On the front line
The National Needle Exchange Forum (NNEF) held its annual meeting in Birmingham last month. The meeting brings together members of the NNEF to present the latest news and updates on harm reduction for needle exchange workers, harm reduction advocates and service users, with a number of exhibitors including Frontier and Exchange Supplies displaying the latest products for needle exchange programmes.
There were presentations on the latest developments on naloxone and updates from Public Health England (PHE), as well as updates on the work of the NNEF over the past year. Alongside some of the presentations there were overdose and naloxone training sessions, delivered by NNEF deputy chair Philippe Bonnet and Kevin Jaffray.
Naloxone changes ‘just a start’
The morning sessions focused on updates and changes to legislation regarding the provision of naloxone. Kirstie Douse from Release presented the legal implications of the changes, highlighting that the new regulations are a good start but don’t go far enough as there is still no national programme or requirement to provide naloxone, resulting in a postcode lottery.
Nigel Brunsdon spoke about practical ways to embed naloxone provision into services, showing the importance of developing protocols and policies as well as working with local partners to raise awareness.
‘When it comes to starting naloxone within your service, it is so important not to let the development of paperwork be a barrier to getting started,’ he said. ‘However we do need to monitor the programmes to evidence the effectiveness to others, as well as working with commissioners at all levels to make naloxone provision a key performance indicator.’
Speakers from PHE and the Home Office provided the latest news from public health. Among them were Viv Hope who outlined the recent emergence of mephedrone injecting in the UK from the unlinked anonymous monitoring survey (UAM) among people who inject drugs. He highlighted that ‘there are higher levels of risk and infections among those who have injected mephedrone, with one in 12 among survey respondents having injected mephedrone within the last 28 days.’
Katelyn Cullen from PHE drew insights from the UAM survey into neck injectors, outlining that interventions are required to improve injecting technique and reduce misconceptions around this practice.
There were also updates from the Home Office with David Ryan-Mills looking for services to get involved with their plans to evaluate foil provision in England.
Jamie Bridge, chair of the NNEF, gave an overview of the work completed by the NNEF within the past year, including the creation of a directory of all the needle exchanges in England following the Freedom of Information request to 152 directors of public health.
‘NICE guidance recommends that directors of public health ensure that services are commissioned to deliver a range of generic and targeted needle and syringe programmes to meet local needs,’ he said. ‘Without a central database or map of exchanges, it is difficult to assess the implementation and coverage of NSPs.’
As deputy chair of the NNEF, I launched the ‘secret shopper’ project to assess the service offered by NSPs within drug services and pharmacies. The main aims are to assess the availability of access to clean injecting equipment, and whether people accessing NSPs are treated with dignity and respect.
The NNEF is currently recruiting service users, service user groups and harm reduction advocates to become secret shoppers to find out what is happening in the real world.
The day finished with keynote speaker Sara McGrail, who gave an inspirational presentation on what the increase in drug-related deaths might be telling us about our drug treatment system. Highlighting the concerns for the sector with the de-prioritisation of harm reduction, changes in the culture of drug services in England as well as the impact of service commissioning and recommissioning every few years, she called for the ‘urgent and focused thematic CQC review of service and commissioning, including contracts in those areas which have the highest rises in opiate-related deaths.’
For more information about the presentations and to join the NNEF (membership is free) visit www.nnef.org.uk
Matt Johnstone is deputy chair of the NNEF
Pics by Nigel Brunsdon