September2 2020 - Page 13

F INVENTION When we did our service user survey, 70 per cent said they didn’t want to go back to daily pick-up. Two or three people said it was the biggest trigger point for relapse, because they were constantly in contact with people who were carrying illicit Valium or whatever. People also felt much more in control of their lives and how they dealt with dosage – instead of having to go to a chemist and drink 120ml of methadone they could spread that over the day.’ His organisation changed all its prescribing options, with a lot more use of buprenorphine, for example. ‘We just gave people options as to what they were more comfortable with. In Scotland we turned all our services into needle exchanges, because we knew people were going to struggle with chemists, we created click-and-collect for needle exchange, and did a lot of video prescribing as well.’ TAILORED TO NEED Not every organisation made the shift to fortnightly pick-ups, however, and instead worked to make sure people were getting a service tailored to their needs. ‘We never went to fortnightly,’ says medical director at WDP, Dr Arun Dhandayudham. ‘Even before the lockdown we were already risk-assessing each patient individually, looking at all their health risks and pick-up regimes. We were already well advanced in our planning, and the maximum anybody got was one week – we were also working very closely with the pharmacies to establish what kind of resilience they had in terms of cover. So we individualised each service user’s pick-up – some went from daily supervised to daily unsupervised, or from once or twice a week to a maximum of weekly.’ Closer working with pharmacies also provided a chance to stay informed about clients who weren’t coming into services, says his colleague, operations manager Vanessa Duke. ‘We’ve been in pharmacies very regularly dropping off prescriptions and talking about clients that they might be seeing but maybe we haven’t seen. We’ve also taken in naloxone, safe storage boxes and leaflets around public health campaigns like World Hepatitis Day.’ ONLINE SUPPORT One of the most significant changes across the sector has been the move to online support, which is not something that everyone thought would necessarily work. ‘A really interesting stat among our service users is that 56 per cent were able to use online groups from a standing start, which is huge,’ says Horne. ‘Everybody said, “It’ll never work – they just won’t do it.” But a huge amount of people have asked if we’ll continue with the online groups after lockdown, because they like the blend of both.’ ‘My service has been a skeleton workforce, but it depends on what you want to put in – that’s what you get out of it,’ Barry, a service user based in Essex, tells DDN. ‘You’ll hear people complain, but it all depends on the individual and if you’re determined to get help. My script’s always there, I can always message my key worker to answer my questions or sort out any problems, and there’s online support if you need it. It’s down to your own determination.’ The overwhelming majority of clients understand completely why these changes had to be made, ‘We’re getting feedback from workers as well who are saying they’ve never had so much contact with clients’ TONY LEE stresses Duke. ‘And many of them have enjoyed the opportunity to work in a different way. That’s had some really positive outcomes, but some have struggled with the more limited one-to-one contact. And of course for some clients it’s been a reduction in face-to-face contact across multiple services. Where that’s been the case we’ve worked with them and identified if it’s ok to bring them in to service – where they’ve got complex needs or are significantly socially isolated, or if there are particular risks in the home environment.’ While many clients have enjoyed the opportunities offered by online support, it’s been ‘a mixed picture’, agrees Tony Lee. ‘We have a lot of clients who don’t have access to the internet – one of the things we’ve been trying is giving out phones so at least we can contact them and have a conversation. We can have a conference call and bring them WWW.DRINKANDDRUGSNEWS.COM SEPTEMBER 2020 • DRINK AND DRUGS NEWS • 13