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All Wales Review of Substance Misuse Prescribing Services



Healthcare Inspectorate Wales (HIW) has today published its report following the all Wales review of substance misuse prescribing services conducted during 2008.
 

Healthcare Inspectorate Wales (HIW) has been commissioned by the Welsh Assembly Government Minister for Social Justice and Local Government to develop and implement a programme of thematic reviews of substance misuse treatment services.  The purpose is to assess the progress made on delivering the national agenda by examining the adequacy and quality of services provided across Wales, identify good practice and make recommendations for future improvement.
 
This first review has focused on the commissioning and provision of substitute drugs such as methadone which is used to help manage and reduce the use of illegal opiate drugs such as heroin.  The review has also established an overview of substance misuse services across Wales and a baseline of provision which will be used to inform future reviews.
 
While recognising significant advances in the availability of treatment and support and in the numbers of people accessing services, HIW found there was still variation in the availability of services locally.   While waiting times for treatment are generally falling across Wales, waiting times were found to be a significant barrier to accessing services in some areas.
 
Services themselves were generally of a high standard, although this too varied.  Some service premises were however found to be inadequate.  Access to other services such as mental health support for substance misusers was also found to be inadequate in many areas.
 
The report also identified variations in how well services were planned and commissioned, some areas being far more advanced than others in developing treatment systems to address local need.  In some areas it was found that treatment systems were not effectively planned, activity was not monitored and there was little strategic oversight. 
 
The report contains thirty four recommendations aimed at improving the quality of both treatment provision and the systems set in place to plan and commission treatment systems, these emphasise the need to:
 
  • Improve strategic management of the delivery of the substance misuse agenda at the local level; 
  • Improve commissioning and planning processes in order to push up quality and ensure availability of services at a local level; 
  • Improve waiting times and access to services and develop a treatment system with identified care pathways at a local level; 
  • Ensure the implementation of a number of Welsh Assembly Government policy initiatives. These include access to services for those with co-existing substance misuse and mental health problems and the use of an integrated assessment tool; 
  • Improve arrangements for the safeguarding of children and vulnerable adults and the local dissemination of learning from reviews into drug related deaths.
 
The Minister for Health & Social Services and the Minister for Social Justice and Local Government, Dr Brian Gibbons, welcomed the contribution the report will make to improving services across Wales. 
 
Dr Gibbons said:
 
“Since 2003 the Assembly Government has increased significantly the amount of resources available for substance misuse services.  There has been a huge expansion in services and our partners across Wales have worked hard to respond to improve the quality of services.    
 
This report is the first full stocktake of substance misuse services in Wales. It provides us with a platform to build on the considerable progress made in recent years. 
 
Our new ten year strategy to tackle substance misuse outlines the areas that we want to focus upon and this report will help us and our partners to target energies and resources effectively towards securing even greater improvements“.
 
Peter Higson, Chief Executive of HIW, said:
 
“Substance Misuse affects not only those who misuse substances, but also their families and friends.  It can result in increased crime, poor educational achievement and anti-social behaviour. Hence the effects on society in general can be far reaching. 
 
This review is the first of a series of reviews that HIW will be undertaking to look at substance misuse services and focused on the commissioning and provision of substitute drugs such as methadone which is used to help manage and reduce the use of illegal opiate drugs such as heroin. 
 
The review has also established an overview of substance misuse services across Wales which will form a baseline to inform future reviews”.
 

Source: Healthcare Inspectorate Wales (HIW)