The Medicines Safety Improvement Programme (MedSIP)

The MedSIP programme aims to address the most important causes of severe harm associated with medicines, most of which have been long term challenges to the health and care system.

Harm associated with high-risk medicines in common use continue to challenge our health and care systems. The Medicines Safety Improvement Programme (MedSIP) affects safety culture and safety systems, bringing the science of continuous safety improvement to bear on this complex problem.

The Faculty of Pain Medicine has advised that increasing opioid load above >120mg/day morphine equivalent is unlikely to yield further benefits but exposes the patient to increased harm. 

Despite this, PHE’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 (including homelessness) and the prevalence of mental health conditions such as anxiety.    

We see a growing number of people who are being supported to manage chronic pain and are awaiting diagnostics or surgery. Primary care prescribing data shows that since the beginning of the pandemic there has been a 27% increase in the number of patients who are prescribed opioid analgesics for longer than 3 months, the limit recommended by The Faculty of Pain Medicine. This increases the risk of long-term dependence which is strongly associated with increased mortality. 

Programme aims

To reduce severe avoidable medication-related harm by 50% by March 2024. Eastern Patient Safety Collaborative is supporting an ICS to implement the “Whole Systems Approach to High-Risk Opioid Prescribing” change package. In 2022/23 this work is in Norfolk and Waveney ICS.

We are also rolling out an Opioid deprescribing toolkit to help support healthcare professionals to address overuse of opioids in chronic pain, based on six behavioural mechanisms identified by a research group from the University of East Anglia (and funded by NIHR ARC East of England) that support prescribers to taper opioids use.

Further information

For more information please contact Caroline Angel, Director of Patient Safety, at

The Patient Safety Improvement Programmes are bring delivered in our region by the Eastern Patient Safety Collaborative (PSC), hosted by Health Innovation East.

What are NatPatSIPs?

The National Patient Safety Improvement Programmes (NatPatSIPs) support a culture of safety, continuous learning and sustainable improvement across the healthcare system. They are run by the Patient Safety Collaboratives (PSCs), which are funded and nationally coordinated by NHS England and NHS Improvement and hosted locally by the Health Innovation Network.

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