Over the past 18 months throughout the COVID-19 pandemic, our Primary Care Drug & Alcohol Support Service (P-RESET) has continued to offer support to Tower Hamlets residents suffering from substance misuse. We spoke to P-RESET Service Lead, Tariq Wooding to learn more.
The primary care drug and alcohol service (P-RESET) contract is held by GP Care Group and is commissioned by the Drug and Alcohol Action Team (DAAT) from the London borough of Tower Hamlets (LBTH). The P-RESET service coordinates substance misuse work in GP practices in the borough and operates in partnership with RESET Treatment and Recovery services for problem drug and alcohol use.
How patients used the service during the pandemic
P-RESET Service Lead, Tariq Wooding said: "During the start of the pandemic in March 2020, all routine general practice services were suspended, which meant that our P-RESET team had to work remotely. This change becomes key to maintaining the team's essential shared care opiate substitute treatment for vulnerable patients in Tower Hamlets.
The balance of risk of getting COVID-19 meant that many patients needed to change from daily dose pickups to fortnightly. Many service users valued the trust involved in the dose changes. The team is particularly grateful to local community pharmacies for maintaining supplies for opiate substitutes.
After the first COVID-19 wave declined in June last year, the team was able to re-design their health-based service to allow remote working where possible. This meant separating the face-to-face indicators from the health check and replacing lung function physical tests with a respiratory questionnaire.
Some clinicians gave positive feedback indicating that the questionnaire was more informative than the physical tests. Using the questionnaire to check patients' health gave the team the incentive to add other important features to the health check questionnaire, such as offering the flu jab.
The restructure also meant that most consultation for shared care patients remained remote. When the COVID-19 vaccine becomes available, the service's NDTMS (National Drug Treatment Monitoring System) patients were added to the vulnerable COVID-19 vaccination invitation list.
As alcohol is a risk for your health and wellbeing, it is vital that the service continues screening, especially because alcohol intake has increased during the pandemic. This encourages the service specialists to work with the whole GP Practice population to include screening (Audit C/Audit, advice, and if appropriate referral). The P-RESET service has tackled screening by getting practices to screen remotely using a text messaging service called 'AccuRx', which is supported by one of the GP Care Group's locality clinical leads and local GP. The messaging service has allowed practices to send alcohol questionnaires to patients and easily follow up appropriately with advice. This new service is one of the reasons why our alcohol screening figures have stayed consistent throughout the pandemic."
Under the P-RESET programme in GP practices, people in treatment at RESET for major problems with alcohol and drug dependency are offered a Primary Care Annual Health Check and Plan. P-RESET works with GP Practices to provide patient alcohol screening, identifying problems, giving brief advice, and referral if appropriate to RESET. P-RESET also works with practices delivering shared care in partnership with RESET Treatment for patients in treatment for problems with Heroin and similar drugs.
Statistics from the P-RESET service
The Team reported that as of 1 July 2021, 109 out of 913 (12%) have had their complete annual remote health check. This is a great achievement and encouraging that over 60% of patients have started their substance misuse health check in the last 12 months.
Women with drug and alcohol problems in Tower Hamlets are at particular risk of cervical cancer, so the team is grateful to practices and very pleased that there has been an increase in cytology screening from 66% last year to 78%. This comes in line with but is a better statistic than the borough's average.
PRESET's work fits in with a major independent review by Professor Dame Carol Black into the misuse of illegal drugs in England. You can read the review here
Our 35 Tower Hamlets General Practices care about the health and wellbeing of their patients with drug and alcohol problems. Throughout the pandemic and beyond the service will continue to work with our practices and RESET developing pathways, offering training, and improving awareness to further support our patients.