1. Annie Steele Lisa Copeland 25 th June 2010 Primary care for people who happen to have a drug problem

2. What difference can we make?

3. Primary care and drug use Who is in this relationship? 60 -70 % of drug users come via primary care. Key members of primary care team:- Receptionist GP Prescribing clerk Health Visitors Drug worker Practice nurses Other GPs in the practice. Drug worker pharmacist Service User Primary care

4. Primary care and drug use How it works for new patients Drug user presents to practice Booked in with GP by receptionist Sees GP (establishes relationship)-GP assessment Sees drug worker- compliments GP assessment Care plan agreed- Drug user, GP,Worker and Pharmacist Other members of primary care team become involved

5. Primary care and drug use Ongoing Weekly meeting with GP to discuss cases Joint appointments happen if required Surgery notes kept up to date Regular reviews of care plan and targets (GP has a copy) Continued health checks

6. Primary care and drug use Outcomes Increased capacity Increased engagement Patients lead on their own care They also take responsibility for their own health Increased BBV screening and vaccination taken up

7. Primary care and drug use Able to engage those who feel stuck in treatment and access the support networks where they live.

8. Primary care and drug use Barry 45 yr old 20 + yrs drug history (c & h) Mental health issues Risk of sudden death syndrome Never engaged unless on order (dabbled) Aunt has died four times

9. Primary care and drug use Result Never missed an appointment Collects meds on time Meets GP for physical health and manages other medical conditions HEP B Vaccinated Next steps Continued encouragement to access mental health (GP in support)

10. Primary care and drug use Paul 30yr old Treatment naïve Heroin use 10 years Presented straight to practice In service for a year 60 mls a methadone- illicit free from Christmas Now 35 mls prepping for lofexidine detox by GP

11. Primary care and drug use

12. Annie Steele Lisa Copeland. Swanswell 0121 233 7400