DDN December 2021 December 2021 - Page 21

OPTIMAL OPTIONS

The DDN-hosted The Right Dose session at Constellations heard from Dr Prun Bijral and Peter Yarwood on the vital importance of making sure people were on the dose that suited them

Everyone

’ s individual needs are individual – and unique ,’ said Dr Prun Bijral , medical director at Change Grow Live . ‘ It ’ s about the balance of getting that dose right for them . In a nutshell , we ’ re trying to help people stay comfortable and get some stability in their lives .’
People entering treatment services were often at a very low point , so it was vital to build relationships that were based on trust and honesty in a supportive environment , said Peter Yarwood , founder of Red Rose Recovery and in
‘ What I will always say to people is , “ it ’ s your treatment ”. It ’ s for us to serve and make that treatment as accessible , practical and useful as possible .’
DR PRUN BIJRAL
long-term recovery himself . ‘ You ’ ve got people at different stages , who might not know what ’ s right for them – that ’ s got to be a process , it can ’ t be fixed in one visit .’
TREATMENT QUALITY Ultimately , whether people felt they were able to speak honestly came down the quality of the treatment , Bijral told the session . ‘ As a doctor I ’ m not going to be able to do my job if I don ’ t know what the real issue is . What I will always say to people is , “ it ’ s your treatment ”. It ’ s for us to serve and make that treatment as accessible , practical and useful as possible .’ Clinicians had to recognise that entering treatment was very often a ‘ make or break ’ situation for people , and it was vital that they did everything they could to make them feel comfortable and informed . ‘ You have to be there for them , rather than have some agenda of “ I ’ m going to get you on this or that ”.’
It all came down to the quality of the relationship , added Yarwood . ‘ Everybody wants to help people improve their wellbeing and get to their destination , but that ’ s not to say we might not get it wrong . But if we do we need to be mature enough to open up a space to explore that without taking it as a personal criticism .’
Bringing about culture change across the sector and addressing sub-optimal treatment depended on education , said Bijral . ‘ Demystifying treatment – it ’ s not rocket science . Get the dose that helps that person feel comfortable .’ Change Grow Live had made the guidance more accessible to its frontline staff , modified its training and , crucially , showed services what their treatment looked like . ‘ Those same issues persisted , people were underdosed , were using when they didn ’ t want to – we weren ’ t providing the treatment
for the need , it was as simple as that . But when you start showing people that , they automatically start to change and have different conversations .’
Stigma remained a significant issue , however . ‘ The solution is broader than a clinical one , it ’ s a social one ,’ said Yarwood . ‘ There ’ s work that needs to be done to educate the community , and then highlight the support available .’ People were now able to put their own stories out on other platforms without needing to go via news outlets , however – ‘ we can counterbalance the negative voices .’
OPPORTUNITY FOR CHANGE The Carol Black report was a crucial opportunity for change when it came to the central role of peers – ‘ it ’ s not about hearing that voice , it ’ s about enabling people to take control of things like commissioning , of policy ,’ said Bijral . This had been one of the few silver linings of the pandemic , he added . ‘ We can ’ t just go , “ Yeah , we ’ re hearing you ” now ’ – the people most affected by the system and change needed to be the ones shaping it . ‘ Then you ’ re going to have a better system and a better service . It ’ s not going to be easy , it ’ s complex – without question – but you ’ ve got to start at the principles .’
Postcode lotteries remained a recurrent issue , but providers had to make sure their practice was in line with the evidence-based guidance , stressed Bijral . ‘ That ’ s key – not just , “ I fancy providing this dose because that ’ s how I woke up this morning .” Our services aren ’ t about fancy machines , they ’ re about people , so you ’ re going to get differences . But it comes down to awareness and shining a light on the treatment that ’ s being provided . We ’ ve got to move more towards a focus on quality
‘ Everybody wants to help people improve their wellbeing and get to their destination , but that ’ s not to say we might not get it wrong . But if we do we need to be mature enough to open up a space to explore that without taking it as a personal criticism .’
PETER YARWOOD
and what people deserve , and view it from people ’ s perspective – not a provider perspective , or a commissioner perspective . It ’ s got to be about the person .’ DDN
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