DDN May 2022 May 2022 | Page 16





A new policy to withdraw diamorphine treatment became a fight for survival , hears DDN

Three years ago , nine people in the South West of England were going about their daily lives , just as anyone else might , juggling jobs and family life with all the everyday ups and downs . Each of them was in regular receipt of a diamorphine ( heroin ) script , which was working well for them in managing their dependence on opiates and giving them a good quality of life .

Then came a letter from their treatment provider – the same letter to each of them , with just their names changed . In line with ‘ best practice ’ they must have their treatment changed . They needed to choose a different option – oral methadone , MXL ( slow-release morphine tablets ), or inpatient rehab .
Four of the nine patients decided they had to challenge the decision . Jill and Helen ( not their real names ) talked to us about what happened and how it affected them .
‘ It was clear in the letter that there was no clinical opinion taken on it ,’ said Jill . ‘ No individual circumstances were taken into consideration – it was done purely on a cost basis .’ She talked to the clinical lead and asked if the patients could have a meeting with the group who had made the decision , ‘ to go through our opinion on it and how it was going to affect us , because nobody that made that decision had any of the rest of our personal records . I was quite concerned that the people making the decision couldn ’ t even put a face to me .’
Advised to put it in writing , Jill went home and wrote down the questions she needed answering . The reply around six weeks later ‘ was absolute nonsense ’ and didn ’ t clarify anything . A few more attempts later , and feeling she was being ignored , she contacted Release for advice .
ADVOCACY Claire Robbins , Release ’ s nurse advocate and drugs advisor , explains what came next . Release wrote advocacy letters to the service provider on behalf of the patients . They introduced themselves and talked about the case , and quoted Department of Health guidance aimed at protecting patients on diamorphine . ‘ It talks specifically about that group and says , if anything , their treatment should be reviewed and optimised ,’ she says .
They wanted to have a conversation ; there was none . The provider forwarded the letters to their litigation department and responded : ‘ sorry you had to raise a complaint ’. ‘ We weren ’ t ever raising a complaint ,’ says Robbins .
Release continued to advocate for Jill and Helen , but the provider refused to reconsider their decision undefined undefined / iStock