DDN March 2022 March 2022 | Page 15


With the number of people using drugs alone , living in isolation , and dying alone it is becoming clear that further interventions will be required .
SPECIALIST CARE A partnership between Derbyshire Healthcare NHS Foundation Trust and ImpACT +, the specialist respiratory / COPD team based at the Royal Derby Hospital , was created to address a recognised need for access to specialist respiratory care for those using our services . This service is now delivered from within two of our treatment bases . More people have been diagnosed and commenced on treatment regimes , with one case of TB identified and treated . Many with symptoms but undiagnosed have been identified and received appropriate
Circumstances of death
With friends – 35
In hospital – 115 Alone – 161 investigations for symptoms they had previously not addressed or been unable to access their GP to discuss . One client was identified to be suffering from a range of conditions including a DVT and heart failure and is only alive today because the health improvement nurse had access to the specialist team who were able to act accordingly on her concerns .
We continue to work in collaboration with several hepatitis C ODNs and peers alongside our nurses to eliminate hepatitis C – in the last two years only one person had hepatitis C referenced on their death certificate . We also introduced on-site ECG testing in Derby , with tests uploaded and results received within 30 minutes . A recent audit showed 33 per cent needed a followup referral , and the system is fully integrated with GPs , hospitals and our own data system . We will soon be rolling this out across the county . Future research should also examine the impact of opioid substitution treatment on mortality .
ENGAGE AND RE-ENGAGE In order to keep people engaged in treatment we employed an outreach worker to re-engage those who had dropped off their prescription and stopped attending appointments ,
Hospital admissions in previous 12 months
Yes – 233
No – 78
Age and gender profile
Number of deaths
60 50 40 30 20 10 0
20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-70 70-74
and optimisation of medication is encouraged to allow people to find a dose that ’ s comfortable for them . More outreach workers were employed in the city and county to work specifically within the homeless community , and in the city we have an outreach worker to work specifically with females who are at risk .
One of the challenges the sector faces is not just deaths through overdose but deaths through physical health conditions . It sometimes appears that it is acceptable to talk about deaths in
Key findings and red flags
• Male gender ( 75 %)
• Living in isolation ( 67 %)
• Problematic alcohol use ( 50 %)
• Being unemployed or retired ( 94 %)
• Smoking ( 97 %)
• Living in deprivation ( 77 % living in the top 40 % most deprived postcodes )
• Current or previous intravenous use ( 83 %)
Age in years
Male Female
general but it ’ s still unusual to see services openly discuss all-cause mortality within their services . As we move into 2022 the full impact of COVID-19 on this client group is currently unknown , but it is reasonable to assume that the isolation and inequalities that they experienced pre-COVID would have intensified throughout 2020-22 . As we all see a rise in the cost of living as always it is those with the least that will be most affected .
Martin Smith is recovery lead at Derbyshire Healthcare Foundation Trust
• Hospital admission / s in the previous 12 months ( 75 %)
• Prison release within the previous 12 months ( 11 %)
• Mental health difficulties ( 64 %)
• Additional prescribed medications ( gabapentinoids / benzodiazipines / opiates etc ) ( 71 %)
• Comorbid health conditions ( 81 %)