Improving NHS Alcohol Services in Tayside

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Implementing SIGN 74 in Tayside
Kirsty Licence, Consultant in Public Health
Medicine Susan Ross, General Manager, Primary
Care Services Nick Fuller, Alcohol Liaison
Practitioner
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SESP Process in Tayside
Implementing SIGN 74 in Tayside

• Long Road to Implementation
• First steps winning hearts and minds
• Alcohol clinical priority by local GPs
• Agree specification and fee
• Roll out including training local IT
• Success to date c3000 (BI) and service will be
  mainstreamed Apr 09
• Pilot BI delivered by Community Pharmacists

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Overview of Specification
Implementing SIGN 74 in Tayside

• Prepare staff at least one team member
• Opportunistically screen patients using FAST
• Develop a register of patient with VE fast
  screen
• Deliver BI on behaviours change
• Provide patient information on support services
• Refer to specialist services
• Use standardised health promotion material
• Record all related information using agreed read
  codes
• Participate in audit.

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theres more
Implementing SIGN 74 in Tayside

• Keep listening to practices
• Variances across practices why?
• Further develop training
• Change in culture how can we help?
• Reviewing specification
• Further develop Community Pharmacy model
• Getting the message across to patients

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Implementing SIGN 74 in Tayside
SIGN 74-screening and brief interventions for
alcohol problems
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Implementing SIGN 74 in Tayside
Clinical Perspective
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Implementing SIGN 74 in Tayside
Primary Care
SIGN 74-screening and brief interventions for
alcohol problems
Secondary Care
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Implementing SIGN 74 in Tayside
Barriers to developing services
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Implementing SIGN 74 in Tayside
Barriers to developing services

• Lack of interest/uptake
• Time available for training
• Resources
• Priorities, ill health/Dependence
• not my job staff attitudes
• Rural locations
• Nursing/Medical Barrier

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Implementing SIGN 74 in Tayside
Overcoming the barriers
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Implementing SIGN 74 in Tayside
Overcoming the barriers

• HEAT (H4) Targets
• Protected Learning Days/Training
• Staff Consultation
• Partnership Working led by Public Health
• Joint Solutions/Ownership/Flexibility
• Pilots
• Handbook/Documentation
• Pathways/Protocols

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Implementing SIGN 74 in Tayside
MIIU Pathway
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Implementing SIGN 74 in Tayside
Discussion the way forward?