Pain Management
On this page we have some resources to aid clinical decisions on prescribing.
Prescribing Guidelines by Clinical Area
Opioids such as morphine, fentanyl and codeine are super strength medications for pain which can be highly addictive. In 2021 there were 4,859 drug related deaths in England and Wales. Approximately half of these deaths involved an opiate. On this page we have some resources to aid clinical decisions on prescribing.
Please see the Somerset Community Pain Management Service website for patient resources to help them understand and manage their pain.
Please see the Somerset Prescribing Formulary for preferred formulations.
Current News
NHS England have developed a new decision support tool: Making decisions to help you live well with chronic primary pain
getUBetter MSK Resource
The getUBetter app, a digital tool to support self management of musculoskeletal conditions, designed and written by local clinicians in Somerset, has been launched. getUBetter was piloted in the Community MSK Service and shown to have positive outcomes and feedback from patients and clinicians.
Please consider providing this non-drug option for patients presenting with musculoskeletal pain. See FAQs for Clinicians and Awareness video for more information.
Patients can be signposted using:
Accurx – Send the getUBetter Accurx template from your practice, which includes a link for patients to get started.
QR codes – get a patient to scan the QR code on a poster or give them a leaflet. If possible, please support a patient with this – it does help them to get started.
Services to help patients wanting to reduce their opiates
There is an Opioid Reduction Advice and Guidance service for GPs provided by Somerset Community Pain Management Service. The advice and guidance is for clinicians who are seeking help reducing opioid medication for patients where opiate use is escalating and there is a safety concern.
There is also a combined Somerset Drugs and Alcohol Service (SDAS) and Somerset Community Pain Management Service (SCPMS) for patients who are wanting to reduce their opiates. The referral criteria for this service can be found here. Further information is available in the GP Bulletin. Practices can refer by either sending an e-referrals using the template provided, or by email to the Somerset Community Pain Management Service. painservice@somersetft.nhs.uk
Ideally specify “Opioid Reduction Support” is required by the combined service.
Presentations for clinicians.
Chronic pain can be really difficult to manage. The patient is suffering and you want to help. Knowing how to help and what support exists can be challenging. As a result, the Somerset Training Hub and SGPET have teamed up with a number of colleagues to produce resources to support clinicians. They have called this work Skills Not Pills. You can access five short presentations (each only 7-17 minutes long) and a patient information leaflet on the work at the Somerset LMC under Somerset Opioid Reduction Presentations.
Resources for clinicians
Opioids Aware is a resource for patients and healthcare professionals to support prescribing of opioid medicines for pain. Tapering and stopping opioids is just one of their many resources.
Lower back pain and sciatica in over 16s
Osteoarthritis in over 16s: diagnosis and management
Controlled drugs: safe use and management
Chronic Pain (primary and secondary) in over 16s
Headaches in over 12s: diagnosis and management with visual summary prophylaxis of migraine with or without aura
Recommendations | Endometriosis: diagnosis and management | Guidance | NICE
A practice by practice review of the data comparing prescribing to other GP practices in England and Somerset can be found on OpenPrescribing. To help with the review of patients who may be taking > 90mg equivalent of morphine per day, find your practice then click on the link below the chart to see the preparations prescribed.
The BNF updated its equivalences in August 2020, this is reflected in the Faculty of Pain Medicine tables.
For a set of Emis searches to run this audit please email helen.spry@nhs.net
The National Health and Care Video Library no longer exists in its previous form. Please contact them directly for more information.
Live Well With Pain is a website for people who are living with persistent pain and those who support them
Learning to live with pain in Somerset
Resources for people living with persistent pain
Resources for practitioners supporting pain self-management
Top Tips for Managing Pain For practice waiting room screens
In Somerset there is increasing activity to develop Pain Cafés. Pain Cafe's, using lived, shared experience and a personalised approach, aim to support people through persistent pain and empower them to feel more in control of their pain. Somerset's Sue Crisfield, Social Prescribing Coordinator for the Rural Practice Network is pioneering this. Sue is also helping to shape a national approach as she works alongside the Live Well With Pain team. To find out more about Pain Cafés check out this Live Well With Pain news article.
