PRIMIS supports substance misuse clinics

Barnsley 2004

Following the need for PCTs to start providing access to Shared Care Substance Misuse (SCSM) schemes for problematic drug abusers, the Barnsley PRIMIS facilitator team has been developing some specialised help for its practices.

While investigating new ways to improve the outcome for patients in this category through accurate data recording, PRIMIS Facilitator Barbara Heyes has worked closely with local clinicians - including a newly appointed Substance Misuse Practice Nurse, Simon Greasley.

One Barnsley practice, who is working towards becoming paperless, was keen to record patient data on a template (similar to templates used for the ongoing care of patients with chronic diseases) in order to provide the best care possible for its patients attending the SCSM clinic.

This template was seen as important, both to meet national reporting needs and to facilitate ongoing patient monitoring. However, while developing the template, it soon became apparent that the Read codes that were needed did not exist. Barbara approached the NHS Information Authority (NHS IA) to approve the addition of certain codes to the Read code list. Although liaising between the NHS IA and local clinicians became a painstaking process, finally 17 new substance misuse codes were added into the January 2005 Read code release.

These new codes include clinic management, monitoring drug methods and usage, detox codes and harm minimisation counselling codes. The benefits of recording patient data using these codes include being able to monitor patient attendance at clinics, ensuring proper recall systems are in place and monitoring defaulters, being able to identify patients deteriorating from snorting to intravenous drug use, and to monitor outcomes by recording increased or decreased drug usage and, where needed, recording leg Deep Vein Thrombosis as a result of intravenous drug use.

Barbara now plans to work with the practice to replace the temporary template which had the practice's own codes, free-text fields and a number of Read codes that were very general, with one based on the more specific new codes. Once this has been endorsed by the local SCSM Team, Barbara will roll it out to all practices running shared care clinics. As more practices run SCSM clinics and more prisons start using clinical systems, the potential benefits brought about by the work of the Barnsley team is far reaching. Barbara commented, "This work illustrates the need for a responsive coding system that can support changes and developments in primary care as they happen.

Since this case study was first produced, Barbara has joined PRIMIS as Learning Consultant at PRIMIS+ (in January 2006).