LETTERS AND COMMENT
One of the most effective changes was embedding specialist practitioners across teams.
services will be able to access key information from hospital, GP and mental health records in one place, saving time, and meaning clients will no longer have to repeat their story every time they encounter a new professional.
TRANSFORMATIVE TRAINING Historically, we’ ve taught staff to become experts in different parts of a person’ s life, then been surprised when services struggle to see the whole person. Joint training has been transformative – staff across services have trained together on trauma-informed care, motivational interviewing, substance use awareness and suicide prevention.
Beyond knowledge, joint training builds relationships and confidence, making practitioners more likely to seek advice and adapt their practice. We’ ve created a culture of ongoing learning rather than one-off knowledge transfer, resulting in regular advice clinics, supervision sessions and specialist assessments led by mental health colleagues.
Perhaps the biggest lesson is that workforce development isn’ t separate from service transformation. The framework talks about co-occurring needs being everyone’ s responsibility. Joint learning is how you turn that into everyday practice.
BUILT-IN PARTNERSHIPS The guidance rightly recognises that partnership working needs to be built into the system. Our progress has relied on agreed referral pathways, joint risk management arrangements, reciprocal training and clear expectations. Regular strategic meetings chaired by public health ensure that collaboration becomes embedded in day-today practice.
We’ ve also taken every opportunity to commission posts from each other. Some embedded roles are funded by mental health services to bring substance use expertise into their teams, while substance use services fund roles that bring mental health expertise into treatment settings. This approach recognises the strengths of each partner, builds trust, and supports more integrated care. We also involve people with lived experience in reviewing and shaping services, as they’ re often the best judges of whether a pathway feels integrated.
Despite the best intentions, priorities inevitably change and organisations come under pressure. To be maintained, partnership working has to be built into the way services are designed.
WHAT’ S NEXT? Our focus now is on rolling out the single record system and strengthening links with talking therapies and ADHD and autism pathways. Initiatives such as embedded practitioners show what’ s possible when services are designed around people’ s experiences rather than organisational boundaries.‘ No wrong door’ and‘ everyone’ s job’ are simple phrases, but achieving them takes years of relationship building, cultural change and shared commitment. For me, the real value of the framework isn’ t that it tells us something new. It’ s that it gives permission to challenge some of the assumptions our systems have been built on.
Apollos Clifton-Brown is director of health and social care at Framework
SMOKE AND MIRRORS
While it’ s encouraging that an updated Cochrane review has( once again) concluded that vapes are by far the most effective smoking cessation tool( DDN, September, p4), I doubt very much that it will have any noticeable impact. Despite being based on 80 randomised trials involving nearly 30,000 people, the results are likely to fall on deaf ears when it comes to certain esteemed medical bodies and( bewilderingly) their cheerleaders in the media. As the article points out, we’ re now at a point where half of UK adults believe, wrongly, that vaping is as harmful as, or even more harmful than, smoking cigarettes. This is despite Public Health England estimating that e-cigarettes were 95 per cent less harmful than smoking – and that was nearly a decade ago. Of course, no one wants nonsmoking young people to take up the vaping habit( apart, perhaps, from unscrupulous shopkeepers). But quite why so many people feel the need to propagate myths around vaping, risking lives in the process, is something I’ ll never be able to understand. John Chambers, by email
SHARED PURPOSE
I wanted to congratulate everyone involved in this year’ s DDN Conference. The programme was excellent, but what really stood out was the atmosphere. It felt positive, welcoming and full of people who were genuinely interested in listening to one another.
What made the day special was how it brought together people from harm reduction, treatment and recovery. In the past these approaches have sometimes been presented as being in competition, but the conference showed how much common ground there is. Ultimately, everyone wants to keep people safe, treat them with dignity and help them make whatever changes are right for them.
There was a real appetite to discuss reducing immediate harm alongside recovery, hope and longer-term change, without suggesting that one mattered more than the other.
People’ s lives rarely fit into neat categories, so services need to offer different kinds of support at different times,‘ meeting people where they are at’. That requires people across the sector to work together and avoid getting stuck in arguments about which approach is the‘ right’ one.
The conference showed how valuable it can be when those different perspectives meet with openness and respect. As one delegate put it in your coverage, the day was‘ full of love and energy’.
Thanks for a great day. Susan Potts, by email
TIME TO BELIEVE
I was inspired to watch Michelle Heaton share her story at your conference( DDN, September, p24). She was so brave and honest – all of us in our group could not stop talking about her on the way home. It was the first time I’ ve ever been to anything like this and I didn’ t know what to expect. I was nervous about coming and talking to people. I need not have worried. I enjoyed feeling part of such a supportive community and am grateful to Michelle for showing me that however public your mistakes are, there’ s a beautiful future ahead. Thank you. Angela, by email
DDN welcomes all your comments. Please email the editor, claire @ cjwellings. com, join conversations on our Facebook page and LinkedIn, or send letters to DDN, CJ Wellings Ltd, Romney House, School Road, Ashford, Kent TN27 0LT. Longer comments and letters may be edited for space or clarity.
/ ddnmagazine @ ddnmagazine www. drinkanddrugsnews. com
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