Active Recovery: A Multidisciplinary Primary Care Approach to Reducing Opioid Harm

Barrowford Surgery

Project summary

Our GP surgery identified long-term opioid prescribing as a major patient safety concern within our population. Historically, our locality experienced some of the highest opioid prescribing rates in the UK, with many patients remaining on long-term analgesia for chronic non-cancer pain despite increasing evidence of limited benefit and significant risk of harm.

We recognised that reducing opioid prescribing alone would not be sufficient unless patients were also supported with practical alternatives to improve mobility, wellbeing and confidence in self-managing pain.

In response, we developed a multidisciplinary opioid reduction and therapeutic wellbeing programme involving our Advanced Clinical Practitioner (ACP), Clinical Pharmacist, Practice Nurse, Health and Wellbeing Coach, reception and administrative teams, with GP oversight.

Following a successful application to the 'Sport England Movement Fund', one consultation room was transformed into a dedicated patient exercise and wellbeing space, allowing targeted exercise interventions to be delivered alongside structured opioid reduction support within the GP surgery.

Patients identified as being at risk from long-term opioid prescribing were proactively reviewed and offered:

• structured medication reviews,

• shared decision-making consultations,

• personalised opioid reduction plans,

• and six targeted exercise and mobility sessions delivered by our Health and Wellbeing Coach.

Over a three-month period, more than 50 patients receiving long-term opioid therapy were reviewed, including every patient prescribed an oral morphine equivalent (OME) above 80mg daily. All patients reviewed achieved opioid reduction. Only three patients now remain above 120mg OME and continue gradual supported dose reduction with ongoing review.

The programme achieved a 30% reduction in opioid prescribing, moving the practice into the top quartile nationally for opioid reduction performance.

Patients reported:

• improved mobility,

• increased energy levels,

• reduced lethargy,

• greater confidence in managing pain,

• and reduced reliance on medication.

Over 40 patients engaged with the therapeutic exercise programme, with many continuing independent exercise and enrolling into local gym facilities.

The project demonstrates how primary care can successfully address overprescribing through integrated medicines optimisation, behavioural support and non-pharmacological intervention.