A post by guest blogger David Henderson, Head of Substance Misuse Services, South Tyneside NHS Foundation Trust
Drug use is a risky business and sadly as a consequence of this activity drug related deaths do occur. It would seem that each area responds to dug related deaths differently and this is dependent on local needs.
In December 2011 the number of recorded drug related deaths in Gateshead had reached 19 for the year (January–December) and there was concern about the numbers from all partners. The local media picked up on it and were fanning the flames that it was unacceptable (quite rightly) but through their reporting there tended to be miscommunication and wanting to hold people to account. One of the issues raised was that drug treatment wasn’t working and too much Methadone was being prescribed.
In response to the increased numbers of deaths we tackled the problem in a balanced way whereby we could address miscommunication issues as local partners took a joint partnership approach. The agencies included were the Substance Misuse Service, the Local Authority Community Safety department, GPs, Pharmacists and the Police.
A number of initiatives were undertaken:
- Awareness sessions with GPs and Pharmacists in the shared care scheme;
- Overdose awareness training with service users;
- Providing Methadone boxes to all service users;
- The Drug Related Deaths Group, investigated every drug related death and shared any learning with GPs, Pharmacists and other partners.
One of the initiatives to reduce drug related deaths was to develop a near miss project between the substance misuse service and the local general hospital. This entailed developing a care pathway that saw substance misuse staff visiting the hospital daily, to assess and provide harm reduction advice to service users who had attended. Service users seen attended for a number of reasons but a significant proportion were overdoses from drugs.
Outcomes for the development were that service users have been referred to drug services if not known. If service users are known to treatment services we let all professionals know that within 24 hours. This included GPs, Pharmacist and practitioners. A welfare check or follow up is undertaken to ensure that service user is ok when they leave hospital. In its first year since we started this service there was a noticeable reduction in drug-related deaths, from 19 in 2011 to five in 2012.
What worked? There are a number of reasons as to why drug related deaths have reduced but I believe the key element has been partnership working between different agencies. It’s not rocket science but we put service users first and forgot our professional and political differences. Other elements included our belief that we needed a pragmatic approach based on the principles of harm reduction.
In July 2013 the substance misuse service won the Health Service Journal and Nursing Times, Care Integration Award which is an award given to health services which provide high quality, effective and seamless care to service users.