The national Medicines Safety Improvement Programme aims to help patients get the maximum benefit from their medicines and reduce waste with an overarching aim to reduce medication related harm in health and social care.

The programme (known as MedSIP) is led by NHS England’s patient safety team, and delivered locally by the West of England Patient Safety Collaborative.

Programme ambition

Our local delivery will focus on improving the care of people living with non-cancer chronic pain by reducing the prescribing of high risk opioids.


There is no evidence for the efficacy of high dose opioids (>120mg/day morphine equivalent) on long term pain. The Faculty of Pain Medicine has advised that increasing opioid load above this dose is unlikely to yield further benefits but exposes the patient to increased harm. Despite this, Public Health England’s review (2019) shows that in 2017 to 2018, 540,000 adults in England were prescribed opioid pain medicines for 3 years or more.

The effects of COVID-19 are anticipated to have exacerbated the use of opioids for chronic pain, which is linked to both deprivation and the prevalence of mental health conditions such as anxiety.

Approach and resources

To support a reduction in the prescribing of high risk opioids across the region’s three systems, we are sharing free resources and learning opportunities.

On 3 August 2022 we held a chronic pain management: reducing harm from opioids webinar. A recording of this event is available here:

On 22 March 2023, a follow-up webinar was held to review alternative approaches to supporting patients to live well with pain. You can watch a recording here:

As part of the Health Innovation Network’s national programme, ‘Polypharmacy: getting the balance right’, we are supporting healthcare professionals to identify patients at potential risk from problematic polypharmacy and support better conversations about medicines.

Find out more and keep in touch

Read more about our regional projects to support medicines optimisation.

Please visit our events listings to find details of all patient safety events.

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