The Citizens’ Jury on Persistent Pain Management in the North East and North Cumbria (NENC) has set a new benchmark for public involvement in healthcare decision-making. Convened by Health Innovation North East and North Cumbria (HI NENC), this pioneering initiative brought together diverse voices from across the region to tackle one of the most pressing challenges in health: reducing opioid reliance and improving access to holistic pain care.

Why a citizens’ jury?

Persistent pain affects thousands of people in NENC, and opioid prescribing rates remain significantly higher than the national average – particularly in areas of socioeconomic deprivation. Traditional approaches have relied heavily on medication, with limited access to non-drug therapies. HI NENC convened the Citizens’ Jury to change that narrative and ensure community voices shape future NHS policy.

“The Citizens’ Jury has provided a powerful way to ensure the voices of the NENC community shape healthcare decisions. By bringing together diverse perspectives, including those with lived experience, it allows the healthcare and wider system to work towards a more effective and compassionate approach to pain management that meets the needs of our region.”
— Professor Julia Newton, HI NENC Medical Director

How it worked

• 14 jurors recruited through an inclusive process to reflect the region’s diversity
• Representation across age, gender, ethnicity, geography, socioeconomic background, caring responsibilities, and lived experience of persistent pain
• 70% women, 30% with lived experience of persistent pain
• Over 35 hours of structured learning and deliberation across four face-to-face sessions
• Input from 17 expert witnesses spanning clinical, academic, and lived experience domains

Jurors engaged in presentations, role-play, and group analysis to develop actionable recommendations.

Six key recommendations

The Jury produced six bold proposals, all strongly supported:

1. A social marketing campaign to raise awareness
2. Mandatory pain education for healthcare professionals
3. Development of community pain hubs
4. Recognition of persistent pain as a long-term condition
5. Commissioner-juror follow-ups to maintain accountability
6. Creation of a National Pain Institute

These recommendations aim to reduce opioid dependency, improve access to holistic care, and tackle health inequalities.

Impact and benefits

• Empowering communities: Jurors reported increased confidence in shaping health policy
• Driving equity: Recommendations promote local care access and reduce barriers
• Economic and environmental benefits: Reduced opioid reliance supports workforce participation and lowers CO₂ emissions through localised care and digital options
• Alignment with NHS priorities: Prevention, personalised care, health inequalities, and Net Zero

What’s next?

HI NENC is working with regional commissioners to integrate these recommendations into regional pain strategies and influence national policy discussions. The Citizens’ Jury model is scalable and replicable, offering a blueprint for inclusive, evidence-informed decision-making across other regions.

Learn more

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• Clinical Topic
• Co-Production
• Health Inequalities
• Quality Improvement