Winning attitude

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Being recognised through a national award made Catherine Larkin and Danny Hames realise the value of Inclusion’s eager adoption of a naloxone strategy.

Last November Inclusion, which is part of South Staffordshire and Shropshire NHS Foundation Trust, won the Health Service Journal award for patient safety. This was for our project titled Naloxone – Increasing Awareness, Saving Lives. As much as this award was well received – and for the team involved, a chance to stop and take pride in what had been achieved – it was also a moment to reflect on what had started back in 2009 in Birmingham.

Catherine Larkin, clinical director at Inclusion.

This was when Inclusion began issuing naloxone in its services. We were able to do this because of the expertise and knowledge our colleagues in medicines management were able to provide, a benefit from being part of an NHS organisation. It wasn’t commissioned or paid for, it started because it was clearly the right thing to do. We could do it because of the infrastructure we had alongside us, and Inclusion were willing to fund it.

Danny Hames is head of development for Inclusion.

The change in legislation that occurred in 2015 provided the catalyst for the development of a national protocol, enabling us to increase the reach of the naloxone through training frontline staff, service users and family members across all our services. We were able to take advantage of the change in legislation straight away because of the knowledge and expertise we had in our trust, and as such were the first organisation in the sector to introduce a protocol of this kind.

The benefit of all this has been that since July 2015, nearly 2,500 people have been trained to administer the kits and, so far, at least 130 lives have been saved and at least £408,000 saved to the local health econ­omy. This has been achieved through the hard work of those involved in the project – service users, managers and staff but also through the bold actions of those who led the organisation and had the foresight and courage to enable the provision of naloxone and then be ready for the change in legislation.

The benefit of making naloxone available is clear for all to see in terms
of saving lives, and we know that for every £1 spent on naloxone it saves the health economy £14.30. However, we have also found that there are further benefits to service users’ health and wellbeing through providing an effective naloxone distribution programme. One example of this has been that we have increased and strengthened our relationships in settings where the most vulnerable service users can be reached. Hostels are a great example of this; working closely with the hostel staff, training them and the service users has meant that stronger relationships have been formed.

By providing naloxone you have a tangible and powerful intervention available to people, and the benefits are obvious. Through forming these relationships, we have then been able to offer health and wellbeing clinics in these settings and provide some of the most vulnerable with flu vaccinations. Before the naloxone programme this wouldn’t have happened, but it is just another of its benefits, raising awareness and improving a service’s ability to engage.

So the reflections from that awards night are that there is still more to do, and that an effective naloxone programme creates new opportunities to reach the most vulnerable members of our communities. It is heartening to see that the provision of naloxone in all community services is increasingly becoming an expectation and reality; however, as we enter into 2017 there are no excuses that this shouldn’t be the case across the whole UK.

There is a responsibility for commissioners, but also providers, to make sure this happens. Who pays for it and how this is achieved are problems to be solved. But there is a moral imperative it should happen, because if it isn’t solved quickly more people who use and don’t use our services will die, with all of the impact on th  ose who are close to them. Surely for all of us, whether we work in the NHS, local authorities, charities or are independent providers, this cannot be tolerated.

Inclusion is committed to this and will continue to champion the use of naloxone in our services and to offer any help we can to those who want to learn from our experience.