The EWG will undertake a comprehensive independent scientific review of all available evidence on the use of opioid medicines in the UK, drawing on best practice internationally, to make sure the information for patients and health professionals helps curb the over-prescription and misuse of these medicines.

In light of growing concerns about overuse and misuse, the review will:

• consider the current data on the utilisation of opioid-containing medicines in the UK, both prescribed and over the counter
• examine whether the risk minimisation measures implemented for over the counter and prescription opioids have been effective or whether further measures are required
• consider the benefit/risk of opioid-containing medicines in particular for non-cancer indications, taking into account alternatives
• make recommendations for regulatory action to better support appropriate use of prescription opioids, such as relevant changes to the Summary of Product Characteristics and Patient Information Leaflet, product labelling and packaging, and any other risk minimisation measures

The EWG is made up of experts in relevant scientific disciplines, including:

• pain management
• general practice
• nursing
• pharmacy
• psychiatry and substance abuse
• anaesthesia
• toxicology and pharmacology
• geriatric medicine
• paediatric medicine
• rheumatology
• epidemiology
• a lay member

The review is anticipated to work promptly in line with the regulatory process.

To support this, we will be engaging with relevant stakeholders from across the health sector, charities and addiction support groups, to advise on how we can improve communications on the use of opioids. We will work together with these stakeholders to raise awareness among both healthcare professionals and the public on the risks of addiction and how these can be managed.

Dr June Raine, Director of MHRA’s Vigilance and Risk Management of Medicines Division, said:

Our highest priority is making sure the medicines you and your family take are safe and effective.

In response to the growing concern internationally and in the UK about overuse and increased prescribing of opioid analgesics, we are seeking expert advice on the benefits and risks of opioid medicines, including best practice for risk minimisation.

We will be listening to patients, stakeholders, and relevant experts, and working across the health sector to make sure the warnings on opioid medicines are consistent, clear, relevant and represent the known risks of tolerance and addiction.

Anyone who has questions about their pain-relieving medicine should speak to their healthcare provider who is best placed to provide advice.

Professor Jamie Coleman, Chair of the Opioid Expert Working Group, said:

In taking forward this important work we will focus on providing clear information to healthcare professionals, patients and carers – no one should be unaware of the potential risks of opioid medicines.

We have set out a clear programme of work to look at regulatory options. We have already planned some initial steps to work with stakeholders to produce consistent and clear label wording that opioid medicines may lead to addiction. We are also going to examine access to opioid medicines.

If you suspect you have experienced a side effect to a medicine, please report this to us through our Yellow Card Scheme.

Foreign Secretary Jeremy Hunt, with US Secretary of State Pompeo, will co-host a meeting of the Yemen Quad – Foreign Ministers of the UK, UAE, USA and Saudi Arabia – to discuss the Yemen crisis, in Warsaw later today.

Quad ministers will inject fresh international political momentum and support to the Yemen peace process, and discuss measures to alleviate humanitarian suffering.

Today’s Quad meeting was called by the Foreign Secretary and is the latest in a succession of diplomatic initiatives to strengthen international support for peace in Yemen. We can be under no illusions, the crisis is deep; resolving humanitarian suffering, achieving sustainable peace and regional stability are urgent UK priorities. The resolutions proposed by the UK and adopted by the United Nations Security Council in January and December have galvanised international support around a UN-led path out of the crisis. Ministers will today reiterate their full commitment to a comprehensive political solution in Yemen.

On the ground, the careful work of the UN Special Envoy Martin Griffiths is supporting the parties to implement commitments made at Stockholm’s landmark peace talks: to build confidence in a political process and to unblock the most urgent obstacles to alleviating human suffering. Quad discussions will focus on how international partners can help parties to implement existing agreements and move towards a second round of peace talks. Seized by the scale of the humanitarian crisis, the Quad will discuss how to accelerate steps to: help stabilise Yemen’s economy; support the government of Yemen’s commitment to pay salaries of civil servants, teachers and health workers; and to keep food and fuel flowing into Yemen.

Ahead of the Quad the Foreign Secretary said:

We now have a shortening window of opportunity to turn the ceasefire into a durable path to peace – and stop the world’s worst humanitarian crisis. Real progress has been made to reach a political solution but there are also real issues of trust between the two sides which mean the agreement in Stockholm has not been fully implemented.

