Safe and sound – home detox with BWR Synergy

What’s involved in a home detox? The expert team at BWR Synergy Health explain the series of very careful stages.

BWR Synergy Health Ltd is a CQC registered organisation set up by a group of clinicians with more than a life total of 100 years of experience in addiction treatment. We deliver a clinically safe, bespoke home detoxification service focused on the holistic needs of the individual, and cover a number of substances including alcohol, opiates and poly substance use.

The service is led by medical director Dr Simone Yule, who continues to work as a senior partner in general practice – ensuring excellent clinical oversight combined with many years of experience working in addiction treatment. Dr Yule was one of the first cohort to achieve the RCGP part two diploma in substance misuse, mentored by Dr Gordon Morse, and has overseen shared care prescribing arrangements in primary care. She then became a deputy clinical lead for Turning Point and medical director at Clouds House, a position she held for 15 years. This has given Dr Yule a wide base of experience in prescribing, understanding, and overseeing a range of medical detoxifications.

Alongside the medical director, BWR Synergy Health has a wealth of clinical expertise in the form of advanced nurse practitioner Dave Ings, who also achieved the RCGP part two diploma and worked in many different prescribing and clinical environments, and experienced nurse consultant Kate Ings with an expertise in mental health. They oversee treatment supported by a number of experienced nurses and healthcare assistants. Consultant psychiatrists are also available for assessment and treatment advice and guidance. The team is complemented by director of services Victoria Smith, who has a background in governance and corporate law.

The home detoxification programme is vigorously risk-assessed from the initial referral onwards, as the treatment episode needs to be as clinically safe as possible. The prospective client will undergo a screening telephone assessment to ensure suitability before being booked into a face-to-face assessment either at our premises in London or in the home environment, and this can take up to two hours. The appointment includes a comprehensive physical assessment and blood tests, alongside history-taking and a clinical risk assessment.

Clients are counselled with respect to confidentiality and providing consent for the release of medical information that will support the assessment, alongside consent relating to emergency situations should they arise.

As per BWR clinical guidelines, prospective clients must fulfil criteria such as no seizure history, are physically assessed as reasonably clinically well and functioning, and must always have a supportive person alongside them in the home environment during the detoxification programme.

Once a telephone and face-to-face assessment have been completed, and with consent, the client’s GP is contacted for an up-to-date patient record. Subject to all relevant information being received, a treatment plan is developed, taking into account all patient information, alongside history obtained from supporting others and the GP report. The treatment plan is shared with the individual and agreed.

Home detoxification can take place in a number of places including the home, as an outpatient, or in a hotel setting. There must be a supporting person with the individual at all times throughout the detoxification and depending on individual need, the clinical team can be in attendance 24/7. All medication is prescribed and provided for detoxification. Monitoring takes place at least six times a day on day one, and is driven by clinical need and assessment. As the team are generalists as well, they are aware of physical and psychiatric symptoms and can manage them appropriately, with access to psychiatric assessment if needed. Intensive monitoring will continue depending on need for the first four days of detoxification, and as the process continues the recovery planning commences.

BWR are very aware that while detoxification is key, the recovery planning and support network put in place to support clients as they complete detoxification is vitally important for continued recovery and ongoing wellbeing. BWR work with the client, their families and organisations involved in this plan as well as looking at lifestyle, diet, exercise, and social connection. For some this will include AA/NA and for others Smart Recovery resonates. Follow-up is provided, for all clients, with regular catch-ups and progress discussions signposting clients to outpatient aftercare.

Alongside our home detoxification services, BWR Synergy Health has developed a corporate support programme as we recognise the challenges of mental health, addiction, and neurodiversity in the workplace. The programme includes a number of interactive e-learning modules, HR support and employee wellbeing checks in the workplace that fulfil employers’ responsibilities as outlined in the government paper Thriving at Work commissioned by Theresa May.