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repeat visits and increased
satisfaction with their care in the
intervention group (Rendelmeier
DA, Molin J, Tibshirani RJ. ‘A
randomised trial of compassionate
care for the homeless in an
emergency department’, Lancet
1995).
More recently, the first
meta-ethnography to examine
the components of effective
problematic substance use
treatment from the perspective
of those experiencing
homelessness has shown that
the way in which services
and treatment are delivered
is more important than the
type of treatment provided
(Carver, H, Ring, N, Miler, J et
al. ‘What constitutes effective
problematic substance use
treatment from the perspective
of people who are homeless? A
systematic review and meta-
ethnography’, Harm Reduction
Journal, 2020.)
The case for compassion has
never been clearer.
Simon Morton, Housing First
Inclusion Health Team manager,
Greater Manchester Mental
Health NHS Foundation Trust
‘We have spent
over three hours
waiting outside
the pharmacy over
the past two days
surrounded by
anxious, worried
and angry people.’
crowd pushes further and further
forward. People have missed
pick-ups due to the unnotified
change in hours, people are
worried about the door closing
at 6pm and being left without
medication when nobody has any
money and there are hardly any
drug dealers selling now, even if
you can pay the inflated prices.
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Most people won’t
understand the anxiety that the
prospect of withdrawal brings
on in those with dependencies.
Couple that with the anxiety
of an international pandemic,
conspiracy theories and a
propensity for pre-existing
mental health issues within our
community, and it’s a mini riot
waiting to happen.
A quick vox pop indicates that
nobody is on a reduced pick-up
regime – the vast majority are
doing this day in, day out. This
is a community without a voice,
often without even having a
phone and certainly without the
confidence to challenge services
to maintain their own wellbeing.
So, the word on the street
is, ‘please, help me, help the
pharamicists and help those that
really need to use the pharmacy
to stay safe. Be reasonable and
please just go out of your way a
little bit to ease this nonsense.’
Stacey Smith shares
Humankind’s clear protocol on
adapting clinical services to fit
with COVID-19 restrictions
A
t least, perhaps, we’ve got to the end of the beginning.
I’ve been keeping a close eye on what our sector has produced
from a standing start over the last couple of weeks, and really
the swift but considered response to what the prime minister
calls a national emergency has been phenomenal.
Overall, it’s been a really tough few weeks for a sector which has such
responsibilities for many of the most vulnerable people in our society.
Here at Humankind, our staff have been exceptional in communicating
vital and timely messages and changing the way we work in respect of the
latest clinical guidelines, including social distancing.
It continues to be a challenging time to run clinical services but
teamwork and, it seems, using new-to-us technology is making all the
difference. It’s been a massively hectic few weeks, but here’s a snapshot of
what we’ve achieved.
We’ve done a lot:
• Developed remote consultations guidance for clinicians to reduce face-
to-face contact
• Reviewed how we manage prescriptions in a world of remote working,
including accessing remote printers for teams to use on the move
• Adapted our supervised consumption to reduce this and increased
provision of take home doses
• Increased access to naloxone and given out safe storage boxes for service
• Improved and updated our infection control processes, policies and
rolled out new training to our whole workforce
• Mapped our critical interventions on a service by service basis so that
we can protect key clinical and harm reduction services wherever
possible
• Developed template letters for people transporting medication, or for
nominated person collections of medication
• Developed an ‘essential journey’ card for service users who are going to
the chemist or to a treatment appointment
• Continued monitoring of changes in drug supply, reports of ‘bad batches’
where drugs may be contaminated or have different levels of purity
• Produced an easy to find and easy to read advice page on our
Humankind charity website with specific areas for people who use
drugs and alcohol and those who are on prescribed medications, as
well as signposting to online and telephone support. Social media and
satellite service websites have been updated accordingly.
As we continue to work on our PPE requirements, services that stay open
have been given clear guidelines – including difficult-to-ignore posters
to back up what we say to people entering our premises in respect of
government social distancing measures.
And Humankind has reviewed and implemented existing business
continuity plans for every service – we have nearly 90. Years of planning for
the worst and hoping for the best appear to have paid off.
We’re all in the same boat here and we’re all
helping and learning from each other. I wish all my
colleagues across this vital sector good luck and
good health.
Stacey Smith is director of nursing at Humankind
APRIL 2020 • DRINK AND DRUGS NEWS • 11