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LT 2 - Health Protection

Enhancement and Novel Psychoactive Substances: Breaking Bad or Making Good?

Presenter: Colin Tyrie, Manchester Mental Health & Social Care NHS Trust

Other author(s): None

Abstract Text: Over the past few years the illicit and 'loophole' drug markets have shifted and diversified as people have become more discerning in their choice of access to on-line pharmacy, 'The Dark Web', and loopholes in on-line sites making 'research chemicals' available at the click of a mouse and a simple bank transfer. Drug services, laws and knowledge have struggled to keep up to date and arguably, are now not fit for purpose. In the abscence of any evidence or available research, and in the deluge of media misinformation and moral panics, I set out to find out who are the new market groups using these drugs and why they use them when there is so little known about the long term effects. My presentation will focus on information accumulated from performance and image enhancing drug users, Chem-sex parties, where HIV+ men are injecting M-Cat and 'bare-backing', and the 'drug geeks' who are injecting research chemicals and writing their detailed experiences on drug forums. Terms like 'slamming', 'rigs', 'bumps', 'bubble' and 'Spice' are now the language of these growing numbers of drug users who attend the needle exchange services at a time when funding for drugs harm reduction is at an all time low. Is it time that needle exchanges were returned to public health and not left in the closet of drug services or willing community pharmacies? I will argue that for the first time we have an opportunity to observe the effectiveness of needle exchange provision at the earliest point of injecting drug behaviour, and in many cases before it has commenced. I will present case studies to suggest we have little time to procrastinate.

A System for Quantifying the Burden of Alcohol-Attributable Harm at a Local Level and its use in the Licensing Process in Tameside

Presenter: Matthew Birchall, Tameside metropolitan Borough Council

Other author(s): David Boulger

Introduction

There is evidence of a link between the density of licensed premises and alcohol-related harm in the surrounding environment.

However, the role of Public Health as a Responsible Authority within the Licensing Act has been limited in the absence of Public Health as a 5th licensing objective.

Aim

To produce a toolkit and composite indicator set to measure alcohol related harm by Lower Super output Area (LSOA), to assess new license applications using the toolkit, and to make representations against new license applications in high harm areas.

Design

Five indicators of alcohol-related harm were chosen representing:

  • Crime,
  • Anti-social behaviour,
  • Domestic Abuse
  • Alcohol-related A&E attendances
  • Alcohol-attributable hospital admissions.

Values for each indicator were calculated for all 141 Lower Super Output Areas (LSOA) in Tameside, normalized to z-scores and weighted.

The resultant composite z-score was mapped across LSOAs using ArcMap:

A linked dashboard was developed to enable staff to quickly identify the levels of harm in an LSOA by postcode:

This is used to screen every new license application, to identify those in high harm areas, and to support the development of full representations to licensing committee.

Results/Conclusion

The system has been used to identify areas with significant levels of alcohol related harm and to successfully support representations against new licenses within such areas.

Local initiatives addressing health inequalities as part of the CQUINs Scheme

Presenter: Eleanor Ennis, Cheshire & Merseyside Sub Regional Team, PHE

Other author(s): none

Abstract Text: Commissioning for Quality and Innovation (CQUINs) has become an integral part of the NHS standard contract. It incentivises health care providers to focus on quality and efficiency. In Cheshire, Warrington and Wirral, a local CQUINs framework was developed to address health inequality issues across all Section 7a services. The Wirral Diabetic Eye Screening Programme embraced this initiative and worked in partnership with the PHE Screening and Immunisation Team. The programme addressed some of their local health inequality challenges to deliver innovative and targeted work to defined population groups.

Specific work included:Auditing the accessibility of screening venues for disabled service users and updating appointment literature to highlight venues with step free access. Better collection of patient health inequalities data at screening appointments to identify prevalence of sub population groups e.g. BME groups. Targeted work will be implemented in accordance with need.Providing a One Stop Shop eye screening clinic at a GP surgery in an area of high deprivation. Invitations were targeted to those patients who had not attended previous screening appointments for at least 2 years. The One Stop Shop also aimed to provide any outstanding foot checks and immunisations for attendees.

Evaluation:The One Stop Shop has been evaluated. We continue to assess the effectiveness of the updated patient information literature and data monitoring of population sub group to ensure equity of access. The most recent results will be included.

Are the reasons for non-uptake of the MMR vaccine being documented in an inner city GP practice?

Presenters: Julia Miah, University of Manchester

Other author(s): Dr Helen Barrett

Abstract Text:

Introduction: The MMR vaccine is an important immunisation for children, protecting against the childhood diseases of measles, mumps and rubella. With the high profile breakouts of measles in Swansea and other parts of Wales, it is important to adhere to the 95% uptake of the vaccine as recommended by the WHO.

Guidance: Along with the guidance about 95% uptakes, NICE also recommends noting down the reasons for non-vaccination, with such individuals being advised to catch up on missed immunisations. This audit aimed to find out whether the reasons for non-immunisation are being documented, in a multicultural inner city practice.

Methods: The cohort of patients used was an EMIS search of the patients at the practice that had not been immunised with MMR. The sample used 20% of the cohort (33). They were selected systematically with every 5th patient in the patient list being selected for the study.

Results: Two patients had their reasons for immunisation documented. Six identified themselves as being English or British. The rest were a mix of south Asian and African ethnicities. The children were aged from 1 year, 7 months to 18 years.

Recommendations: Our recommendations for this practice are to document, in every case, the reasons for non-uptake of the MMR vaccine. The practice should also offer, by post, telephone or at an opportunistic consultation, the MMR vaccine to all individuals who had not received it. These recommendations should be met by June 2015.