System teamwork saves lives and supports people to “live well with pain”

Fewer people are coming to harm, including avoidable deaths, and more people are managing their pain better, thanks to teamwork across the health and care system.

The success come from a programme to as a result of reducing the use of high dose opiates in non cancer pain and to support people to “live well with pain”.

After just over three years:

  • the number of people prescribed opioids fall from 21,662 in January 2021 to 20,730 in May 2024 – 932 fewer people
  • the number of people on “high dose” opioids drop from 1,660 to 1,497 in May 2024 – 163 fewer people

Examples of opioids include morphine, codeine, oxycodone, fentanyl and tramadol.

It is estimated that 1 person in 62 who takes opioids will die as a result and that high dose opioids double the risk of death.

Work across the system has included:

  • support to patients on discharge following operation or injury, providing appropriate advice and guidance on use of opioids
  • training and support to clinicians and healthcare staff in primary care, including support for referrals and regular reviews
  • GP Practices across Derbyshire have set up 20 “let’s live well with pain” support groups. Groups are situated in the South Dales, Chesterfield and Dronfield, North East Derbyshire, Erewash, and Derby.
  • 81 people have trained to become a ‘Ten Footsteps Practitioner’. This is a methodology for managing pain. These have included pharmacists, social prescribers, health and wellbeing coaches, link workers, physiotherapists and GPs.
  • targeted support to GP practices where prescribing of opioids is higher than normal

The work programme has been put together in collaboration with a wide range of healthcare professionals, and using the insight from people with lived experience of pain and opioid addiction.

This has been achieved through a wide-ranging collaboration across the health and care system, says Steve Hulme, Chief Pharmacy Officer for NHS Derby and Derbyshire Integrated Care Board.

He said: “We began this programme because opioid prescribing rates for Derby and Derbyshire were higher than other comparable areas.

“Additionally we have seen that areas of higher deprivation tend to have higher rates of opioid prescribing.

“But there is little evidence of benefit from long-term use of opioids for chronic pain, that is not caused by cancer, and there is a lot of evidence that they can be harmful.

“By reducing rates of prescribing we are saving lives and supporting people to better manage their pain through other methods.”

Living Well with Pain groups in Derbyshire were pioneered by Lister House Surgery in Derby, working with Health Innovation East Midlands.

Watch a video of their health and wellbeing coaches Dawn Lee and Nichola Davis and their service users speak about their experience on the Health Innovation East Midlands website.