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Pharmacy Training Event
17th June 2014
Claire Walters Services Manager SoT Routes to Recovery
Stuart Fisher Clinical Co-Ordinator
Welcome!!
• Here to improve relationships, share knowledge and best practice
• Regular event going forward
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
Missed Pick Ups….
• 1st Missed Pick Up
– Try and contact SU are they OK??
• 2nd Missed Pick Up
– Outreach team contacted, Visit at Home
• 3rd Missed pick up
– Police called safe and well
– PX Stopped. Need to see Dr before restart
– OD risk higher
Missed Pick Ups and SPOC
• 1st Missed Pick Up – Try and contact SU are they OK??– Call the SPOC leave a message
• 2nd Missed Pick Up – Outreach team contacted, Visit at Home– Call SPOC and leave a message
• 3rd 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
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
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
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
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
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
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
Prescriber Q and A
• Any questions for Dr Ian Coffey?
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.
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?
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?
Case Study
• You have noticed for the past 4 days a SU has come in with small children.
• What happens next?
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
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
Ideas For Next Time…
• What would you like support in
• Ideas for Discussion
• Case studies for peer support
Any Questions?
Thank You and Goodnight!