The Faculty's Statement on NHS England’s Five Year Forward View Delivery Plan

Published: 29/03/2017

In response to media reports announcing details of NHS England’s Five Year Forward View, Dr Barry Miller, Dean of the Faculty of Pain Medicine at the Royal College of Anaesthetists said:

“The Faculty of Pain Medicine is deeply concerned by reports of plans to remove patient access to some effective pain management treatments as part of NHS England’s Five Year Forward View delivery plan.

The inclusion of fentanyl in the list of products deemed as having 'more cost effective alternatives' will lead to a substantial threat to the ongoing treatment of patients with debilitating complex pain problems.

Although there are other opioid medications available, in a significant proportion of patients with complex pain (including cancer related issues) fentanyl is the best option.

Transdermal fentanyl provides the only pure opioid that can be given through a skin patch, allowing the drug to be absorbed slowly into the body.

It is a well-established drug for the management of complex long-term pain problems, and is a unique and highly effective drug.  Fentanyl is not used as a first line opioid but is often highly effective in selected patients where oral medication cannot be tolerated.

Its use should be guided by clinicians who specialise in Pain or Palliative Medicine, and in a shared care situation between general practice and these specialist services.

The Faculty calls on NHS England to engage with pain management specialists to ensure patient care is not affected by withdrawal of effective treatment options.”