NHSSMPA CoNfereNCe
Giving the
This year’ s NHSSMPA conference was dedicated to creating lasting behaviour change, as DDN reports
‘
How can we give the best chance of long-term behavioural
chair Danny Hames. There were many challenges – loss of expertise, disinvestment and diminishing resources, and
change?’ This was the question 13 NHS trusts gathered to discuss at the NHS Substance Misuse Providers Association( NHSSMPA) conference in London.
The context for this debate was not easy, said NHSSMPA
increasing needs from all areas of the population.
‘ As a sector we really need to think about how we do stuff and the quality of what we do,’ he said. While the sector had‘ held up pretty well’ against recession, we should not be measuring success by successful completions.
We needed to address the critical loss of expertise right the way through the workforce – from addiction psychiatrists, to recovery workers, to commissioners. Add to this the loss of many small valuable organisations and it gave a‘ bleak picture’ and many separate challenges.‘ We need to up the ante and be more dynamic,’ he said. We had lost‘ vital capital’ so we needed to understand how to use investment to the best effect.
‘ One of the things we could be doing better is finding allies and forming alliances,’ he suggested. We needed to think about how we worked with commissioners, improved influence in local authorities, and sought out meaningful partnerships with service users. Our culture should focus on being transparent – making the effort to understand where risk is, focusing on evidence and‘ sharing what works more openly’.
Cutting the numbers of specialists was a backward step, agreed Dr Luke Mitcheson, a consultant clinical psychologist at South Maudsley NHS Foundation Trust, who said that the loss of clinical psychologists was one of the biggest challenges faced by the sector.
Psychosocial interventions( PSI) contributed significantly to positive treatment outcomes, but delivering them effectively depended on highly trained staff and good governance, he said. Cutting down on the level of supervision and on skills such as motivational interviewing undermined our capacity to use PSI effectively.
Many clients had experienced trauma and abuse – in fact‘ we should start from the premise that clients have trauma,’ he suggested. The skills to deal with this had to go hand in hand with a flexible approach – the capacity to do different things at different times and‘ step things up or down’.
It was important to keep the perspective of delivering PSI as part of an integrated service that included opioid substitution treatment( OST) and other harm reduction initiatives, said Mitcheson.‘ Some recovery services don’ t understand harm reduction, and that’ s a problem.’
Another major challenge was the ever-changing drugs market – how was the sector meant to keep abreast of new information? Since 2009 there had been 803 new substances identified by the UN, said Dr Dima Abdulrahim, of the Central and North West London NHS Foundation Trust. She was the main author of guidance for NEPTUNE – the Novel Psychoactive Treatment UK Network – which had been developed to improve knowledge around club drugs and NPS and was funded by the Health Foundation.
Many clinicians lacked confidence in dealing with the rapid growth in new substances, she explained. A panel of experts, including experts by experience, had developed a system to simplify guidance to new drugs by categorising them into stimulants, depressants, hallucinogens and synthetic cannabinoids. This framework had proved effective in helping clinicians to orientate themselves when they came across a drug they were not familiar with.
More than 70,000 downloads over the past two years had confirmed the need for
18 | drinkanddrugsnews | October 2018 www. drinkanddrugsnews. com