Dear Health and Social Care Board for Northern Ireland,

This request relates to the service commissioned within Northern Ireland relating to de-escalation and withdrawal management of prescribed opioids.

This request does NOT relate to instances of drug misuse.

This request does relate specifically to the commissioning of services related to those cases where there is an underlying condition leading to a need for chronic or acute pain management for which opioids have been prescribed and has led to dependence. De-escalation and withdrawal management from opioids in these cases needs to be done in conjunction with the requirement to continue treating the underlying condition.

[1] Does the HSCB advise the Trusts on any particular pathway that the Trusts should follow in dealing with de-escalation and withdrawal management of prescribed opioids?

[2] What existing guidelines does the HSCB propose that the Trusts adhere to in dealing with de-escalation and withdrawal management of prescribed opioids?

[3] Is there a specific integrated service team within the HSCB that deals with de-escalation and withdrawal management of prescribed opioids? If not – can you confirm which integrated service team is responsible for commissioning services in this area?

[4] Can the membership – and associated hierarchy – of the relevant integrated service team be provided? (Can the hierarchy be provided up to Director level please?)

[5] Can you provide any specific advice, policy or guidance that has been provided to the Trusts relating to de-escalation and withdrawal management of prescribed opioids since 1st April 2016?

[6] How many cases of de-escalation and withdrawal management of prescribed opioids have the Trusts initiated and managed since 1st April 2016?
Can this information be broken down by year:
- 1st April 2016 to 31st March 2017
- 1st April 2017 to 31st March 2018
- 1st April 2018 to 31st March 2019
- 1st April 2019 to current day

Yours faithfully,

Jimmy Hamill