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As part of our Medicines Safety Improvement Programme led by NHS England, our key national ambitions are:
Why are we doing this work?
Opioid medication includes medicines such as morphine, fentanyl, tramadol and codeine. Whilst opioids have a place in the management of acute pain e.g. post-surgery and cancer-related pain, there is no evidence to support the routine use of opioids in chronic, non-cancer pain.
Opioids are classed as a high-risk medicine. The risks and side-effects from opioids are dose related with doses of 120mg per day of morphine (or equivalent) providing no further benefit but an increased risk of harm.
A review by Public Health England in 2019 shows that from 2017 to 2018, 5.6 million adults in England received opioid pain medicines (13% of the adult population).
National guidance from NICE, published in March 2021 recommends that opioids should not be initiated to manage chronic primary pain in people aged 16 years and over.
The system change model
Management of ‘chronic non-cancer pain’ requires personalised care and shared decision making at its core with patients requiring a mixture of biopsychosocial support. A whole system approach is proposed to support people to live well with their ‘chronic non-cancer pain’. The EMPSC will work with key stakeholders and Integrated Care Systems to support system wide changes to opioid prescribing that will reduce the risk of harm to patients from opioids. We are intensively supporting Joined Up Care Derbyshire ICS in using a systems approach to test out this approach and share the learning, as shown in the diagram below:
Read the results of the national programme in the published article: National improvement initiative operationalising a 7 Phase Whole System Approach Framework (WSA7) to improve the management of chronic pain and decrease high-risk opioid prescribing across integrated care systems in England
We have developed a series of learnings and reflections through our work with Joined up Care Derbyshire on taking a systems approach to high risk opioid prescribing. The reflections and learnings have been split into phases, click below to either listen to the presentation slide deck or download.
We hosted two webinars that introduce practical strategies to support pain management in the context of a busy GP practice.
Part 1 - implementing a realistic approach to pain management - view the event resources
Part 2 - implementing a realistic approach to pain management - view the event resources
Supporting patients with chronic non-cancer webinar
This webinar is aimed at social prescribers and health and wellbeing coaches working in primary care. It is relevant for anyone wishing to gain an understanding of chronic non-cancer pain and how best to personalise a support offer that is not medicines-focused.
Supporting people with persistent pain to become more active
My life with pain, opioids and quality of life - Dora
Shared learning from setting up a pain management group, Jane Lindsay
Shared Learning from setting up a pain management course, Luke Wilkinson
Formulary case study
My Journey with Paul Hemsil
A video sharing lived experience of dependence to prescribed opioids to support patients considering opioid tapering.
We have developed an adaptable pain management programme entitled "Let's Live Well With Pain". For more information and resources about this click here.
Repeat prescribing of opioid medication in general practice is common. Click here to read more about the Human Factors approach we have taken to understand the prescribing process and create some minimum standards for practices in an ICS (in collaboration with Joined Up Care Derbyshire ICS).
Digital tools to aid clinicians with consultations
‘For more information contact This email address is being protected from spambots. You need JavaScript enabled to view it.
For more information on our opioids programme, please email This email address is being protected from spambots. You need JavaScript enabled to view it.