East Cheshire, Greater Manchester

Patient Safety Collaborative - Medicines

Patient Safety Collaborative - Medicines

The National Patient Safety Improvement Programmes (NatPatSIPs) five programmes of work collectively form the largest safety initiative in the history of the NHS. They support a culture of safety, continuous learning and sustainable improvement across the healthcare system.

The aims of the medicines safety programme are:

  1. Reduce severe avoidable medication-related harm by 50% by 2024 

Reduce severe avoidable medication related harm by 50% by 2024


  • Over 0.5 million people in England are prescribed opioid analgesia for longer than 3 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 
  • 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

Desired Outcomes

  • 30,000 fewer people prescribed oral or transdermal opioids (of any dose) for more than 3 months (NNH 62):   
    • Prevent ~484 deaths  
  • Of the 30,000 above 4,500 of these will have been prescribed a high dose (≥120mg day ME) at baseline and have now stopped opioids (NNH 9):   
    • Prevent 500 hospital admissions   
    • Avoid £1.7M in admissions costs   

Project Approach

Gain a better understanding of the high-dose opioid issues at a local level, by conducting a diagnostic phase consisting of:

  • Scoping current provision for alternatives to opioid prescribing   
  • Gaining an understanding of variation in demographics and health inequalities 
  • Identifying effective ways to segment the affected population by need and harm   
  • Identifying networks, partners, levers and opportunities in the system that will support a culture around the safer prescription of opioids   
  • Identifying effective interventions that lead to a reduction in opioid prescribing for chronic non-cancer pain    
  • Using existing medicines networks and relationships to deliver this work 

The next GM Medicines Optimisation Community of Practice (CoP) will be held virtually on Microsoft teams in October 2023.   If you have any ideas for future topics, are willing to be a facilitator/convener or attendee or anything else relating to our community please do get in touch.

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