So more must be done. Today, I will chair a meeting in Warsaw of my US, UAE and Saudi Arabian counterparts to give UN envoy Martin Griffiths our full backing and undertake to redouble efforts to reach a lasting political resolution.

Yemen’s devastating famine is a man-made economic crisis not a natural disaster. Today we can make clear strides to support the government of Yemen, including on practical steps to improve Yemenis’ lives, such as resuming the payment of government salaries to civil servants. This significant step could improve access to food for millions.

Further information

The Medicines and Healthcare Products Regulatory Agency (MHRA) today recalled 3 batches of Irbesartan. The affected batches can be viewed here.

The recall is taking place as part of the continued investigation into potential N nitrosodiethylamine (NDEA) contamination of sartan containing medicines, a class of medicine to treat blood pressure and heart attacks and heart failures.

Currently there is no evidence that the NDEA impurity can cause harm and patients are being advised to continue taking their medication.

MHRA twice recalled Irbesartan containing products in early and late January 2019 after testing revealed possible NDEA contamination.

The investigation into possible contamination began in 2018, after another impurity, N-nitrosodimethylamine (NDMA), was identified as part of the manufacturing process in a valsartan active substance manufactured at one facility based in China. NDEA was discovered after further testing.

Last year MHRA recalled batches of valsartan to pharmacy level in July and November after due to possible NDMA contamination.

The MHRA continues to monitor the situation in the UK and are comprehensively investigating the issue alongside the European Medicines Agency (EMA) and the European Directorate for the Quality of Medicines (EDQM).

Dr Sam Atkinson MHRA’s Director of the Inspection, Enforcement and Standards Division said:

Patient safety is our top priority and we will take any necessary steps to protect public health.

Today’s Irbesartan recall shows we are continuing to investigate potential contamination of sartan containing medicines.

There is no evidence at present that medicines containing NDMA or NDEA have caused any harm to patients the recall is occuring as a precaution.

Because of the risk associated with suddenly stopping high blood pressure medication, continue to take your medicines as prescribed by your doctor.”

Please speak to your doctor or pharmacist if you have any concerns about your medicine.

Notes to editor

1. MHRA is responsible for regulating all medicines and medical devices in the UK. All our work is underpinned by robust and fact-based judgments to ensure that the benefits justify any risks. MHRA is a centre of the Medicines and Healthcare products Regulatory Agency which also includes the National Institute for Biological Standards and Control (NIBSC) and the Clinical Practice Research Datalink (CPRD). The Agency is an executive agency of the Department of Health.
2. In July, MHRA advised pharmacies to recall affected batches of Valsartan containing medicines made by Mylan and Teva as a precautionary measure.
3. In November, we advised pharmacies to recall batches of valsartan from Dexcel and Actavis as a precautionary measure.
4. Earlier this January, MHRA advised pharmacies to recall all affected batches of Irbesartan containing medicines made by Actavis as a precautionary measure. More information [here].(https://www.gov.uk/government/news/irbesartan-blood-pressure-and-heart-medication-recalled-from-pharmacies-by-mhra).
5. In late January, MHRA advised pharmacies to recall all affected batches of Irbesartan containing medicines made by Macleods Pharma UK as a precautionary measure. More information here
6. Find out more about our Yellow Card Scheme.
7. Read the Drug Alert in full for further information.

A major milestone was reached today (13 February) as contracts to develop, deliver and award the first three T Levels have been awarded by the Department for Education (DfE) and Institute for Apprenticeships and Technical Education (the Institute).

T Levels will be the technical equivalent to A Levels, combining classroom theory, practical learning and an industry placement. Following a competitive bidding process, Awarding Organisation NCFE has been awarded a contract to deliver the Education and Childcare T Level, and Pearson has been awarded contracts to deliver T Levels in Design, Surveying and Planning as well Digital Production, Design and Development. Around 50 further education and post-16 providers will teach these T Level programmes from September 2020.

To protect the gold standard of T Levels and ensure they are a valued qualification recognisable by employers, one awarding body will have exclusive rights to deliver each T Level subject. This was a key recommendation made by Lord Sainsbury in his independent review of technical education in 2016.

