To support a reduction in the prescribing of high-risk opioids across the region’s three systems we are sharing information on:

What system incentives are there?

Quality and outcomes framework (QOF)

The QOF is a voluntary annual reward and incentive programme for all GP practices in England, detailing practice achievement results. It is not about performance management but resourcing and rewarding good practice.

In 2022/2023, there is a drive to use non-pharmacological alternatives, identifying review patients taking high dose medicines and to reduce the use of dependence forming medicines.

37 QoF points are available for quality improvement work around prescription drugs of dependence in 2022/23.

NHS England – QOF guidance.

Investment and impact fund (IIF)

The IIF is an incentive scheme focussed on supporting primary care networks to deliver high quality care to their population, and the delivery of the priority objectives articulated in the NHS Long Term Plan and in the five-year GP contract framework.

The scheme provides a focus towards improving health and the quality of care for people with multiple morbidities.

NHS England – IIF guidance.

Commissioning for Quality and Innovation (CQUIN)

This is a system introduced in 2009 to make a proportion of healthcare providers’ income conditional on demonstrating improvements in quality and innovation in specified areas of care. For 2022/23, increasing referrals for the discharge medicines service for people on opioids is a CQUIN target for acute trusts.

NHS England – CQUIN guidance.

What help is available?

Guide for primary care to reducing harm from opioids

We have launched a new easy-to follow guide for healthcare professionals working in primary care. The guide will support clinicians to identify patients at risk from opioid prescribing, includes templates and ideas as well as providing information on training and examples of best practice initiatives.

Identifying patients for structures medical reviews (SMR) related to opioids

The comprehensive medication review is aimed at ensuring medicines work well for people.

The NHS BSA Epact2 Opioids Dashboard helps the primary and integrated care networks to understand the size of their opioid prescribing issues and identify any particular areas with higher prescribing rates.

Visit the ePACT2 training web page for further information, recorded training sessions and to book training. More information can also be found on the NHS BSA website.

Community Pharmacy Consultation Service (CPCS)

The NHS CPCS is a national advanced service to refer patients requiring minimal advice, treatment and urgent repeat prescriptions to community pharmacies.

NHS England – CPCS guidance.

Further resources and learning opportunities

Understanding Pain video – A short video explaining what happens in the brain when a person stops taking opioids.

Decision support tools – Information from NHS England to support shared decision making by making treatment, care and support options explicit.

Flippin Pain resources – A selection of resources co-created by people with persistent pain, healthcare professionals, pain scientists and communications experts to help make sense of the science behind pain.

Moving Medicine resources – Resources to help healthcare professionals integrate physical activity conversations into routine clinical care.

Live Well with Pain resources – Collection of resources that are designed to help patients learn the skills they need to effectively self-manage their pain; full of tried and tested ideas and methods – many suggested by people who are themselves living well despite their pain.

Versus Arthritis resources – A wide range of helpful online resources about many pain related health conditions, for patients and clinicians.

The Pain Toolkit – Easy-to-follow advice, written by someone who has personally experienced persistent pain, plus a suite of tailored resources for both healthcare professionals and people living with persistent pain.

Pain Killers Don’t Exist campaign – An NHS campaign which includes resources for more information about pain and pain medication.