The BMJ Awards 2020: Primary care team

Patients have gained a better understanding of chronic pain and cut drug use

To tackle a range of problems, the practice team took control of the list of patients who are prescribed opiates for chronic pain issues.

“These included high substance misuse rates, high opioid prescribing, including a couple of patient deaths, lack of effective organisational structure, professional isolation, and long waiting lists for the pain clinic,” says practice manager, Caroline Ironside. “We decided it was time for a change.”

The partners funded additional hours for a practice pharmacist to gather resources, including NHS Oxford guidelines, and liaise with the local substance misuse pharmacist and secondary care pain team. The practice team held multidisciplinary meetings with the patients to review diagnosis and treatment and effect an opioid reduction programme.

“We explain to patients all the issues around the opiates they are on and look at ways of supporting them to reduce their opiate use,” says Ironside. Support can include referral to a substance misuse team, physiotherapy, a pain clinic in secondary care, and self management.

Since the programme’s launch in February 2019, patients are taking more responsibility for their own health and have a better quality of life and better understanding of their chronic pain. Problems from overuse of opioids have reduced while doctors also feel better supported. “There have been fewer appointments to request drugs, freeing up clinicians’ time for other patients,” says Ironside.

Scheme has trained hundreds of people to signpost health and wellbeing services

Frome Medical Practice identified that many local people were unaware of important services and groups that supported health and wellbeing in the community. Moreover, health professionals themselves often did not know what services were …