POST-ITS FROM PRACTICE
MY PRACTICE
has long had a reputation in Birmingham for working with
people who use drugs and alcohol, and who are much more complex than
those seen in most shared care practices. We were recently approached by
the newly commissioned service to see if we would treat a man who – for a
variety of reasons – wasn’t engaging with the main drug service. This has
happened before and no doubt will again; as while a commissioned service is
designed to deliver a good level of service to the majority of its clients, by
virtue of commissioning arrangements it has to work within defined
parameters.
So what happens when a client falls out with a service, or a service falls
out with a client? It is a fact of life that we don’t see eye to eye with everyone
and sometimes irreconcilable differences develop. In my experience, within
drug and alcohol treatment this is frequently due to intransigence in both
parties. However the service user can’t fall back on or blame ‘procedures’,
‘staff shortages’ or ‘we aren’t commissioned to do that’ statements.
Previously when drug and alcohol treatment was part of health services, a
service user would usually be placed in an alternative treatment system,
bearing in mind that access to NHS treatments should be fair, equitable and
available to all. However since public health has moved into the realm of local
government this seems to have changed.
All councils will commission drug and alcohol services but I suspect they
are less willing to fund the ‘square pegs’ that may need to be sent to a
different service. I have come across a number of clients now who simply fall
through the cracks and, due to a breakdown in the relationship with the ‘only
show in town’ are outside of treatment and, despite wanting help, they can no
longer access it.
We are fortunate in Birmingham to have a number of highly skilled GP
practices as well as the central service for drug and alcohol treatment, so it is
usually possible to accommodate most clients who have a problem with one
provider in an alternative service – albeit that a client may need to embrace
change within themselves too, for the arrangement to work.
I worry about what may happen elsewhere in the country if this diversity
isn’t available, how many people are excluded from their local treatment
provider (for whatever reason) and are simply not able to find an alternative?
And what should we do about it?
Steve Brinksman is a GP in Birmingham and clinical lead of SMMGP,
He is also the RCGP regional lead in substance misuse for
the West Midlands.
TOOMUCH
AT STAKE
We’re seeing the unwelcome
return of the ‘postcode lottery’,
says
Dr Steve Brinksman
March 2016 |
drinkanddrugsnews
| 17
Read the reports, see the pictures:
Service user and carer involvement is
embedded within treatment and support
services. We expect that service users are
listened to, involved and consulted on
decisions about their treatment and
support, and ensure that both they and
carers are involved in the planning,
development and delivery of services.
This commitment is to give
opportunities for our service users and
carers to be involved at all levels.
At an individual level
, we want service
users to be actively involved in their own
treatment and support, specifically
through their relationship with workers in
devising care/support plans.
At a service level
, they should be
consulted and involved in the decisions
about the running of those services.
Meaningful involvement is a contractual
obligation and services should be able
to give evidence of measures they have
used to obtain the views of the
patients/clients about their treatment
experience, the running of the service
and any proposed changes to how that
service is delivered.
At a strategic level
, we are
committed to involving people in the
planning, evaluation and development
of future provision. We run long-
standing service user forums for those
with issues around drug and alcohol
use and mental health, which provides
a continuous consultation function.
At a policy level
, we work with
Public Health England to promote good
practice through regional forums for
service users and carers. Some of our
service users attend national conferences
and events and get involved in national
strategy and policy.
We also undertake consultation on
specific themes and issues with these
groups and do joined-up consultation
activities with partners in the CCG, local
authority and public health.
All of this is enshrined in the
treatment system charter, and the
commissioners, in partnership with
previous and existing service users,
providers and wider stakeholders, have
established a set of locally agreed values,
which underpin local drug and alcohol
treatment.
We believe that involvement means
better services, better commissioning and
better outcomes for people seeking help.
All of these people need to remember
that involvement isn’t an optional extra
or just a nice thing to do – it is a right.
Details, including the charter, are in the
service user and carer involvement section of
the CDP website,
How is
your area
doing?
LET US KNOW
by emailing
