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Pharmacy Training Event. 17 th June 2014 Claire Walters Services Manager SoT Routes to Recovery Stuart Fisher Clinical Co-Ordinator. Welcome!!. Here to improve relationships, share knowledge and best practice Regular event going forward. Why Are We Here?.
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Pharmacy Training Event 17th June 2014 Claire Walters Services Manager SoT Routes to Recovery Stuart Fisher Clinical Co-Ordinator
Welcome!! • Here to improve relationships, share knowledge and best practice • Regular event going forward
Why Are We Here? • You are an important ‘piece of the puzzle’ and our eyes and ears in managing the risks that our SU present with • We need to make sure that you now what information we need, when we need it and why we need it • We need to be clear about what you need from us • We all need to know the best ways to communicate with each other in order to manage risk and support decision making • Some things work well some don’t – from all sides we could be better
Missed Pick Ups…. • 1st Missed Pick Up • Try and contact SU are they OK?? • 2nd Missed Pick Up • Outreach team contacted, Visit at Home • 3rd Missed pick up • Police called safe and well • PX Stopped. Need to see Dr before restart • OD risk higher
Missed Pick Ups and SPOC • 1st Missed Pick Up • Try and contact SU are they OK?? • Call the SPOC leave a message • 2nd Missed Pick Up • Outreach team contacted, Visit at Home • Call SPOC and leave a message • 3rd Missed pick up • Police called safe and well • PX Stopped. Need to see Dr before restart • OD risk higher • Call SPOC and leave a message – Don’t dispense again until new prescription is issued
SPOC Phone • For information giving only. • All hubs info is on the back of prescription. If you need to speak to someone call that number – they will be able to advise
What to do with Missed Pick Ups • One Day Missed • If Titration script don’t dispense and urgent Red call to hub • If not call SPOC and continue dispensing • Two Days Missed • Call SPOC and continue to dispense • Three Days Missed • DO NOT DISPENSE • Call SPOC • Prescription is cancelled. Only dispense again after new prescription is issued
What we can help with… • Violent and aggressive SU’s • Training for new staff • Advice and guidance on complex cases • Alerts and Info on local trends
Supervised Consumption • One of the most important things you do • Ensure that SU’s are getting what is prescribed and reduces illicit drug availability • Check and Balance • Concerns of missed pick ups for weekly dispense
Supervised Consumption Agreement • Highlighted text is why we have chosen to have this event today • We have slightly changed the wording to fit in with the SPOC process and behaviour expectations of our service users • Look through the agreement
Supervised Consumption Assessment • The tool we use to help determine who is who isn’t on supervised consumption • Things we consider • Safeguarding • Alcohol Use • Drug use ‘on top’ • Engagement with services • Continual missed doses • Intelligence that full doses arn’t being taken
Prescriber Q and A • Any questions for Dr Ian Coffey?
LIN • We work closely with the LIN liaising with them around errors, issues and security concerns that we have • We report • prescriptions not dispensed by the correct pharmacy • Wrong amounts dispensed • Dispensing not in accordance with how prescribed • Lost prescriptions • They were instrumental in, (and paying for!), tonights event in an attempt to reduce the amount of incidents that are reported • Important work in reducing the amount of illicit prescribed substances that are on the streets of Stoke on Trent.
Case Study • What could have happened if we don’t communicate…. • SU A comes in severely intoxicated. He is on weekly dispense 75ml methadone a day. • Whats wrong with this picture? • What are the dangers here?
Case Study • SU is on daily supervised buprenorphine. They are being increasinly inpatient for having to wait for it to disolve…. • What happens next? • What could be happening? • What part can we play in this?
Case Study • You have noticed for the past 4 days a SU has come in with small children. • What happens next?
Case Study • Service User comes in and asks you to accept a prescription that hasn’t got your stamp on it • What happens next? • What could be the consequences
Safeguarding… We Need You • Regular contact with our service users • Might see things that haven't been disclosed • Patterns of behavior, including people that they are regularly with • General welfare of the child if they are with them • Like anything we are only as good as the info we are told. • Good way of making sure everything adds up
Ideas For Next Time… • What would you like support in • Ideas for Discussion • Case studies for peer support