NETWORK A national newsletter on substance misuse management in primary care
NETWORK 20 NOVEMBER 2007
Clinical guidance special edition
The National Treatment Agency for to work together to meet needs. Most
Substance Misuse (NTA) is pleased to be primary care-based drug treatment is now
supporting the publication of this special well-integrated into local drug treatment
edition of SMMGP’s Network newsletter, systems but we think much is still outside
covering the 2007 Clinical Guidelines local or national enhanced schemes (LES
and NICE suite of drug treatment clinical or NES) or what would once have been
guidance published this year. It forms an called formal shared care arrangements.
important part of the package of guidance NTA annual drug treatment plans 07/08 tell
and support that the NTA, SMMGP, RCGP us that, on average, only 35% of GPs in an
and others will be providing to those area provide treatment within a shared care be asking providers to review their practice
involved in drug treatment over the arrangement and a further 6% prescribe against the clinical guidance and plan
coming months. The NTA is grateful to to drug misusers in a commissioned improvements where necessary. We will
SMMGP staff and members for the hard service model outside shared care. There also be asking commissioners to support
work they have put into developing it. is considerable scope both to increase the local services in the implementation of the
GPs and their primary care colleagues have
number of GPs providing drug treatment new suite of clinical guidelines.
played a vital role in helping to expand drug
and for primary care to be better integrated
The NTA is also pleased to be able to work
treatment and its quality. In further building
into drug treatment systems.
with the RCGP to develop other support for
on this success the challenge for primary There have been great improvements in the primary care including:
care – and its commissioners – is threefold: quality and consistency of drug treatment
n updates to RCGP Part 1 and 2
n to expand the numbers of patients
and the publication of such a wealth of
Certificates in the Management of Drug
receiving treatment in primary care
evidence-based guidance provides a real
opportunity to make sure all drug treatment
is effective and in line with best practice.
n CPD events for primary care staff
n to encourage all GPs providing drug
As GPs know well, drug misusers often n revisions to the highly-valued range of
treatment to be active members of local
have a complex range of needs. The 2007 RCGP guidance on drug treatment
treatment systems rather than individual
guidelines stress that substitute prescribing
practices treating drug misusers in
Finally, we are aware that the articles in
alone is not enough to deal with those needs
this newsletter represent a range of expert
and “Treatment for drug misuse should
views. In some cases, the NTA may not
n to ensure clinical practice is in line with always involve a psychosocial component”.
agree with everything said but we welcome
the new guidelines For some primary care based drug treatment
the opportunity to encourage debate about
Drug misusers have a wide range of needs
providing psychosocial interventions may
how to provide the very best treatment for
and, as the 2007 Clinical Guidelines say,
be a challenge – particularly in busy GP
this group of patients. We look forward to
“It is seldom the case that one clinician will
practices. This is one reason why GPs are
working with you, the RCGP and SMMGP
be able to meet these needs in isolation.”
encouraged to work in partnership with
in our mutual goal to provide high quality
Primary care is used to working with other
other local drug treatment providers.
health and social care professionals to meet Improvements in clinical governance across
the needs of its patients and drug misuse the drug treatment sector will help ensure
is no different in needing professionals compliance with the guidance. The NTA will Director of Quality, NTA
In this issue
Dr Jenny Keen gives a powerful description of how the 2007 Clinical We provide brief views of the 2007 Clinical Guidelines from practitioners and
Guidelines reflects the advances in drug treatment since the 1999 Clinical service users on page 10.
Guidelines were written. Page 2.
On pages 11-15 we take you through the various NICE publications, including
We provide readers with a summary of the status of the 2007 Clinical Guidelines
their status under Standards for Better Health. For the two clinical guidelines
on page 3.
(psychosocial and detoxification) members of the guideline development groups
(Dr Nat Wright, page 12 and Dr Eilish Gilvarry, page 14) respond to
We have collated the key points from the 2007 Clinical Guidelines for a quick
issues raised by SMMGP members.
reference guide on page 4.
See the bulletin board for the Regional clinical guidance events being delivered
Dr Chris Ford takes us through her views of the 2007 Clinical Guidelines.
by the NTA and NICE. Page 16.
She concludes that the guidelines offer great potential for drug users to receive
humane and equitable services. Page 6.
The NICE implementation team have provided us with a summary of
handy tools that can be used to help us implement the recommendations from
Tom Neville discusses the 2007 Clinical Guidelines’ approach to injectable
the various NICE guidance documents. Page 16.
opioid treatment, and the effect this is likely to have on service users. Page 8.
We hope you enjoy this special edition.
Dr Stefan Janikiewicz believes that the 2007 Clinical Guidelines will
become the textbook for practitioners in the drugs field. Page 9.
Dr Kostas Agath highlights the importance of the 2007 Clinical Guidelines in
Don’t forget to become a free member and receive regular
clinical and policy updates - the newsletter can also be
light of the current policy and practice in the drug treatment field. Page 10. emailed to you – all for free www.smmgp.org.uk/membership
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