You will be aware that there is a mounting body of evidence which suggests that doses above 120mg morphine equivalent per day are ineffective in the treatment of non-cancer chronic pain and can lead to harm – see here from the Royal College of Anaesthetists, and here for further information about Opioid Dose Equivalences.
The NHS England and NHS Improvement (London Region) Controlled Drugs Accountable Office (CDAO) team invites you to take part in an audit of high dose opioid prescribing in primary care for non-cancer chronic pain.
The exercise can be included in appraisal portfolios and used as evidence at CQC inspections.
It is hoped that it will encourage reflection on prescribing potentially identifying patients that are being prescribed higher levels of opioids than may be appropriate, in turn leading to improved quality of patient care.
It is also hoped that a regional overview of high level opiate prescribing will potentially provide the opportunity at a strategic level to identify particular challenges in pain pathways and managing patients with difficult to manage pain.
GP system searches have been produced that will identify the patients that are on doses of opioids higher than 120mg morphine equivalent per day for you – these can be accessed here, thanks to PrescQIPP.
Some work will then be required by the practice to identify and exclude patients from the list who are on such doses for reasons other than non-cancer chronic pain.
This document, ‘opioids-proforma-for-optional-use-not-to-be-returned’ (also available on PrescQIPP), may be useful when you are pulling together the data for the ‘London Opioids Aware returns form’. Please only return the latter of these documents.
Practice staff will need to answer a few simple questions about the remaining patients before a GP reviews and reflects on the cases on the ‘returns’ form, which includes web link resources intended to assist with this.
Once you have completed the audit and the reflection, please send your ‘returns’ form back to england.londoncdaccountableoffice@nhs.net marking your email Opioids Aware in the email subject line.
Please do not send any patient identifiable information.
The CADO team would be grateful to receive your ‘returns’ form by the end of Friday 9 August 2019.
Please note this audit is voluntary. NHS England and NHS Improvement are unable to provide remuneration for participation.
This user guide with additional instructions to import searches from SystemOne may be useful. There is a user guide for importing searches from EMIS Web accessible alongside the system searches at PrescQIPP. There is not at present a user guide with instructions about importing searches from Vision.
Unfortunately the CDAO team does not have the capacity or technical expertise to provide further information about importing GP system searches.
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