click here.
