Knowledge exchange

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Drug-related deaths:

NHS Trusts from across England came together to mark a vital new initiative in tackling drug-related deaths, as Danny Hames reports.

For a number of reasons 25 April was a significant date. In 1684, the patent was granted for the most sensible but useful of inventions, the thimble, but also it marked the formal launch of the NHS Substance Misuse Provider Alliance (www.nhssmpa.org.uk).

As a collaboration of a number of NHS trusts one of our key objectives has been to use the resources within our alliance to positively impact upon the drug and alcohol treatment sector. If as an alliance we can be half as useful as the thimble has been in avoiding harm we will be doing well. However, on a more serious note, this was a day when we were able to bring together service users and professionals from a range of backgrounds to share information and practical examples of service provision that we hope can contribute to reducing drug-related deaths.

The conference was hosted at Greater Manchester Mental Health Foundation Trust’s (GMMH) Curve Conference Centre and started with introductions from colleagues at GMMH, Bev Humphrey, chief executive, and Richard Rodgers, strategic lead for substance misuse. The challenge that was posed to all delegates was to ensure that we do not allow the marketisation and competitiveness of the drug and alcohol treatment sector stop the sharing of best practice – particularly important when sharing expertise and understanding between the drug and alcohol treatment sector and mental health. As Bev Humphreys said, this was a key reason why GMMH have remained in the sector – a reason that would apply to many of the NHS trusts across the country.

Dr Emily Finch, chair for the conference, introduced Professor John Strang who delivered the keynote speech alongside presentations from Steve Taylor of Public Health England and Dr Tim Millar from the University of Manchester. Professor Strang talked about the need for better action in preventing opioid deaths – a call to arms for the sector in responding to where the risks are and applying a broad range of remedies. This includes ensuring the availability of naloxone and also the many related factors, such as ensuring that family groups are not overlooked and are supported in how to manage overdose.

Steve Taylor provided a national overview of the impact of drug-related deaths, highlighting that although the majority of these are still male, female deaths are also steadily rising. Dr Tim Millar gave a useful insight into the cause of service users deaths that are not directly related to the use of a substance: a user of substances over the age of 45 was 27 times more likely to die of a homicide than someone in the general population and the risk of suicide was also very significant. His research also posed some interesting discussion points for service providers and commissioners; for example, the evidence would indicate that for those solely in psychological treatment the risk of drug-related death is no different to those who are not in treatment.

The morning concluded with a presentation from colleagues at Pennine, Derbyshire and Greater Manchester NHS Foundation Trusts providing their findings from drug-related death audits they had completed independently over the last few years. Again, the prevalence of suicide was notable in these audits.

The afternoon sessions were very much focused on initiatives that are provided at a service level and can be taken away and developed. This included a lung health pathway in Lambeth by South London and Maudsley NHS Foundation Trust; presentations from Inclusion about their take-home naloxone project nationwide; and then in collaboration with the Hepatitis C Trust, a presentation of their P2P:peer mentor and hepatitis C project from Hampshire, which included a moving and inspirational film about the reasons for this work.

Mike Linnell walked us through the important work regarding early warning systems that has been happening in the Manchester area, and delegates also benefited from understanding the highly effective hospital liaison services working with alcohol users that GMMH and Salford Royal Foundation Trust are providing.

The purpose of the conference was to provide an insight into what is causing so many of the people we work with to die early through what are also often avoidable deaths. It was also meant to have a practical application, whereby the NHS organisations and partners who provided their expertise on the day gave the opportunity to make contacts and take away tangible and realistic innovations that can be applied in their services. From feedback on the day, the conference and launch of the NHS SMPA did this – but this is only the start, and we look forward to this being the first of many such events.

Danny Hames is chair of the Substance Misuse Provider Alliance

For more information about the day, contact candie.lincoln@sssft.nhs.uk