Guard-Rx Ltd

NHS problem

Around 2.7 million adult elective surgeries are carried out in the UK each year, and around 15% of these patients take regular prescribed opioids. Preoperative opioid exposure is associated with poorer perioperative outcomes, yet identification and risk assessment remain inconsistent between hospitals. Despite national guidance, there is no standardised approach to recognising these people early enough for proactive planning. This creates unwarranted variation in care, missed opportunities to optimise pain management, and avoidable healthcare use. Independent health-economic modelling suggests that reducing length of stay alone could save an average acute NHS Trust around £150,000 annually. 

Founder Story

OptiOpioid grew directly from Dr Dawe’s clinical experience as a Consultant Anaesthetist and Pain Physician. Across anaesthesia, acute pain rounds and chronic pain clinics, she repeatedly encountered people taking prescribed opioids whose increased perioperative needs had not been recognised early enough for proactive planning. Local teaching and quality improvement work demonstrated the importance of education and the challenge of achieving consistent change through education alone. Dr Dawe left the NHS in 2025 and now works in private clinical practice alongside developing Guard-Rx, translating this clinical insight into a digital product that standardises earlier identification and supports personalised perioperative pain care. 

The solution

Guard-Rx Ltd was founded by Consultant Anaesthetist and Pain Physician Dr Hannah Dawe. Its first product, OptiOpioid, is a digital clinical decision-support tool being developed as Software as a Medical Device. It identifies prescribed opioids from medication information, calculates oral morphine equivalent dose and applies transparent, rules-based risk stratification aligned with national guidance. This helps clinicians recognise perioperative risk earlier and supports proactive pain-management planning through existing pathways. OptiOpioid uses deterministic, auditable logic rather than AI, supporting transparency, clinical safety and automatic updating as guidance evolves. Its initial application is elective surgical care. 

Impact

All figures below are modelled expected impacts; OptiOpioid has not yet undergone clinical deployment. 

Independent health economic modelling estimates that reducing length of stay alone could save an average acute NHS Trust approximately £152,000 annually, equivalent to around 127 bed days released each year. At an illustrative annual licence price of £25,000, this represents a modelled 6.1× return on investment. 

At this early stage, the model deliberately excludes other potential benefits, including reduced cancellations, opioid-related adverse events, readmissions, persistent postoperative opioid use, chronic postsurgical pain and downstream healthcare utilisation. These therefore represent potential additional value rather than assumed savings. 

An upcoming first NHS evaluation at Portsmouth Hospitals University NHS Trust will assess OptiOpioid in real-world clinical practice, focusing on technical performance, human factors, workflow fit, clinician behaviour, staff and patient acceptability, and patient and service outcomes. Findings will inform product refinement and subsequent multicentre evaluation of transferability, clinical effectiveness and economic value.