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Addiction to Medicines:

Addiction to Medicines: Training and support for GPs, pharmacists and other healthcare professionals Dr Ben Riley Medical Director of Curriculum Royal College of General Practitioners Michelle Styles Regional Manager, London Centre for Pharmacy Postgraduate Education.

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Addiction to Medicines:

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  1. Addiction to Medicines: Training and support for GPs, pharmacists and other healthcare professionals Dr Ben RileyMedical Director of CurriculumRoyal College of General Practitioners Michelle StylesRegional Manager, London Centre for Pharmacy Postgraduate Education

  2. About the Royal College of GPs Leading professional body for general practice with over 46,000 members Sets the training curriculum and assessments and recommends standards for the licensing and revalidation of GPs Policy development and research in general practice

  3. The role of the GP in safer prescribing In the NHS, 90% of medical consultations take place in general practice: over 300 million each year Each year in England, around 900 million items are prescribed in primary care GPs write 98.5% of these prescriptions. An estimated 1.5% are written by nurses and other non-medical prescribers (of which 0.6% are by dentists) Around 70-80% of prescriptions are issued on ’repeat’ Sources: The Information Centre, 2009 and Prescribing Support Unit, 2010

  4. The RCGP Curriculum This means that as a GP you should: 1.1 Appreciate that drug and alcohol use is common the community and that harmful use is often unrecognised and can take a range of forms 1.2 Recognise the special needs of patients with drug and alcohol problems, who often have very difficult lives and are frequently marginalised by society 1.3 Ensure that patients with drug and alcohol problems have equal access to care in your practice and are treated with compassion 1.5 Provide evidence-based screening, brief interventions and effective primary care treatments for these patients, where appropriate ..../.... 1.6 Make sure that repeat prescriptions are monitored for long-term prescribing of addictive drugs and appropriate action taken if this is happening 1.7 Work in partnership with the wider primary healthcare team including pharmacists, specialist services, the voluntary and criminal justice sectors 1.8 Recognise that older adults can have unrecognised alcohol or drug problems www.rcgp.org.uk/curriculum Incorporates Academy of Medical Royal Colleges core competencies

  5. Outdated organisation and service boundaries Diverging UK care systems Focus on process measures/’tick-boxes’ Growing financial pressures Future challenges for the NHS Ageing, multi-morbid population Avoiding greater fragmentation of care Growing expectations of access and quality Increased demand

  6. CPD & Revalidation EnhancedTraining Towards Expert System improvement Multidisciplinary team-working From Novice Training Consultation skills Concept based on Harden and Stamper, 1999 and Dreyfus and Dreyfus, 1986.

  7. Four-year Enhanced GP Training

  8. Plans to improve GP skills • Submitting proposals for enhancing consulting and prescribing skills of all new GPs through a new four-year training programme (subject to Government approval) • Introducing practical quality improvement training for all senior GP trainees • Developing educational tools and resources for the continuing professional development of qualified GPs • e-Learning • Printed materials

  9. Existing resources • Online Learning Environment: www.elearning.rcgp.org.uk • RCGP/SMAH blended courses • Identification and Brief Advice for Alcohol Misuse • Management of Drug Misuse (Harm Reduction) • RCGP Certificate in the Management of Drug Misuse • SMMGP AtM GP workshops

  10. Addiction, misuse and dependency: Focus on prescribed and over-the-counter medicines E-learning programme Educational solutions for the NHS pharmacy workforce

  11. Background • Joint project with the Centre for Pharmacy Postgraduate Education (CPPE) and Royal College of General Practitioners • Key focus is GPs and pharmacists but relevant to others • Project lead by • Dr Linda Harris, GP and clinical director, RCGP, Substance Misuse and Associated Health • Professor Christopher Cutts, Director, CPPE

  12. Centre for Pharmacy Postgraduate Education - Funded by the NHS via SHA (LETB/HEE) for England - Learning for the whole professional pharmacy workforce in England - Hosted by the University of Manchester

  13. CPPE Quality Assurance process

  14. Development team Claire Barber, Pharmacist with interest in this substance use Richard Cooper, Lecturer in public health and course director, University of Sheffield Colin Fearns, Secure environment pharmacist Ajay Birly, RCGP substance misuse and associated health unit Jenny Keen, clinical director, Primary Care Addiction Service Sheffield Ruth Fleming , Project officer, RCGP Aileen Bryson, Practice and policy lead for Scotland, Royal Pharmaceutical Society Simon Butterworth, Community pharmacist with an interest in the area Cathy Stannard, Chair, British Pain Society Kate Halliday, Policy and development manager, Substance Misuse Management in GP Jo Clark, Local pharmacy tutor, CPPE

  15. Externalreviewers Steve Brinksman, GP, regional lead in substance misuse for the West Midlands, RCGP, and clinical director of Substance Misuse Management in General Practice Matthew Young, GP and London regional lead, RCGP Substance Misuse and Associated Health unit Andrew Mawdsley, Clinical tutor and clinical pharmacist, Central Manchester University Hospitals NHS Foundation Trust Graham Parsons, Pharmacist with special interest and pharmacist prescriber (substance misuse), NHS Devon, Plymouth and Torbay

  16. Learning objectives Define the term ‘addiction to medicines’ with respect to prescribed and OTC medicines Interpret key data sources and reports which discuss the public health problem with medicines addiction and misuse Identify key at-risk groups of people and patients who could become dependent on medicines

  17. Learning objectives cont’d Differentiate between prevention and treatment aspects of medicines addiction Recognise best practice in safe and effective prescribing most likely to reduce the risks and harms from addictive medicines Describe appropriate services, treatment interventions and care pathways which can support people who have become dependent on medicines

  18. Structure of the learning

  19. Build in ‘Storyline’ software • Great look, style and feel • Compatible with PC, iPad, iPhone and Android tablets • Video stories, exploring graphics • Case studies to challenge • Web links & references

  20. Development, hosting and delivery Currently at the e-build stage Hosted on CPPE (www.cppe.ac.uk) and RCGP website Happy to discuss hosting options with other organisations Aiming for 1st April 2013 launch Email: christopher.cutts@manchester.ac.uk

  21. Completing the learning cycle

  22. Revalidation requirements for GPs • General information about professional work • Keeping up to date • - CPD activities • - Review of practice • - Quality improvement activity • - Significant events • Feedback on professional practice

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