HPU Bulletin: New Chiropractic Quality Standard for Headache

HPU Bulletin: New Chiropractic Quality Standard for Headache

The Royal College of Chiropractors’ Health Policy Unit has announced the publication of a new quality standard which covers the chiropractic assessment and management of adult patients presenting with headache.

Headaches are one of the most common health complaints, with most people experiencing them at some point in their life. The World Health Organization (WHO) reports that almost half of all adults worldwide will experience a headache in any given year. In the Global Burden of Disease Study 2017, headache disorders were the second most prevalent condition worldwide, as well as the second highest cause of years lost due to disability (YLD).

In the UK, migraine headache occurs in 15% of the adult population, with around 200,000 individual episodes estimated every day, resulting in high levels of disability and work absence, as well as having a significant impact on the wider economy. Episodic tension-type headaches affect 80% of people at some time, and are chronic (having more days with a headache than without one) in up to 3% of the population. Medication-overuse headache is the third most common cause of headache, affecting up to 2% of adults. Despite these figures, headache is under-estimated, under-diagnosed and under-treated, and remains a major public health concern.

Chiropractors regularly see patients that present with headache, often having not been seen by any other healthcare professional, and with no diagnosis having been made. Chiropractors have the skills and competencies to assess patients in order to diagnose most primary headaches, identify secondary headaches that require further investigation and, importantly, recognise the red flags that indicate a medical emergency.

As well as having a role in the management of some primary headaches and a few secondary headaches (in particular cervicogenic headaches), chiropractors also play an important public health role in providing support and advice to patients, signposting and making appropriate referrals.

There are a wide range of different patient presentations associated with headache and the management in each case will be different, requiring an individualised approach. The quality statements that comprise the new Headaches Quality Standard are therefore general but, nevertheless, provide aspirational but achievable markers of high-quality, cost effective patient care.

Given the chronic nature of many headaches, where appropriate, the Headaches Quality Standard should be read in conjunction with the chiropractic quality standards on “Chronic Pain” and “Supportive Self-Management in Chronic Care”, both also published by the Royal College of Chiropractors.

All the RCC’s Chiropractic Quality Standards are available for download here in full and abbreviated versions. Note that a  separate copy of the Headache Assessment & Management Flowchart, which forms part of the full version of the Headaches Quality Standard, is available on the same webpage.

Quality Standard Consultation: Headaches


Quality Standard Consultation: Headaches

The RCC has opened a consultation on a new Headaches Quality Standard and are seeking the views of all stakeholders including interested organisations, chiropractors, other healthcare professionals, patients and the public. Comments are invited on any aspect of the document including its relevance and applicability to the chiropractic profession, the achievability of the standards described in the quality statements, the utility of the quality statements in terms of promoting best care, the document’s accuracy and validity in terms of the evidence base and the clarity of the content to practitioners, patients and other stakeholders.

Any comments must be submitted by the deadline of 12 noon on Monday 9th March 2020 using the comments form provided below. Comments will not be published but will inform the development of the final version of the quality standard which will be widely publicised.

The draft Headaches Quality Standard is available here
The comments form can be downloaded here