1. Pharmacy Training Event 17 th June 2014 Claire Walters Services Manager SoT Routes to Recovery Stuart Fisher Clinical Co-Ordinator

2. Welcome!! Here to improve relationships, share knowledge and best practice Regular event going forward

3. Why Are We Here? You are an important ‘piece of the puzzle’ and our eyes and ears in managing the risks that our SU present with We need to make sure that you now what information we need, when we need it and why we need it We need to be clear about what you need from us We all need to know the best ways to communicate with each other in order to manage risk and support decision making Some things work well some don’t – from all sides we could be better

4. Missed Pick Ups…. 1 st Missed Pick Up –Try and contact SU are they OK?? 2 nd Missed Pick Up –Outreach team contacted, Visit at Home 3 rd Missed pick up –Police called safe and well –PX Stopped. Need to see Dr before restart –OD risk higher

5. Missed Pick Ups and SPOC 1 st Missed Pick Up –Try and contact SU are they OK?? –Call the SPOC leave a message 2 nd Missed Pick Up –Outreach team contacted, Visit at Home –Call SPOC and leave a message 3 rd Missed pick up –Police called safe and well –PX Stopped. Need to see Dr before restart –OD risk higher –Call SPOC and leave a message – Don’t dispense again until new prescription is issued

6. SPOC Phone For information giving only. All hubs info is on the back of prescription. If you need to speak to someone call that number – they will be able to advise

7. What to do with Missed Pick Ups One Day Missed –If Titration script don’t dispense and urgent Red call to hub –If not call SPOC and continue dispensing Two Days Missed –Call SPOC and continue to dispense Three Days Missed –DO NOT DISPENSE –Call SPOC –Prescription is cancelled. Only dispense again after new prescription is issued

8. What we can help with… Violent and aggressive SU’s Training for new staff Advice and guidance on complex cases Alerts and Info on local trends

9. Supervised Consumption One of the most important things you do Ensure that SU’s are getting what is prescribed and reduces illicit drug availability Check and Balance Concerns of missed pick ups for weekly dispense

10. Supervised Consumption Agreement Highlighted text is why we have chosen to have this event today We have slightly changed the wording to fit in with the SPOC process and behaviour expectations of our service users Look through the agreement

11. Supervised Consumption Assessment The tool we use to help determine who is who isn’t on supervised consumption Things we consider –Safeguarding –Alcohol Use –Drug use ‘on top’ –Engagement with services –Continual missed doses –Intelligence that full doses arn’t being taken

12. Prescriber Q and A Any questions for Dr Ian Coffey?

13. LIN We work closely with the LIN liaising with them around errors, issues and security concerns that we have We report –prescriptions not dispensed by the correct pharmacy –Wrong amounts dispensed –Dispensing not in accordance with how prescribed –Lost prescriptions They were instrumental in, (and paying for!), tonights event in an attempt to reduce the amount of incidents that are reported Important work in reducing the amount of illicit prescribed substances that are on the streets of Stoke on Trent.

14. Case Study What could have happened if we don’t communicate…. SU A comes in severely intoxicated. He is on weekly dispense 75ml methadone a day. Whats wrong with this picture? What are the dangers here?

15. Case Study SU is on daily supervised buprenorphine. They are being increasinly inpatient for having to wait for it to disolve…. What happens next? What could be happening? What part can we play in this?

16. Case Study You have noticed for the past 4 days a SU has come in with small children. What happens next?

17. Case Study Service User comes in and asks you to accept a prescription that hasn’t got your stamp on it What happens next? What could be the consequences

18. Safeguarding… We Need You Regular contact with our service users Might see things that haven't been disclosed Patterns of behavior, including people that they are regularly with General welfare of the child if they are with them Like anything we are only as good as the info we are told. Good way of making sure everything adds up

19. Ideas For Next Time… What would you like support in Ideas for Discussion Case studies for peer support

20. Any Questions?

21. Thank You and Goodnight!