National recognition for work to reduce harm from opioids
Late last year, Tony Jamieson, the England Patient Safety Specialist & Clinical Improvement Lead for the Medicines Safety Improvement Programme at NHS England visited Joined Up Care Derbyshire (JUCD) to hear about its collaborative work with East Midlands Academic Health Science Network (EMAHSN), supporting a systems approach to reducing harm from opioids for people living with chronic non-cancer pain.
The event included professionals from across the system, Healthwatch Derby, and patients with lived experience of chronic pain, who have played an active role in the programme. The work forms part of the National Medicines Safety Improvement Programme, which in the East Midlands is delivered by the Patient Safety Collaborative, part of EMAHSN.
Opioids, such as morphine and codeine, are a type of pain relief. There is little evidence of significant benefit for the use of opioids for pain that is chronic (lasting more than three months) and is not cancer related. There are also serious harms associated with opioids and the risk of dependency when taken long-term. For this type of pain, there are often more effective approaches that may not involve medication.
Alison Brailey, Chief Pharmacist and Head of Medicines Management at Chesterfield Royal Hospital NHS Foundation Trust and the Senior Responsible Officer for the project, said: “The ability to share progress and challenges with a diverse range of people and hear a range of perspectives is really important in moving this work forward.”
During the event, attendees heard from patients Michelle Butler and Paul Hemsil, both of whom have experience of living with chronic pain. Michelle, previously an Engagement Manager at Healthwatch Derby, presented a report called Chronic Pain Experiences 2022 to the group, that offered some valuable insight into the experiences of people living with chronic pain. Alison Brailey said of Michelle’s report: “There is a really clear message here that it’s not all about medication, we need to think broader than this.”
Steve Hulme, Director of Medicines Management & Clinical Policies at NHS Derby and Derbyshire Integrated Care Board, said: “This project has been an exciting opportunity for JUCD to do some collaborative work with everyone across our partnership to improve the care of our patients in Derby and Derbyshire. We can’t do this without taking this approach.”
Tony Jamieson said: “It feels like this partnership is coming together really well and today has made me realise the potential of what can be achieved taking a system-wide approach.”
Prior to the programme (to January 2021) there was a year-on-year increase in patients prescribed opioids from 16,659 in November 2017 to 20,257 by January 2021 – since then this increase reversed and by October 2022 (16 months) 1,120 fewer patients were being prescribed, equating to 18 deaths avoided.
You can find out more about the Medicines Safety Improvement Programme here, and watch short films of Michelle Butler and Paul Hemsil talking about their experiences of living with chronic pain.