“The whole is greater than the sum of its parts” Dr Mark Lawton Medical Lead Coventry Rachel Abbott Volunteer and Training Co-ordinator

Recovery Who? Formed from two existing charities working together for a single goal

THE CONTRACT  To provide a comprehensive range of integrated drug and alcohol services for adults across Coventry and Warwickshire, from 1 December 2011, to include:  Open access, advice and information  Harm reduction  Brief interventions  Treatment interventions  In-patient detox and access to rehab  Criminal justice services  Aftercare

KEY PRINCIPLES Recovery involves: Voluntary, sustained control of substance use Health and well being Participation in rights, roles and responsibilities Coordinated care Personalisation Service user voice Joint working and information sharing Integrated substance misuse services

PLAIN SAILING?

CHALLENGES We have had to overcome a number of challenges so far: Having to replace lost staff New ways of working Adapting policies Still more work to do Clear pathways and working relationships with other services (e.g. dual diagnosis with mental health services )

CLINICAL INPUT Substitute prescribing by both Doctors and Nurses and Specially trained NMP’s Addressing physical issues and illnesses Helping to address Mental illnesses BBV checks and Vaccination Screening

SUBSTITUTE PRESCRIBING Main Medical intervention Replaces street opiates with controlled prescribed opiates Allows a person to stabilise giving space to address the other issues in their lives Allows controlled detoxification (although not always necessary for this) Reduces Mortality in the population from times normal to some 4-8 times normal

NON-MEDICAL PRESCRIBERS (NMP’S) Senior nurses who have undergone additional training Offer community detoxification from opiates and alcohol Run community clinics Available in Coventry and Warwickshire

MEDICAL PRESCRIBERS Offer clinics both within the locality base and via Shared Care arrangements in General Practice Initiate medication and stabilise clients who may then move to the NMP clinic Maintain those client’s with more complex medical or Psychiatric issues within the locality. Offer alcohol clinics involving detoxification support for planned in-patient admission

WHY DO THIS? No one uses drugs to become an addict Significant numbers with mental illness (up to 80%) Massive social,educational, housing,financial issues It not only affects the individual –they are part of a family and society as a whole It is estimated that each £1 spent on treatment services saves £4 in other costs There but for the Grace of God go I

WHAT ELSE DO WE DO? None Clinical aspects of the service

Chaos Service User Service User Engagement (SUE) Recovery Champions Volunteers Those whose lives are currently affected by their substances and problematic use and not currently engaged in services Someone who makes the choice to engage in services and engages with various interventions and programs. Focused on meeting their own needs at this point. An opportunity for a service user who is engaged in services and made progress. May be involved with basic, information, unstructured assisting/supportive helping in conjunction with other SUE’s, RC’s, Volunteers and/or staff which forms part of their own recovery plan. Not volunteers but more formal and structured than SUE. Remit is to promote recovery, internally and externally. They are there to listen, identify, inform, discuss and support current service users in terms of their recovery. The focus is not on the RC’s needs but on the needs of the service user. Formal and structured with recruitment process and comprehensive training. Involved in all levels, including basic and essential duties, as well as being involved with respect to new ideas and projects. Volunteering can be the next step on from being a Recovery Champion.