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Reducing harm for people with chronic pain by reducing the prescribing of opioids
August 7, 2023At the Health Innovation Network (HIN) South London we developed a local programme across south London in response to the nationally commissioned Medicines Safety Improvement Programme (MedSIP). The Patient Safety Collaboratives (PSCs) across England have worked with over 50% of Integrated Care Boards (ICBs), with the aim to collectively achieve the ambition to improve care for people with persistent (chronic, non-cancer) pain by reducing opioid analgesic use by the end of March 2025.
Through the programme, 414 lives have been saved nationally by reducing use of opioids. Data from September 2022 to July 2023 shows 7,217 fewer people per month were prescribed high-dose opioids compared to the 2021 baseline. As a result of improved care, patients report a better quality of life; less pain; and less disability.
In south London, the approach to improving the management of chronic non-cancer pain has involved:
Raising awareness.
Shared learning.
- Testing and scaling models of care that enable personalised care.
Shared decision-making.
Biopsychosocial support.
Supported self-management.
“All too often the complexity of having chronic pain and of helping people and professionals to manage pain are overlooked. High prescriptions of opioids can be a result. I’m delighted that this work has looked at how to manage pain as well as reducing harm from opioids.” Natasha Curran, Consultant in Anaesthesia and Pain Medicine at UCL Hospitals and Medical Director of the Health Innovation Network.
Our local programme
Working with staff to drive improvement
During the programme we:
Worked with clinicians across South London through our Opioid Stewardship Quality Improvement Collaborative (2022/23) to deliver projects to make local improvements.
Delivered an Opioid Action Learning set series with local and national partners. These were affiliated with: the British Pain Society; the European Federation of Pain; the Royal College of General Practitioners; and the Royal College of Psychiatrists.
Delivered masterclasses to consolidate learning on how to support patients prescribed long—term opioids to manage chronic pain.
Worked with colleagues in South East London ICB and across the system to plan an Innovation Sprint. We helped in identifying the key issues they were looking to address within Chronic Pain, and supported the development of short Test and Learn projects to address these.
Using opioid prescribing data for system audit-feedback
We shared local opioid prescribing data packs with GP practices across south London based on the Campaign to Reduce Opioid Prescribing. Find out more about the impact of the evidence-based audit and feedback across general practices in south London.
Working in partnership with people living with chronic pain
At the HIN, we seek to understand, design, and improve the experience of health and care for staff, service users, and patients. We believe that this requires a deeper understanding, using people’s personal experiences to improve things.
As part of this work, we facilitated an experience-based co-design project using the Point of Care Foundation methodology. The aim of the project was to improve chronic pain management by bringing patients and staff, with lived and learnt experiences, together to prioritise and co-design solutions as equal partners.
Read the reflections, one year on.
Download the EBCD poster , which provides guidance on how social prescribing link workers can support patients in dealing with persistent, chronic pain.
To test out and support scaling biopsychosocial alternatives to opioids and supported self-management programmes, we have worked with:
King’s Health Partners, on the Pain: Equality of Care and Support within the Community (PEACS) programme.
- University of Warwick on the I-WOTCH (Improving the Wellbeing of People With Opioid Treated Chronic Pain) programme.
Blogs
Read more about the developments of our local programme:
