Lightbulb innovation: reaching out to substance misusers

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A one-stop shop drop-in and outreach service for clients who are substance misusers, set up by the NHS Wakefield District Community drug treatment team.

In Wakefield and the surrounding areas, a small team of specialist nurses is pursuing radical ways of improving the health of substance misusers. Concerned that clients were slipping through the net of primary care, the team now operates both a drop-in clinic and outreach service to engage with some of the most hard-to-reach people in society.

Establishing need

RCN member Sheila Hayward says: ‘We know that our clients have chaotic lives so expecting them to attend appointments is quite futile. We’ve adapted our service to suit the lifestyle of the people we treat so they can be seen whenever and wherever works best. If they don’t come to us, we seek them out instead. I have been known to give health advice in McDonalds and we hold regular vaccination sessions in a city centre bar.’


Although the service is now proactively offering a range of health interventions for drug users, it has grown from humble beginnings. Set up three years ago with just one nurse employed, the service was initially tasked with simply screening for blood born viruses. Since then the team has grown and additional services have been introduced in two local prisons.

Evaluating impact

All clients entering the service are given a full health screening and a range of care pathways have been developed to address key areas including dentistry, sexual health, nutrition and family planning. Among the most successful pathways are those addressing wound care and deep vein thrombosis. As drug users often inject into the groin, these conditions are commonplace among clients and need to be managed to avoid costly hospital admissions.

Building on success

Team leader Karen Jordan says: ‘Some of the clients we see have suffered with chronic leg ulcers for more than five years. They’re often treated in A&E to avert a crisis but then sent on their way with no after care plan. We intercept these people and educate them so repeat visits to hospital are avoided. It’s about empowering clients with knowledge and getting them to engage with health services. We’re now seeing real results.’

If you'd like to know more about this innovation, please contact Sheila Hayward, email: sheila.hayward@wdpct.nhs.uk.

NHS Wakefield District Community drug treatment team's work was runner-up of the inaugural RCN Frontline First Innovations award 2011.

 

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