Congratulations to two of our Substance Misuse Services teams - who are both finalists in a national awards
Our C&I and Whittington Health Respiratory Outreach Clinic is a finalist in the Innovation in Mental Health category of the Forward Healthcare Awards 202. It works with substance misuse clients, offering respiratory and physical health checks. The clinic has detected life-threatening conditions and supported clients to engage in treatment.
The BOWS service works in GP surgeries in both Camden and Islington and aims to help patients reduce and in some cases stop their use of opioids, benzodiazepines and other drugs. It assesses their needs and switches them to other medications where appropriate, adjusting dosage and monitoring outcomes on a weekly or fortnightly basis, where needed. It is a finalist in the Community or Primary Care Innovation category.
Liz McGrath, Clinical Director, SMS, said: “These services have both offered innovative and creative care that has been of enormous benefit to service users. I’d like to thank everyone involved – it is great that their work has been recognised. They deserve every success.”
The success of the C&I and Whittington Health Respiratory Outreach Clinic
Those attending substance misuse services are a hard-to-reach group, often suffering from health inequality with high rates of undiagnosed, or unmanaged, respiratory disease. Most substances in the UK are smoked and almost all substance misuse service users also smoke tobacco. This is a cause of high morbidity and mortality for people; it also creates high costs for health services as physical health problems associated with smoking are often diagnosed late due to individuals’ limited engagement with traditional medical services. Clients do, however, attend substance misuse services more readily to get prescriptions for opioid substitution therapy and engage with other service offerings.
The clinic capitalises on this attendance, and offers assessment, testing, education and advice by a respiratory physician on site at Better Lives. It aims to pick up on cases of smoking-related lung disease that would otherwise go undiagnosed, or present late and at an advanced stage. It also provides a respiratory "MOT,” alongside a brief intervention that may foster change in their use of smoked substances, with resulting impact on their physical and mental health.
The unique features of the BOWS service
Evidence collected by Public Health England (PHE) shows an increase in the use of over-the-counter codeine medicines as well as prescribed benzodiazepine use. It is also recognised by health professionals that opioid medications used to treat pain become less effective over time. Often, doses can be increased to high levels of opioid medication but usually this does not work and can create a dependency on opioid medications in the long run, particularly codeine-based ones (Ref 1). Also, the use of oxycodone and some illicit drugs has been used by patients accessing medications through the internet. BOWS was developed as an answer for patients with effective clinical treatment for these issues.
The vision for the service was developed around addressing this issue with expert, experienced non-medical prescribers delivering the service in primary care. The clinic helps service users reduce the use of these drugs, transferring them to other medication when possible.