The West Midlands Patient Safety Collaborative (WMPSC) is supporting Integrated Care Boards (ICBs) across the West Midlands region to improve the care of people living with chronic non-cancer pain by reducing harm from opioids.  

This is part of the National Medicines Safety Improvement Programme (MedSIP) which contributes to the World Health Organisation third global safety challenge to reduce severe avoidable medication-related harm by 50% by March 2024.  

Why is this a focus? 

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

The Faculty of Pain Medicine has advised that increasing opioid load above >120mg/day morphine equivalent is unlikely to yield further benefits but exposes the patient to increased harm.  

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’. 

Key ambitions of MedSIP  

The overall aim of the programme is to facilitate the identification of priority areas, share intelligence and good practice, learning and resources and support the reduction of overall opioid prescribing. The WMPSC is supporting development of a holistic approach to the identification of patients from areas of high deprivation, and/or high opioid prescription rates within each ICS with the aim of reducing overall total patients prescribed an opioid and overall total number of patients on high dose opioids. 

The WMPSC region already has numerous initiatives being carried out across all six ICSs to reduce opioid prescribing and associated risk. However, during engagement with stakeholders, the WMPSC team recognised that there was a need for clear signposting to existing resources available to support this important improvement work and enable or empower people to self-manage their chronic non-cancer pain.  

Resources  

The WMPSC has developed a repository of resources for health and social care practitioners in ICBs across the West Midlands available to support people to live well with their chronic non- cancer pain and move towards the ambition of reducing harm from opioids.