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SIP 2019: Pain as a Health Quality Indicator – Joint Statement implementation

Ulrich Vogel, Cesar Margarit, Rolf-Detlef Treede, Santiago Calvos-Ramos, Ioana-Maria Gligor

SIP 2019: Pain as a Health Quality Indicator – Joint Statement implementation
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Pain as a Health Quality Indicator – SIP Joint Statement Implementation


  • Robert Jakob (video conference), World Health Organization
  • Ulrich Vogel, German Institute of Medical Documentation and Information (DIMDI)
  • Cesar Margarit, Hospital General Universitario de Alicante, SIP Spain
  • Ioana-Maria Gligor, DG Sante, European Commission
  • Santiago Calvo-Ramos, DG ECFIN, European Commission
  • Rolf-Detlef Treede, European Pain Federation EFIC

Moderators: Michael von Fisenne (Grünenthal), Winfried Rief (Philipps University of Marburg)

Session Objective

SIP has been actively calling on the EU and Member States to promote and implement the roll-out of the 11th revision of the WHO International Classification of Diseases (ICD-11) and the WHO International Classification of Functioning, Disability and Health (ICF), with a specific focus on pain in health policies. During this session, SIP’s recommendations have officially been presented and delivered to the future German EU Presidency.

Policy Opportunities

Despite the strong political consensus of the recent past, there is still a need to continue translating intention into decisive and effective action to improve pain care in the daily practice of healthcare delivery for the benefit of patients and society. In order to evaluate and improve the access to treatment for patients with chronic pain, the work started under previous EU Presidencies needs to be continued. At policy level, the biggest hurdle identified is that there is a huge data gap in how we measure and monitor the societal impact of pain across the EU.

The implementation of both ICD-11 and ICF as well as their combined use will contribute to the transformation of healthcare in the Digital Single Market, which is a key policy priority for the EU and Member States to provide access to digital services in healthcare. Further, this would be an important first step towards the practical roll-out of the common definition and classification of chronic pain for documentation and policy purposes. It will also enhance research reports by using more precise definitions and improve patient management through adequate diagnostic classification. The pro-active use of the ICD-11 and ICF for pain documentation will provide the opportunity to learn from the practices amongst the European Member States.


SIP is celebrating its first ten years of activities that have been marked by major achievements at both EU and national levels.

Key to ensuring major policy changes is the support of the EU Presidencies. After endorsement of SIP by the Hungarian EU Presidency in 2011 and the facilitating support of the Danish EU Presidency in 2012, a big step was taken in 2014 under the Italian Presidency of the Council of the EU (1) (2). For the first time, European Health Ministers jointly stressed the relevance and importance of the Societal Impact of Pain campaign. They also reached a common position on the need to create a European network regarding pain therapy, ensuring the training of professionals in the sector, and exchange of information on the effectiveness of therapies for the most vulnerable population groups.

In 2017, under the leadership of the Maltese EU Presidency, European Health Ministers agreed on the evaluation of the current access to treatment for patients with chronic pain (3). Improving access to treatment for patients with chronic pain and quality of pain care is a key area for social and economic gains, for which a broad political consensus for policy action has been built at the European level.

Against this background, the upcoming Trio Presidency composed of Germany (July-December 2020), Portugal (January-June 2021) and Slovenia (July-December 2021) offers a great opportunity for the European Member States to ensure effective action, addressing the societal impact of pain when it comes to the implementation of the policy recommendations of the SIP Joint Statement covering health quality indicators, research, employment and education (4) (5). The SIP partners plan to offer cooperation to the upcoming Presidencies of the Council of the EU, beginning with Germany, to help the EU Member States in bridging the gap in how the societal impact of pain is measured and monitored.


  1. SIP. Background Materials on SIP 2011 Symposium. [Online] 2011. [Cited: 26 09 2019.]
  2. Italian presidency of the Council of the EU. Summary of the conclusions of EU Health Ministers meeting in Milan. [Online] 23 September 2014. [Cited: 26 July 2016.]
  3. Council of the European Union. Council Conclusions on Encouraging Member States-driven Voluntary Cooperation between Health Systems (2017/C 206/02). Official Journal of the European Union. [Online] 16 06 2017. [Cited: 26 09 2019.]
  4. Permanent Representation of the Federal Republic of Germany to the European Union. Trio Presidency of Germany, Slovenia and Portugal in the EU. [Online] 23 05 2019. [Cited: 26 09 2019.]
  5. SIP. SIP Thematic Network 2018 - Joint Statement now available in several languages. [Online] 24 07 2019. [Cited: 26 09 2019.] Ready, L. Brian and Edwards, W. Thomas. Management

You can find more materials from the SIP 2019 Symposium here:

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