Transcript Document

Addiction to Medicines:
Training and support for GPs,
pharmacists and other healthcare
professionals
Dr Ben Riley
Medical Director of Curriculum
Royal College of General Practitioners
Michelle Styles
Regional Manager, London
Centre for Pharmacy Postgraduate Education
Educational solutions for the NHS pharmacy workforce
About the Royal College of GPs
 Leading professional body
for general practice with
over 46,000 members
 Sets the training curriculum
and assessments and
recommends standards for
the licensing and
revalidation of GPs
 Policy development and
research in general practice
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The role of the GP in safer prescribing
 In the NHS, 90% of medical consultations take place in
general practice: over 300 million each year
 Each year in England, around 900 million items are
prescribed in primary care
 GPs write 98.5% of these prescriptions. An estimated
1.5% are written by nurses and other non-medical
prescribers (of which 0.6% are by dentists)
 Around 70-80% of prescriptions are issued on ’repeat’
Sources: The Information Centre, 2009 and Prescribing Support Unit, 2010
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The RCGP Curriculum
This means that as a GP you should:
1.1 Appreciate that drug and alcohol use is common the community and that harmful
use is often unrecognised and can take a range of forms
1.2 Recognise the special needs of patients with drug and alcohol problems, who
often have very difficult lives and are frequently marginalised by society
1.3 Ensure that patients with drug and alcohol problems have equal access to care in
your practice and are treated with compassion
1.5 Provide evidence-based screening, brief interventions and effective primary care
treatments for these patients, where appropriate ..../....
1.6 Make sure that repeat prescriptions are monitored for long-term prescribing of
addictive drugs and appropriate action taken if this is happening
1.7 Work in partnership with the wider primary healthcare team including
pharmacists, specialist services, the voluntary and criminal justice sectors
1.8 Recognise that older adults can have unrecognised alcohol or drug problems
www.rcgp.org.uk/curriculum
Incorporates Academy of Medical Royal Colleges core competencies
Educational solutions for the NHS pharmacy workforce
Future challenges for the NHS
 Ageing, multi-morbid
population
 Outdated organisation and
service boundaries
 Avoiding greater
fragmentation of care
 Diverging UK care systems
 Growing expectations of
access and quality
 Focus on process
measures/’tick-boxes’
 Growing financial pressures
 Increased demand
Educational solutions for the NHS pharmacy workforce
CPD &
Revalidation
Towards
Expert
System improvement
Multidisciplinary
team-working
From
Novice
Consultation skills
Concept based on Harden and Stamper, 1999 and Dreyfus and Dreyfus, 1986.
Training
Four-year Enhanced GP Training
Clinical
skills
Generalist
skills
Leadership
skills
People who
misuse
substances
Multi-morbidity
Quality
improvement
Mental health
Safer
prescribing
Multidisciplinary
working
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Plans to improve GP skills
 Submitting proposals for enhancing consulting and
prescribing skills of all new GPs through a new four-year
training programme (subject to Government approval)
 Introducing practical quality improvement training for all
senior GP trainees
 Developing educational tools and resources for the
continuing professional development of qualified GPs
• e-Learning
• Printed materials
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Existing resources
 Online Learning Environment:
www.elearning.rcgp.org.uk
 RCGP/SMAH blended courses
 Identification and Brief
Advice for Alcohol Misuse
 Management of Drug
Misuse (Harm Reduction)
 RCGP Certificate in the
Management of Drug Misuse
 SMMGP AtM GP workshops
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Addiction, misuse and dependency:
Focus on prescribed and
over-the-counter medicines
E-learning programme
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Background
 Joint project with the Centre for Pharmacy Postgraduate
Education (CPPE) and Royal College of General Practitioners
 Key focus is GPs and pharmacists but relevant to others
 Project lead by
- Dr Linda Harris, GP and clinical director, RCGP,
Substance Misuse and Associated Health
- Professor Christopher Cutts, Director, CPPE
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Centre for Pharmacy Postgraduate Education
- Funded by the NHS via SHA (LETB/HEE) for England
- Learning for the whole professional pharmacy workforce
in England
- Hosted by the University of Manchester
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CPPE Quality Assurance process
Design
and
content
definition
Content
development
External
review
Edit &
e-build
Pilot with
users
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Development team

Claire Barber, Pharmacist with interest in this substance use

Richard Cooper, Lecturer in public health and course director, University of Sheffield

Colin Fearns, Secure environment pharmacist

Ajay Birly, RCGP substance misuse and associated health unit

Jenny Keen, clinical director, Primary Care Addiction Service Sheffield

Ruth Fleming , Project officer, RCGP

Aileen Bryson, Practice and policy lead for Scotland, Royal Pharmaceutical Society

Simon Butterworth, Community pharmacist with an interest in the area

Cathy Stannard, Chair, British Pain Society

Kate Halliday, Policy and development manager, Substance Misuse Management in GP

Jo Clark, Local pharmacy tutor, CPPE
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External reviewers
 Steve Brinksman, GP, regional lead in substance misuse for
the West Midlands, RCGP, and clinical director of Substance
Misuse Management in General Practice
 Matthew Young, GP and London regional lead, RCGP
Substance Misuse and Associated Health unit
 Andrew Mawdsley, Clinical tutor and clinical pharmacist,
Central Manchester University Hospitals NHS Foundation Trust
 Graham Parsons, Pharmacist with special interest and
pharmacist prescriber (substance misuse), NHS Devon,
Plymouth and Torbay
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Learning objectives
 Define the term ‘addiction to medicines’ with respect to
prescribed and OTC medicines
 Interpret key data sources and reports which discuss the
public health problem with medicines addiction and misuse
 Identify key at-risk groups of people and patients who could
become dependent on medicines
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Learning objectives cont’d
 Differentiate between prevention and treatment aspects of
medicines addiction
 Recognise best practice in safe and effective prescribing
most likely to reduce the risks and harms from addictive
medicines
 Describe appropriate services, treatment interventions and
care pathways which can support people who have become
dependent on medicines
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Structure of the learning
Reflective questions
Background to the issue
Risk factors, identification and
assessment
Service, support, interventions and
recovery
Case studies
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Build in ‘Storyline’ software
 Great look, style and feel
 Compatible with PC, iPad,
iPhone and Android tablets
 Video stories, exploring
graphics
 Case studies to challenge
 Web links & references
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Development, hosting and delivery
 Currently at the e-build stage
 Hosted on CPPE (www.cppe.ac.uk) and RCGP website
 Happy to discuss hosting options with other
organisations
 Aiming for 1st April 2013 launch
 Email: [email protected]
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Completing the learning cycle
• What do I
need to
learn?
• How has it
changed
practice?
• How and
when will I
learn it?
Identifying
Planning
Evaluating
Acting
• Is this way
of learning
effective?
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Revalidation requirements for GPs
 General information about professional work
 Keeping up to date
- CPD activities
- Review of practice
- Quality improvement activity
- Significant events
 Feedback on professional practice
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