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Kristin Rothert Head of Clinical Standards & Quality Bridge Project

Setting up and delivering a Specialist Benzodiazepine Withdrawal Service in a Primary Care Setting. Kristin Rothert Head of Clinical Standards & Quality Bridge Project kristin.rothert@bradford.nhs.uk Dr Beverley Bray PhD Head of Performance Bridge Project beverley.bray@bradford.nhs.uk.

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Kristin Rothert Head of Clinical Standards & Quality Bridge Project

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  1. Setting up and delivering a Specialist Benzodiazepine Withdrawal Service in a Primary Care Setting Kristin Rothert Head of Clinical Standards & Quality Bridge Project kristin.rothert@bradford.nhs.uk Dr Beverley Bray PhD Head of Performance Bridge Project beverley.bray@bradford.nhs.uk

  2. Consider: • . • What is the need within your own practice area? • 2. Consider: • . • What are the barriers to delivering this service from both your own and the patient's perspective?

  3. First decision: Funding the service........ Local funding sources? Time limited grants? Local CCGs? Pooled treatment budget?

  4. Second decision: What does success look like? Reduction in benzodiazepine prescribing?

  5. Second decision: What does success look like? Increased health and well-being?

  6. Second decision: What does success look like? Fewer secondary health issues?

  7. Second decision: What does success look like? Reduction in benzodiazepine prescribing Increased health and well-being Fewer secondary health issues

  8. Third decision: Making it happen – who needs to be around the table? Commissioners Clinicians Delivery service GP practices

  9. Fourth decision: Making it happen – what needs agreeing prior to launch? Clinical standards? What model? What documents? Cost / funding sources? Who? . Where? .

  10. Implementation – getting stuck in!

  11. Identify practices / areas with sufficient need for the service and • Identifying the target cohort Target cohort

  12. 3. Contact target cohort and invite for a medication review

  13. 4. Assess and work with cohort identified

  14. Delivering the service – lessons learnt • Communication • Buy – in • Consistency • Skilled worker • Located within practices • Flexibility • Multiple contacts, not • always face to face

  15. Delivering the service – demonstrating outcomes.... NDTMS data items - numbers in treatment - successful outcomes - re-presentations into treatment Other outcomes – locally agreed - reduction in benzodiazepine prescribing - Health and well being measures

  16. Delivering the service – demonstrating outcomes.... • Set up information collection at outset • Agree which measures will be used • Set up processes in design stage • Design integrated care planning • and data collection paperwork

  17. Background • Bridge Benzodiazepine Withdrawal Service • Operating since mid 2008 • Re-designed in January 2010 • Lone worker employed and supervised by Bridge • Located within GP practices • Initially funded by Voluntary Sector grant funding • A Brave New World – reporting to NDTMS

  18. The story so far 223 individuals helped since January 2010 75 individuals helped since April 2012

  19. The story so far 50% helped to stop their medication completely 50% reduced by between 25-80% (average 52.5%) CANCELLED

  20. The story so far Average 24 weeks receiving support Between 9 – 47 weeks for a medication free outcome

  21. Where to from here? What ideas / thoughts will you be taking back to your area / practice?

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