Working to improve safe prescribing of opioids in an acute trust

Dr David McCarthy, a Consultant in Anaesthesia and Pain Medicine is part of the Manchester University NHS Foundation Trust (MFT) Opioid Safety Group which has been set up to lead work across the Trust on the Safe Prescribing of Opioids to support the design and delivery of the Pain Management Techniques and the Benefits of Reducing Harm from Opioids Virtual Workshop for health and care professionals.

David is the clinical lead for the adult Acute Pain Service and has been appointed to a Clinical Safety lead role. He works within an interdisciplinary team, aiming to facilitate patient rehabilitation, and maximise functional outcomes. He has been based in the Northwest for 15 years and has worked in multiple tertiary centres for pain, trauma, and burns.

David has interests in medicines safety and opioid related governance so plays a key role in the MFT Opioids Safety Group. The Group consists of pain consultants, pain specialist nurses, surgical clinicians, pharmacists, primary care and community colleagues and a palliative care consultant working together to drive forward several initiatives to support the safe prescribing of opioids across the Trust, these include:

  • Production of a risk assessment tool to highlight “high risk” and vulnerable patientsg., opiate naive patients, concurrent drug and alcohol users, patients with serious mental health issues, polypharmacy with gabapentin/pregabalin, benzodiazepine/Z drugs and antidepressants.
  • Include the high-risk patient “flag” on the HIVE system to support a “pause and check” of opioid prescribing in these patients.

Referral of appropriate patients to pain team for review to support patients to live well with pain, including production of a care plan which is communicated to the patients GP and carers.

  • Surgical pathway and interventions specifically designed for patients pre- and post-surgery to ensure “high risk” patients are highlighted, in addition to ensuring pain management post-surgery is well managed as part of a care plan.
  • Shared learning for staff through safety bulletins, safety huddles and team meetings.
  • Staff and patient education – delivery of dedicated sessions, with supporting materials.

In addition to this, David has been instrumental in working collaboratively with Health Innovation Manchester supporting the design and delivery of the Pain Management Techniques and the Benefits of Reducing Harm from Opioids Virtual Workshop for health and care professionals.  This was a key opportunity to come together, learn, share experiences, challenges, and best practice.

At the workshop David highlighted some of the issues he sees in practice, provided an overview of current guidance, and shared some pain management tools and resources, if you missed the workshop you can watch it here

We also heard from Dr Ashwin Khanna GPwSI Pain Medicine from Northern Care Alliance, as a GP he spoke about what primary care prescribers could do to work with patients to reduce opioid use and Lisa Jones who lives with chronic pain, described her daily experience, and shared how she has worked with clinicians to find ways to manage her pain.

Following the success of this workshop we are planning a second workshop which focuses on the wider resources and services available to help clinicians to support individuals living with chronic pain.  Click on the following link to register for a free place.

The recording and supporting slide deck will be included in a Greater Manchester Opioids Reduction Resources Hub which is currently being developed as part of Health Innovation Manchester Medicines Safety Programme. This work is driven by Manchester Pain Collaborative, Safety Integrating Pharmacy and Medicines Optimisation (IPMO) Group and Greater Manchester Medicines Management Group (GMMMG). For more information please email:


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