Pharmacy Training Event

17th June 2014

Claire Walters Services Manager SoT Routes to Recovery

Stuart Fisher Clinical Co-Ordinator

Welcome!!

• Here to improve relationships, share knowledge and best practice

• Regular event going forward

Why Are We Here?

• You are an important ‘piece of the puzzle’ and our eyes and ears in managing the risks that our SU present with

• We need to make sure that you now what information we need, when we need it and why we need it

• We need to be clear about what you need from us

• We all need to know the best ways to communicate with each other in order to manage risk and support decision making

• Some things work well some don’t – from all sides we could be better

Missed Pick Ups….

• 1st Missed Pick Up

– Try and contact SU are they OK??

• 2nd Missed Pick Up

– Outreach team contacted, Visit at Home

• 3rd Missed pick up

– Police called safe and well

– PX Stopped. Need to see Dr before restart

– OD risk higher

Missed Pick Ups and SPOC

• 1st Missed Pick Up – Try and contact SU are they OK??– Call the SPOC leave a message

• 2nd Missed Pick Up – Outreach team contacted, Visit at Home– Call SPOC and leave a message

• 3rd Missed pick up – Police called safe and well– PX Stopped. Need to see Dr before restart– OD risk higher– Call SPOC and leave a message – Don’t dispense again until

new prescription is issued

SPOC Phone

• For information giving only.

• All hubs info is on the back of prescription. If you need to speak to someone call that number – they will be able to advise

What to do with Missed Pick Ups

• One Day Missed

– If Titration script don’t dispense and urgent Red call to hub

– If not call SPOC and continue dispensing

• Two Days Missed

– Call SPOC and continue to dispense

• Three Days Missed

– DO NOT DISPENSE

– Call SPOC

– Prescription is cancelled. Only dispense again after new prescription is issued

What we can help with…

• Violent and aggressive SU’s

• Training for new staff

• Advice and guidance on complex cases

• Alerts and Info on local trends

Supervised Consumption

• One of the most important things you do

• Ensure that SU’s are getting what is prescribed and reduces illicit drug availability

• Check and Balance

• Concerns of missed pick ups for weekly dispense

Supervised Consumption Agreement

• Highlighted text is why we have chosen to have this event today

• We have slightly changed the wording to fit in with the SPOC process and behaviour expectations of our service users

• Look through the agreement

Supervised Consumption Assessment

• The tool we use to help determine who is who isn’t on supervised consumption

• Things we consider

– Safeguarding

– Alcohol Use

– Drug use ‘on top’

– Engagement with services

– Continual missed doses

– Intelligence that full doses arn’t being taken

Prescriber Q and A

• Any questions for Dr Ian Coffey?

LIN

• We work closely with the LIN liaising with them around errors, issues and security concerns that we have

• We report

– prescriptions not dispensed by the correct pharmacy

– Wrong amounts dispensed

– Dispensing not in accordance with how prescribed

– Lost prescriptions

• They were instrumental in, (and paying for!), tonights event in an attempt to reduce the amount of incidents that are reported

• Important work in reducing the amount of illicit prescribed substances that are on the streets of Stoke on Trent.

Case Study

• What could have happened if we don’t communicate….

• SU A comes in severely intoxicated. He is on weekly dispense 75ml methadone a day.

• Whats wrong with this picture?

• What are the dangers here?

Case Study

• SU is on daily supervised buprenorphine. They are being increasinly inpatient for having to wait for it to disolve….

• What happens next?

• What could be happening?

• What part can we play in this?

Case Study

• You have noticed for the past 4 days a SU has come in with small children.

• What happens next?

Case Study

• Service User comes in and asks you to accept a prescription that hasn’t got your stamp on it

• What happens next?

• What could be the consequences

Safeguarding… We Need You

• Regular contact with our service users

• Might see things that haven't been disclosed

• Patterns of behavior, including people that they are regularly with

• General welfare of the child if they are with them

• Like anything we are only as good as the info we are told.

• Good way of making sure everything adds up

Ideas For Next Time…

• What would you like support in

• Ideas for Discussion

• Case studies for peer support

Any Questions?

Thank You and Goodnight!