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Since 1967 when St Christopher’s Hospice, Sydenham, — the pioneer of the modern hospice movement in England — opened, numerous adults with advanced cancer have been able to benefit from the expertise of specialist palliative care services. Currently, in the UK nearly one fifth (17.5%) of cancer patients die in a hospice or palliative care unit, and a further 39% die while in the care of a domiciliary palliative care team (Eve et al, 1997).

A chart was designed for the assessment and monitoring of chronic cancer pain. A pilot study involving thirty hospital in-patients indicated that the chart was useful in 53% of cases. Problems identified in this study and initial experience with the chart enabled us to incorporate improvements in its design and also made it possible to identify patients for whom the chart may be inappropriate. The revised charts were used throughout the hospital for a trial period. Questionnaires completed by 50 nurses and patients indicated that the chartwas a valuable tool for pain assessment in 89% of cases. The factors contributing to the successful use of the chart and its possible disadvantages are discussed.