The drugs don’t work: Waiting well for surgery with Ways to Wellness

For many people, waiting for surgery can make them feel as if their life is on hold, leading to higher rates of depression and anxiety. And the North East has some of the starkest health inequalities in the country, including higher rates of smoking, alcohol consumption, and hypertension.  

These risk factors have been consistently linked to poorer recovery after surgery. That’s why since January 2023, through our Perioperative Social Prescribing project (PROSPeR), Ways to Wellness has been a proud part of ‘Waiting Well’, a programme set up by the NHS to support people with their fitness, weight management and mental health ahead of their operations, with our specialist link workers providing non-medical support to ‘Waiting Well’ patients in order to test the relationship between holistic, relational social prescribing, and better surgical outcomes.  

Historically, we’ve also seen that usage rates of very strong painkillers are significantly higher in the region than the national average, particularly in areas of high deprivation. Meanwhile, evidence against the usefulness of such prescriptions continues to emerge, not only before surgery but for the treatment of acute pain in general.  

This is why PROSPeR also became part of the region-wide TAPER2 initiative. Our project partner Angela Telford, a Specialist Inpatient Pain Nurse with the ‘Waiting Well’ team at The Newcastle upon Tyne Hospitals NHS Foundation Trust, sat down with us to explain how the type of support advocated by Ways to Wellness through all our prototypes, is making a huge difference to ‘Waiting Well’ patients, and the GPs she supported through TAPER2, where her role included specific case support along with education around the long-term effects of pain medication on surgical outcomes.  

A pilot within a pilot 

TAPER2, which concluded in 2025, worked with 10 GP practices around Newcastle upon Tyne that were part of the Deep End Network, each identifying 20 patients from their surgical waiting lists to be offered support to taper off opioids and gabapentinoids from GP staff, and/or the chance to work with PROSPeR’s specialist link workers. 

In only six months we were able to demonstrate a clear reduction in the use of painkillers among patients that took up this offer, many of whom had been relying upon them for many years. Across TAPER2 there was a 64% overall reduction in analgesic prescriptions, and 74% of patients supported by Ways to Wellness reduced their opioids by more than 50%.  

In addition, Ways to Wellness uses Triangle’s Wellbeing Star to measure outcomes over the duration of any client intervention, and many of our TAPER2 participants showed significant improvements in areas such as symptom management and emotional wellbeing.    

Why listening matters  

Before ‘Waiting Well’, Angela explained there was little to no support for people on surgical waiting lists, leaving people feeling worried and isolated. By offering non-medical support through social prescribing, she feels TAPER2 patients felt they had the space to ask questions that other professionals may not have had time for.  

"One of the major things about this project was that people had time to sit with these patients. And if a patient has chronic pain, they often feel like they're being a burden to everybody; they think, 'Nobody's listening to me, nobody cares, nobody really believes that I'm in pain’.  

“The fact we could fund this project and give the healthcare professionals and the social prescribers time to sit with these people and actually listen to them; the patients really felt validated and accepted, and they felt like the healthcare professionals understood them better. And I think that was probably one of the most important things."  

This experience corresponds with feedback we’ve received from other PROSPeR clients. Laura, who worked with a Ways to Wellness link worker before her operation, had anxiety following a difficult previous hospital experience. She explained that having her specialist link worker call the hospital to explain her concerns made a real difference: "That worked really well. They were very supportive, and a nurse stayed with me the whole time. That really kept me calm."  

Helping join up healthcare  

Angela said that for her, the most crucial element of the TAPER2 prototype was collaboration. 

"We're not very good in the NHS at joining things together sometimes. The social prescribers really helped us. They're really looking at the person's whole life and supporting them in lots of different areas, not just one. 

"It's meant that I've got better relationships with primary care, and with the social prescribers. We're all working together more."    

Our specialist link workers know the difference it can make to clients to look at the whole picture. Shirley, a PROSPeR client who had been waiting for an operation to remove a skin cancer lesion, almost missed her surgical appointment because she needed a wheelchair to travel due to accessibility issues following a stroke, but her current chair hadn't been crash-tested, so health and safety protocols meant patient transport wasn't able to take her to the hospital.  

Ways to Wellness arranged a wheelchair taxi so she could get to her first appointment, as well as contacting the wheelchair waiting list on her behalf, so she could get one that had been properly crash-tested.  

GPs, surgeons, or pain nurses whose focus must be on the medical side of treatment are not always well-positioned to support their patients with barriers such as this, but for this client, this seemingly minor adjustment not only relieved stress, but ensured her surgery, and any future treatment, could go ahead as planned.  

What’s next for PROSPeR?  

Having seen its success with Ways to Wellness recognised for Partnership Working at last year's Newcastle upon Tyne Hospitals NHS Foundation Trust Celebrating Excellence Awards, the TAPER programme is continuing to expand into Phase 3 and beyond. And Angela is hopeful: "It was one of the most enjoyable things I've ever done in my career as a nurse. Everything just seemed to fall into place."  

Ways to Wellness also continues to support PROSPeR patients, including those who are ‘Waiting Well’, to continue to show the difference that can be made when the voluntary, community and social enterprise sector and healthcare join up.  

To find out more about PROSPeR, visit our projects page. You can also watch Angela's interview in full on our YouTube channel.