NHS APA exists to develop the collaboration between service users, carers and organisations, enabling services to provide the best quality care. As part of this, we want to share inspiring stories of great practice. NHS APA Member Avon and Wiltshire Mental Health Partnership Trust’s (AWP) recent innovative partnership work to ensure the safe delivery of Opioid Substitution Therapy (OST) to service users who are self isolating during the COVID-19 pandemic is a remarkable example of this.
Jon Shorrock, Area Service Manager for AWP, has displayed remarkable insight and creativity to work in partnership with Will Haydock (Senior Health Programme Advisor at Public Health Dorset), Dorset Council, third sector drug and alcohol services provider EDP, Dorset Council’s Highways Team, non-medical prescribers and administrators at AWP, and local pharmacies, to build in the space of two weeks an impressive system that ensures the safe delivery of OST to service users.
Jon wanted to find a way to protect vulnerable service users and reduce the amount of contact they had with other people, reducing their chances of catching the virus and transmitting it to other people. As Jon explained: “we’re responding to the human need here for OST and we’ve always got our service users first and foremost in our minds”.
“We’ve seen service users in tears on doorsteps because they’ve been so relieved that their OST has been delivered.”
While some service users are able to collect their prescription themselves, others who are self isolating and social distancing, and who have no nominated family member or friend available to collect on their behalf would not be able to access their OST. Working in partnership, Jon designed a courier scheme which utilises members of the local authority’s Highways team to safely collect service users’ prescriptions, take them to the pharmacy, and then deliver OST to service users across Dorset.
How was the programme created?
Jon approached a number of commissioners, including Will Haydock, as he felt that there might be some capacity within the council to help with the safe delivery of OST as certain functions within the council were no longer in use due to COVID-19. Will Haydock saw the potential risk to service users and approached the Community Resilience Group within Dorset Council to request resource for the programme. Jon explained that “in Will Haydock you have a commissioner who works collaboratively and is extremely willing to try and help problem solve, doing what he can through the influences he has”. Will explained how the speed of the response from the council was quite remarkable: “the response came back quite quickly, within a day, that there were some staff who were available and able to deliver”.
Eight drivers from the Highways team swiftly completed a full induction and training programme delivered by AWP with support from EDP. The drivers were then ready to begin delivering and have been operational, managed by a team at EDP, for just over a week. The local pharmacies have also played a significant role in the successful running of the programme, displaying incredible willingness to accommodate the scheme and grant the delivery drivers priority access into pharmacies to prevent them waiting in queues to get prescriptions. The programme would also not be possible without the work of the AWP’s non-medical prescribers and administrators, alongside the locality managers.
What were the key considerations when designing the programme?
Safety has been the priority throughout development of the programme. Two standard operating procedures were developed as part of the programme: one is for drivers using a work mobile phone, and the second is for drivers who are using their personal mobile phone. Deliveries take place through ‘a barrier of care’ method to ensure the safety of the drivers and the service users. As Jon explained, “we said to the drivers: ‘if you don’t feel comfortable going to a place, don’t go, we will make arrangements. Everything is about protecting the service users and the delivery drivers”.
What has the response been like?
Michelle, an Independent Non-Medical Prescriber at AWP has described the service as “a Godsend!”
“Charlie [McCaig, Services Team Leader at Reach Drug and Alcohol Services, delivered by EDP, in charge of organising deliveries] is coordinating this flawlessly!”
Charlie commented: “I'm so proud of the effort and determination of the Reach staff and the Dorset Council drivers in their effort and resilience it has been inspirational and a perfect example on how two teams with contrasting backgrounds can work to well together to get such important work done. I can personally endorse all the work that the Reach team complete behind the scenes to prepare the drivers daily tasks and the can do attitude of a great bunch of drivers.”
Jon also described how “we’ve seen service users in tears on doorsteps because they’ve been so relieved that their OST has been delivered.”
“It really has been a genuinely fantastic experience, from start to finish, in terms of the willingness, in terms of the partnership working, in terms of some of the logistical management, the service user outcome, and the human impact that it’s had. It has been, for me, a really wonderful experience. To share it and to think that other people could benefit from it, is equally wonderful as well. If it helps and it gets OST to people, and it keeps that curve flat, then that’s essential”.