Harms associated with high-risk medicines in common use continue to challenge our health and care systems. The Medicines Safety Improvement Programme brings safety culture, safety systems and the science of continuous safety improvement to bear on this complex problem.
The Faculty of Pain Medicine has advised that the use of high does opioids such as morphine, to treat non cancer pain is unlikely to bring further relief and may expose the patient to increased harm.
The effects of COVID-19 are anticipated to have exacerbated the use of opioids for chronic pain. We see a growing number of people who are being supported to manage chronic pain and are awaiting diagnostics or surgery. Primary care prescribing data shows that since the beginning of the pandemic there has been a 27% increase in the number of patients who are prescribed opioid analgesics for longer than 3 months, the limit recommended by The Faculty of Pain Medicine. An uplift of 27% increases the risk of long-term dependence which is strongly associated with increased mortality.
The programme aims to reduce severe avoidable medication-related harm by 50% by March 2025.
The East of England Patient Safety Collaborative supports Integrated Care Systems (ICS) in the region to implement the “Whole Systems Approach to High-Risk Opioid Prescribing” change package. Our work began in Norfolk and Waveney ICS in 2022, and has been with Suffolk and North East Essex ICS and Hertfordshire and West Essex ICS since September 2023. We also run a regional community of practice, open to all Integrated Care Board leads in the East to support their leadership in this complex area.
In Norfolk and Waveney we implemented the Opioid deprescribing toolkit to help support healthcare professionals to address overuse of opioids in chronic pain, following the National overprescribing review report (2021). The toolkit is based on six behavioural mechanisms identified by a research group from the University of East Anglia (funded by NIHR ARC East of England) that support prescribers to taper opioids use.
For more information, please email improvement@healthinnovationeast.co.uk
The National Patient Safety Improvement Programmes support a culture of safety, continuous learning and sustainable improvement across the healthcare system. They are run by the Patient Safety Collaboratives (PSCs), which are funded and nationally coordinated by NHS England and NHS Improvement and hosted locally by the Health Innovation Network.
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