Organisational practices in postoperative opioid prescribing at discharge in UK NHS day surgery units: the OPIOID ‐discharge survey

Summary Introduction In March 2025, the Medicines and Healthcare products Regulatory Agency published a drug safety update removing the indication of postoperative pain from the licence of prolonged‐release opioids and mandated discussing risks with patients. Our study assessed compliance with these recommendations 6 months post‐publication. Methods A cross‐sectional survey on organisational discharge opioid prescribing practices was distributed via the National Confidential Enquiry into Patient Outcome and Death Local Reporter pathway to acute hospitals in England, Wales and Northern Ireland. Surveys targeted Day Surgery Unit managers and Drugs and Therapeutics Committee secretaries. Results We received responses from 83 Day Surgery Units and 70 Drug and Therapeutics Committees (approximately 68% response rate). Before March 2025, 51/70 (73%) Trusts routinely used modified‐release opioids. Following the drug safety update, 59/70 (84%) committees shared the guidance and, consequently, 38/51 (75%) organisations that previously used modified‐release opioids no longer do so. However, 10/70 (14%) units still dispensed modified‐release opioids. Among day surgery units dispensing opioids, only 19/60 (32%) provided discharge letters that advised general practitioners against repeat prescriptions and 17/60 (28%) units provided patient information on opioid risks. Formal training on acute postoperative pain management was confirmed for only 22/83 (27%) responding units. Discussion Six months after the drug safety update, there is evidence of significant impact, with most Trusts sharing the alert and moving away from modified‐release opioids. However, substantial work is still required. Key gaps include continued dispensing of modified‐release and combination opioids, and poor communication with patients and general practitioners regarding opioid risks and safe disposal.