Brief insight three: NHS Dumfries & Galloway: Long acting injectable Buprenorphine service development
Background
NHS Dumfries & Galloway covers a substantially rural area 110 miles wide, and holds two main hubs with 55 Specialist Drug and Alcohol Service (SDAS) staff members in multidisciplinary teams. Introduction of long-acting injectable buprenorphine was identified as a pilot service development to improve people’s choices of treatment.
Impact
Since the launch of their pilot in December 2020, continuous growth and investment has enabled the service to expand their offering. Increased funding has expanded their capacity of patients they can treat with buprenorphine from 30 to 200 people. The service now supports 210 on buprenorphine with numbers increasing weekly. In line with MAT Standard 2, buprenorphine is offered as a first line treatment for new assessments if suitable.
Increasing the medication options available to people to include buprenorphine has had considerable impact on service users. They are given more choice in treatment and enabled to make informed decisions. The impact of this service development is evaluated using the WHO’s Quality of Life (QOL) Index.
There is no one size fits all approach in the service. Giving people a choice of treatment and connecting them to support options has led to feedback such as:
“No more feelings of being ashamed.”
“Opportunity to work.”
“Family trust back.”
Learning
The service has valued building multidisciplinary teams; including roles such as support workers and clinical psychiatrist alongside nurses, GPs, pharmacy technicians and pharmacists. Investing in staff training can help people make informed choices as it enables staff to provide clear and up to date information.
A significant barrier to implementation was the organisation and costs of the Home Office licence to store buprenorphine. Stock wastage is also a challenge due to the variability of client need. Open communication with service users has improved trust and relationships. The team reported that people understand the costs in running this service and appreciate being invested in.
Top Tips
- Importance of evaluation to demonstrate impact – LAIB pilot became an integral part of service.
- Capture data and learn from it – this was vital to secure further funding.
- Adapt and innovate the service as numbers grow.
- Work in partnership with community pharmacy and general practice.
Next Steps
The service plans to continue adapting their service to expand their drop-in care offering and broaden roll out to Primary Care.