Improving Chronic Pain Management by Reducing Harm from Opioids

Opioids are a highly effective form of pain relief and, when used judiciously, benefit many people living with pain. However, in the case of ‘chronic non-cancer pain’, when long-term pain does not have a treatable cause, opioids can do more harm than good, particularly when used at higher doses.

To help address this, the Health Innovation Network (HIN) has developed a new, CPD accredited Opioid Stewardship Quality Improvement Collaborative for clinicians across south London. The collective will help clinicians to develop their skills in safe opioid use and quality improvement processes, while supporting them to design and test improvements to treatment of chronic non-cancer pain.

Why is this a focus?

Over half a million people in England are prescribed opioids for longer than three months, the majority having chronic pain that is not associated with cancer. National Institute for Health and Care Excellence (NICE) guidance states that opioids should not be offered to manage chronic non-cancer pain as harm out-weighs the benefit.

If left unchecked around 6,000 people a year could be hospitalised as a result of taking opioids for extended periods. Covid-19 is thought to have increased the use of opioids for chronic pain, which is linked to both deprivation and mental health conditions such as anxiety.

Primary care prescribing data shows that since the pandemic began there has been a 27% increase in the number of patients who are prescribed opioid paid relief for longer than three months, the limit recommended by the Faculty of Pain Medicine. This increases the risk of long-term dependence which is strongly associated with increased mortality.

“I am delighted that we are launching our Opioid Stewardship QI Collaborative. This programme will arm clinicians with the knowledge, skills and confidence they need to drive forward improvements in chronic pain management and reduce harm from opioids. As a practicing pain doctor, I know what a difference this will make to patients and also to the staff who care for them.” Natasha Curran, Consultant in Anaesthesia and Pain Medicine at UCL Hospitals and Medical Director of the Health Innovation Network

Who can join the collaborative?

The programme is aimed primarily at GPs and prescribing practice pharmacists. However if you are a non-medical prescriber and are keen to champion safe prescribing of opioids, you're also welcome to apply. If you're a non-prescribing pharmacist and would like to join, you must have the support of a prescriber in your area of practice.

The programme is free to join, however participants (and their employer/line manager if applicable) must commit to attend all the masterclasses and collaborative sessions.

We ask you to commit a minimum of four hours per month to implement improvements to chronic non-cancer pain management within your practice, PCN or Trust.

The programme is CPD accredited. You will receive your CPD certificate on submission of a case study, poster or report outlining your impact in this area of practice.

What will the collaborative involve?

The collaborative will...

  • provide participants with expert clinical advice and QI support which will help them become Opioid Stewards within their practice/PCN or Trust;
  • help participants reduce harm from opioids in their practice and local area;
  • speed up the adoption of innovative harm prevention initiatives and improve care of people living with chronic pain across south London.

The collaborative will last six months and combine masterclasses from local and clinical specialists with collaborative sessions. Participants will be supported to develop an improvement project linked to one of the focus areas in their own practice.

It will build on the expertise participants bring from their own experience across the health sector. Learning from each other is an integral part of the programme, with activities centred around knowledge exchange between participants, speakers and facilitators.

Masterclasses will be delivered in virtual workshop format, using an interactive approach. Collaborative sessions will include a mixture of talks, group work, exercises, participant presentations and discussion.

Timeline: October 2022-March 2023

  • Three 90-minute lunch time masterclasses delivering clinical knowledge by specialists focused on safer opioid use. These will take place 12.30-2pm on the following dates:
    • Monday 10 October - "Why is this a focus?"
    • Wednesday 12 October - The Complexity of Pain
    • Friday 14 October - Supporting Patients
  • Five 2 ½ hour Improvement Collaborative Sessions, 9.30am-12noon:
    • Friday 7 October – Identifying the problem: an opportunity for improvement
    • Tuesday 1 November – Understanding the problem
    • Tuesday 22 November – Developing a strategy and change ideas
    • Wednesday 7 December – Testing
    • Tuesday 7 March – Implementation: showing improvement
  • A celebration event (face to face) will be held in March 2023


Applications for the Collaborative have now closed.

If you would like to find out more information, contact Cleo Butterworth, Associate Clinical Director for Patient Safety and Experience.

Get in touch