Why are we not controlling cancer pain adequately in the community?

Poorly controlled cancer pain has recently received a considerable amount of negative media attention, partly as a result of the publication of a report by Marie Curie Cancer Care that is based on interviews with patients at end of life and with their carers.1 The report highlighted a number of unmet needs. Insufficient access to pain relief and delays in administering analgesia were expressed as particular concerns. Interviewees described carers ‘having to chase prescriptions’, and nurses waiting around at night for prescriptions to arrive. Concerns were raised about uncoordinated and discontinuous care, and a failure to implement appropriate anticipatory care. Out-of-hours (OOH) services were criticised for being inefficient and lacking empathy.