There is a strong case for a peer-led needle and syringe exchange service in London, according to a new report from the London Joint Working Group on Substance Use and Hepatitis C (LJWG). The group has been working with Hackney Council to look into the feasibility of developing a peer-led and delivered NSP with added hep C awareness and testing facilities, using focus groups and interviews with specialists (DDN, December/January, page 5).
Peers are able to use their lived experience of injecting drug use to deliver education and advice, says LJWG, with a peer-led service able to fully ‘embed leadership’. More than 40 per cent of people who inject drugs still report sharing equipment, with hepatitis C infection levels remaining high.
The report, which was funded by Hackney Council as part of project ADDER, looks at the feasibility and acceptability of a peer-led NSP, as well as practical considerations. It found a high level of support among peers, people who inject drugs and commissioners, with an initial three-to-five-year funding commitment able to provide stability for the new service. The facility would be welcoming and non-judgemental, says the document, with people signposted to other essential services. Monitoring and evaluation mechanisms would need to be embedded, with peers delivering the service via clearly defined roles – both paid and unpaid – with training and supervision.
‘There is clear support from people who inject drugs, people who work with people who inject drugs, commissioners and from public health specialists for an innovative, peer-based needle exchange service in London,’ says the document. ‘This will support important public health goals including reducing health inequalities, reducing harms from drug use, and reducing hepatitis C and other BBV transmissions. There are complexities in developing and delivering such a service, which would need to be designed and led by a cross- stakeholder steering committee which will include peers. Robust evaluation mechanisms should be put in place so this service could become a blueprint for services across the UK and beyond.’