Home > Improving clinical responses to drug-related deaths. A summary of best practice and innovations from drug treatment providers.

Collective Voice, NHS Substance Misuse Provider Alliance. (2017) Improving clinical responses to drug-related deaths. A summary of best practice and innovations from drug treatment providers. London: Collective Voice and the NHS Substance Misuse Provider Alliance.

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Collective Voice and the NHS Substance Misuse Provider Alliance (NHS SMPA) have worked together, with Public Health England's support, to produce a set of recommendations for providers with the aim of ensuring that everything that can be done is done by service providers to help reverse this damaging trend. This demands a challenging balancing act, retaining a focus on the importance of harm reduction and safety while not undermining the opportunity and ambition for recovery of many people we work with. The document covers a number of subject areas, but detailed below are the key recommendations we believe providers and those commissioning services should commit to:

1. Drug treatment services should review their information systems to enable data relevant to risk of overdose to be captured and deployed to inform individual treatment plans.
2. Treatment plans should be consistent with the 2017 Clinical Guidelines and should be individually tailored to balance the protective benefits of OST with the opportunity to safely progress towards recovery. Providers and commissioners should guard against forced reductions or premature removal from treatment in a desire to achieve targets.
3. All providers should establish clear protocols for managing the risk of overdose and ensure their staff are competent to implement them. This should include ensuring naloxone is widely available.
4. Commissioners and service providers have a responsibility to maximise their contribution to addressing all the physical and mental health needs of service users, ensuring these are met either within their own services or by effective engagement with timely and appropriate access to primary care and specialist services in the NHS. This includes ensuring that more people are tested and treated for hepatitis C.
5. Commissioners and treatment systems need to increase local penetration rates to reduce deaths among those who are currently not engaged in treatment or in contact with harm reduction services. Fundamental to this is promoting and expanding access to needle and syringe programmes.

Introduction p.5
1 Identifying risk of drug-related death p.6
2 Delivering safe, recovery-orientated drug treatment p.10
3 Preventing overdose in people who use drugs p.13
4 Meeting physical and mental health needs p.16
5 Reducing the risk of drug-related death for people outside drug treatment p.19
Appendix 1. Sources of information for assessing risk of drug-related death p. 25
Appendix 2. Contributors p.26

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