Education Secretary Damian Hinds said:

This is a major step forward in our work to upgrade technical education in this country. T Levels are a once in a generation opportunity to create high-quality technical education courses on a par with the best in the world, so that young people gain the skills and experience they need to secure a good job, an apprenticeship or progress into further training.

We have made significant progress to implement these vital reforms which are on track for delivery from 2020. Working alongside the Institute for Apprenticeships and Technical Education the Awarding Organisations will play a vital role ensuring T Levels are high-quality and deliver the skilled workforce employers need.

More than 200 businesses, including Fujitsu, Skanska, and GlaxoSmithKline as well as many small and medium sized firms, have helped design the course content so far to make sure young people taking T Levels are equipped with the knowledge and skills that employer’s value. On 31 January, the Institute assumed responsibility for approving the content and procurement for T Levels and will continue to work with industry and the Awarding Organisations as the T Level roll out continues.

Sir Gerry Berragan, CEO of the Institute, said:

I am really pleased at the pace the work has developed and the Institute will continue to build on the work of DfE. Technical Education offers a real and exciting alternative to A Levels for young people, with T Levels now sitting alongside apprenticeships. We remain committed to the pace of the roll out and look forward to working with these suppliers as they develop the first T Level qualifications.

Welcoming this announcement, Lord Sainsbury, Chair of the Independent Panel on Technical Education, said:

My panel recommended the single provider model for two reasons. Firstly, greater clarity. There are currently more than 3,000 Level 3 qualifications eligible for public funding for 16 to 18-year-olds, spread across more than 100 different awarding organisations. We cannot expect every employer in the land to know which of these qualifications are any good and actually deliver the knowledge and skills they are looking for in new recruits.

Secondly, we wanted to remove any possibility of a race-to-the-bottom on quality, where awarding organisations are incentivised to compete for market share on the basis not of rigour but instead on which qualifications are easiest to pass.

I am delighted that we have reached this milestone in the roll-out of the T Levels programme. With the first schools and colleges to offer T Levels in 2020 well advanced in their preparations, and now confirmation of these initial awarding organisations, I am confident that we remain on track to deliver the transformation to technical education that this country so desperately needs.

Rod Bristow, President of Pearson in the UK, said:

We are delighted to be delivering the first wave of T Level qualifications in Construction and Digital. The award of these licenses recognises our longstanding collaboration and partnership with employers of all sizes to design, develop and deliver world class qualifications in these industries.

T Levels represent a significant opportunity to strengthen the recognition and value of technical education in England. We look forward to continuing to work with the Government, employers, and providers to ensure their successful implementation, and to support learners as they begin their programmes of study from next September.

Stewart Foster, Managing Director, NCFE Awarding said:

At NCFE, we are committed to creating opportunities for learners to progress and succeed and we are therefore excited to be at the forefront of the implementation of T Levels. T Levels mark a revolution in technical education and the CACHE developed Technical Qualification will help ensure that learners entering the education and childcare workplace have been trained to the highest of standards. We would like to thank the sector for the huge amount of support offered to us throughout this process and look forward to continuing to work together.

In December 2018, the government announced the next 7 T Levels to be taught from 2021 as: Health; Healthcare Science; Science; Onsite Construction; Building Services Engineering; Digital Support and Services; and Digital Business Services. The procurement to deliver this next wave is expected to be launched in spring 2019.

To support the further education sector to deliver the new T Level programmes, the government will provide an additional half a billion pounds every year once they are all fully rolled out. The government is also investing £20 million to help prepare the sector for the introduction of T Levels. This includes the £5 million Taking Teaching Further programme, which aims to attract more industry experts to work in the sector, and the £8 million T Level Professional Development offer to help teachers and staff prepare for the roll-out of the new qualifications.

On Thursday 30 January 2019, eligible further education providers that will teach the first T Levels from 2020 were invited to bid for funding to refurbish their existing buildings or to build new spaces.

The T Level Capital Fund was announced by the Chancellor in the 2018 Budget. It is designed to make sure young people taking the new technical courses have access to industry standard equipment and high quality facilities so they gain the skills and knowledge employers demand. The fund will be delivered in two parts, with funding for specialist equipment such as digital and audio visual kit, allocated to all providers in spring 2020.