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Pike, Brigid (2016) HSE National Service Plan 2016. Drugnet Ireland, Issue 57, Spring 2016, pp. 26-27.

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The HSE’s National Service Plan 2016 (NSP), approved by the government in December 2015, sets out the HSE’s priorities and targets for tackling tobacco use and alcohol and substance misuse in 2016.1 Initiatives are identified in three distinct areas – in the context of the Healthy Ireland policy framework, and within the HSE’s Primary Care Division and Mental Health Services.

 

Healthy Ireland framework2

The key priorities and actions for tobacco and alcohol are listed under the goal of ‘promoting health and well-being as part of everything we do so that people will be healthier’ (pp. 45–49).

 

Tobacco

  • Maintain and strengthen the HSE Tobacco Free Policy
  • Maximise impact of the QUIT Campaign
  • Make all new residential units tobacco-free
  • Train frontline workers to support smokers to quit

 2016 Quality Indicator: 45 per cent of smokers on cessation programmes quit at one month.

2016 Access Indicator: 11,500 smokers received intensive cessation support from a cessation counsellor.

 

Alcohol

  • Develop a three-year alcohol implementation plan to reduce alcohol consumption and related harms, incorporating actions from the National Substance Misuse report3 and aligned to new legislation.
  • Develop and prepare the enforcement provisions of the Public Health (Alcohol) Bill 2015 in partnership with the Department of Health.
  • Further progress a co-ordinated approach to prevention and education interventions through the community mobilisation on alcohol initiatives with drugs and alcohol task forces, and through the REACT award and accreditation scheme in the third-level sector, which recognises and rewards an institution’s efforts to reduce alcohol-related harm amongst its students.
  • Increase awareness among the public of alcohol-related harm by building on the 2015 communication campaign. 

Primary Care

Smoking and alcohol and illicit substance misuse are all addressed by the HSE’s Primary Care Division, which is responsible for primary teams (PCTs) and general practice, primary care reimbursement schemes (PCRS), social inclusion and palliative care services.

 

Smoking

As part of collaboration between Primary Care and Health and Wellbeing for Health, PCTs are to support brief intervention training for staff on smoking cessation (p. 54).

 

Methadone treatment

Methadone treatment is one of a number of primary care reimbursement services (PCRS). These PCRS are delivered by over 7,000 primary care contractors such as general practitioners, pharmacists, dentists, optometrists and/or ophthalmologists, who are reimbursed by the HSE. A key priority and action for 2016 relevant to methadone treatment is the implementation of the plan for the roll-out of individual health identifiers in 2016 in line with the Health Identifiers Act 2014 (p. 56).

 

Addiction and substance misuse

Addiction services are provided by Social Inclusion Services, the core objective of which is to improve health outcomes for the most vulnerable in society including Irish Travellers and Roma, asylum seekers, refugees and lesbian, gay, bisexual, transgender (LGBT) service users. Issues of addiction, substance misuse, homelessness and domestic, sexual and gender-based violence are overarching themes within the service user groups. Social Inclusion Services work with mainstream services and voluntary sector services to ensure accessibility for disadvantaged service users.

 

The priorities and key actions to improve health outcomes for people with addiction issues include the following (p. 56):

  • implement the outstanding actions in the National Drugs Strategy (2009–2016);4
  • ensure that adults deemed appropriate for treatment for substance abuse receive treatment within one calendar month;
  • ensure that children deemed appropriate for treatment for substance abuse receive treatment within one week;
  • ensure that addiction services operate within the person-centred care planning processes of the Drugs Rehabilitation Framework;5
  • finalise the response to drug-related deaths through a National Overdose Prevention Strategy;
  • audit drug services in line with the Drugs Rehabilitation Framework on care planning, assessment, key working and referrals; and
  • strengthen clinical governance structures by the appointment of an Addiction Clinical Lead. 

2016 access indicators (p. 63):

  • Substance misusers (over 18 years) for whom treatment has commenced within one calendar month following assessment: 100%
  • Substance misusers (under 18 years) for whom treatment has commenced within one week following assessment: 100%
  • Number of clients in receipt of opioid substitution treatment (outside prisons): 9,515
  • Average waiting time from referral to assessment for opioid substitution treatment: 14 days
  • Average waiting time from opioid substitution assessment to exit from waiting list or treatment commenced: 28 days
  • Number of unique individuals attending pharmacy needle exchange: 1,731 

Community-based responses

Actions to strengthen community-based responses include (p. 59):

  • development and distribution of standardised problem alcohol and substance use screening and brief intervention SAOR (Support, Ask and Assess, Offer Assistance and Refer) toolkits to support Tier 1 and Tier 2 services, and
  • publication a Guiding Framework for Education and Training in Screening and Brief Intervention for Problem Alcohol Use for nurses and midwives in acute, primary and community settings. 

The aim is to roll out SAOR screening and brief intervention training to 300 staff for problem alcohol and substance use within Tier 1 and Tier 2 services, and to deliver 30 SAOR trainings and complete four train-the-trainer programmes nationally.

 

To strengthen community development approaches in line with the Healthy Ireland framework, Social Inclusion Services are also to establish a social inclusion working group on community development, to incorporate principles in respect of addressing health inequalities, community development, community participation, social prescribing etc. with a focus on vulnerable communities (p. 59).

 

Mental health

The mental health service, integrated with other areas of the wider health service, extends from promoting positive mental health and suicide prevention through to supporting those experiencing severe and disabling mental illness. It includes specialised secondary care services for children and adolescents, adults, older persons and those with an intellectual disability and a mental illness. The 10-year national policy, A Vision for Change,6 continues to inform the roadmap, charting the way forward for the mental health service.

 

Among the priorities for Mental Health in 2016 is the development of a new clinical programme specifically for dual diagnosis of mental illness and substance misuse including alcohol (p. 65).

 

Among measures to contribute to promoting the mental health of the population in collaboration with other services and agencies, including reducing loss of life by suicide, is an action to ‘develop an increased focus on the health and wellbeing of the population in the delivery of mental health services, including supporting the continued rollout of the Tobacco Free Campus policy’ (p. 65). 

1 Health Service Executive (2015) National service plan 2016. Dublin: Health Service Executive. https://www.drugsandalcohol.ie/24939/

2 Department of Health (2013) Healthy Ireland: a framework for improved health and wellbeing 2013–2025. Dublin: Department of Health. http://www.drugsandalcohol.ie/19628/

3 Department of Health (2012) Steering group report on a national substance misuse strategy Dublin: Department of Health. https://www.drugsandalcohol.ie/16908/

4 Department of Community, Rural and Gaeltacht Affairs (2009) National Drugs Strategy (interim) 2009–2016 Dublin: Department of Community, Rural and Gaeltacht Affairs. https://www.drugsandalcohol.ie/12388/

5 Working Group on Drugs Rehabilitation (2007) National drugs strategy 2001–2008: rehabilitation. Report of the Working Group on Drugs Rehabilitation, May 2007 Dublin: Department of Community, Rural and Gaeltacht Affairs. https://www.drugsandalcohol.ie/6267/

6 Expert Group on Mental Health Policy (2006) A vision for change: report of the Expert Group on Mental Health Policy Dublin: Stationery Office. https://www.drugsandalcohol.ie/6154/

Item Type
Article
Publication Type
Irish-related, Open Access, Article
Drug Type
Tobacco / Nicotine
Intervention Type
Treatment method
Issue Title
Issue 57, Spring 2016
Date
May 2016
Page Range
pp. 26-27
Publisher
Health Research Board
Volume
Issue 57, Spring 2016
EndNote

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