Policy Update

Many of the people we support at YMCA Liverpool accommodation services are prescribed a number of medications including controlled medication such as methadone and subutex.

We have been working with prescribing services, local GP practices and pharmacies to enable and support residents living in our supported accommodation to have access to treatment that will stabilise their health and drug use. There are number of risks around people we support handling their own medication and we wanted to make sure that we keep everybody safe and healthy.

Consultation with local GP surgeries, prescribing services, pharmacies and other accommodation providers helped us to review how we manage medication coming into the building.

A further consultation with people supported and staff ensured we considered the practical issues that needed managing on a daily basis.

This involved looking at the impact upon individuals, the benefits and risks of our current process and a proposed change to that process.

Another local accommodation provider had already changed how medication and methadone was managed, and had experienced a significant reduction in incidents around misuse and handling.

Members of our leadership team visited this setting with key members of the support team, allowing them to observe the application of the procedure within the support setting

The system involved the delivery of methadone and controlled substances to the service daily, logging in and storing within a locked area that residents can access under observation of staff.

We were encouraged by the outcomes the service had experienced:

• No individuals falling out of script
• No stock piling or selling of substances within the hostel
• Significant reduction in risk of overdose and loss of life
• Individuals being able to access their methadone without needing to leave the hostel
• Reduced anti-social behaviour , no room break ins to access controlled substances

These are just a small number of the many successful outcomes they experienced.

Taking this information back to teams involved another review of potential risks with a new process. Through further consultation with staff and people supported, controls were agreed to minimise these concerns and for the past six months the revised process has been in operation at YMCA Liverpool.

A consultation was carried out with staff and residents in November last year to review how the process has been working, feedback from this was positive, here’s a sample of some of those comments:

• Easy to come and collect it, it makes sure I get it – if it didn’t get delivered I wouldn’t collect it myself from the pharmacy
• I have not withdrawn since I get it here, and cut down on my drug taking
• I’ve been on and off methadone for twenty years – never been able to maintain it – never manage to collect it from the chemist. This is definitely better for me and helping me to stay stable
• Has enabled me not to miss my script, staff are very helpful and respectful when observing me – they’re there if you want to engage with them, if you don’t that’s fine – they just see to the medication
• Having this procedure in place, I feel has reduced the amount of residents that have accidentally overdosed by taking someone else’s methadone. The complete reduction of illegal selling of methadone
• The implementation of this process has reduced if not stopped the sale of methadone within the hostel. The risk of illicit methadone being supplied to others has stopped because those who have methadone delivered are supervised by staff when having medication dispensed to them. OD risk has also been reduced because the process of recording when medication is dispensed to residents. Staff now know to a certain degree of what medication has been taken by residents, especially if there are concerns re an OD of meds and illicit drugs. The process has also helped with keeping residents in script which has helped in bringing a certain amount of stability to the hostel.