Annie SteeleLisa Copeland25th June 2010

Primary care for people who happen to have a drug problem

What difference can we make?

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

pharmacistService User

Primary care

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

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

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

Primary care and drug use

Able to engage those who feel stuck in treatment and access the support networks where they live.

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

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)

Primary care and drug use

Paul

30yr oldTreatment naïveHeroin use 10 yearsPresented straight to practiceIn service for a year60 mls a methadone- illicit free from ChristmasNow 35 mls prepping for lofexidine detox by GP

Primary care and drug use

Primary care and drug use

Annie SteeleLisa Copeland.

Swanswell0121 233 7400