SMMGP - Substance Misuse Management Good Practice

Substance Misuse Management Good Practice

Supporting good practice in drug and alcohol treatment

SMMGP News Archives - 2006

Please note that the older the news item the more likely it is that details such as contact names and addresses, or links to 3rd party web sites, may have changed.

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Home Office Letter on Personal Export Licenses

(Posted 27th November 2006)
The Home Office has issued the following letter to service providers on changes to the personal export licences for patients travelling in possession of controlled drugs that have been prescribed to them. A large proportion of those traveling in possession of such drugs are patients who have been prescribed them for the treatment of addiction. These changes take effect from 1 January 2007.

More information is available from the Home Office Drugs web site.

Personal Export Licences

The Home Office Drugs Branch is in the process of streamlining all its licensing activities, including the issue of licenses to those who may be travelling with controlled drugs. The overall aim is to deliver to the public a simplified procedure and reduce the current bureaucratic burden.

As you will be aware, travellers carrying prescribed controlled drugs are currently, in most circumstances, covered by the Home Office "open general licence" enabling them to carry such drugs without the need to be individually licensed by this office. In circumstances where they travel with amounts in excess of certain specified thresholds, an individual license is required. These thresholds vary dependent on the drug (for example, travellers can carry up to 500mg of methadone without requiring an individual license). Such licenses are issued solely to facilitate a traveller's passage through Customs when leaving and re-entering this country and have no validity abroad.

With effect from 1 January 2007, the ambit of the "open general licence" will be extended to allow patients to travel for periods of up to one month, irrespective of the amount of prescribed controlled drugs they may be carrying, without the need to be individually licensed. The current drug thresholds will no longer apply and individual licenses will only be required for those travelling for periods in excess of one month. In instances where this occurs, they will need to apply to this office for an individual license as at present.

As is currently the case, travellers, whether in possession of an individual licence or not, are advised to carry with them a doctor's letter confirming their prescribing regime and the drugs they are carrying and ensure that any drugs they may have are carried in their hand-luggage and in its original packaging. Travellers are also advised to contact the embassy or consulate of the country they will be visiting to ensure that there will be no objections to their entering that country in possession of their drugs.

Yours faithfully,
Mike Evans
Drugs Branch

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NTA/RCGP Prescribing Seminar Presentations Available

(Posted 20th November 2006)
The following documents are now available to download in the Conference Reports & Presentations section of the Resource Library...

NTA, RCGP & West Midlands Prescribing Seminar
7th November 2006

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Alcohol Harm Reduction Campaign Stakeholder Update 1

(Posted 9th October 2006)
The Department of Health and the Home Office will launch a joint media campaign in mid October as part of the national Alcohol Hard Reduction strategy. The aim of the campaign is to contribute to a long-term change in behaviour amongst key groups in relation to alcohol consumption. The priority audience for the campaign is 16-24 year old binge drinkers.

Here is the campaign briefing...

In mid-October, the Government will launch the next phase of the national Alcohol Harm Reduction Strategy.

In support of this, a hard-hitting advertising campaign will begin to target 16-24 year olds to prompt consideration of the risks associated with excessive drinking, particularly in relation to their own personal safety.

It is hoped that other 'at risk' groups will also benefit from a renewed focus on alcohol consumption including pre/pregnant women and those adults who may unknowingly be drinking at levels that could pose risks to their health.

Professionals working in health, criminal justice, local government, education, the voluntary sector and the drinks industry will be crucial to the success of the campaign, and constructive cross-sector partnerships will be essential.

Through regular communications,we will keep you updated so that you can prepare your activities and/or partnership work and pass information on to your colleagues regarding:

You may already be carrying out activities around alcohol or related issues. If so, it would be extremely helpful if you could consider incorporating the forthcoming campaign into your planning.

We're also keen to encourage and pass on best practice, so do let us know of any good projects you've been involved with that could serve as future case studies by e-mailing us at

We look forward to staying in touch and working with you to develop the campaign in the future.

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RCGP 12th National Conference Call For Papers

(Posted 21st September 2006)
RCGP Sex, Drugs & HIV Task Group

RCGP 12th National Conference
Management of Drug Users in Primary Care

Date: Thursday 19 April - Friday 20 April 2007
Venue: Hilton Birmingham Metropole at the National Exhibition Centre

Call for Papers, Posters & Films

You are invited to submit papers and posters based on any research or audit on the management of drug users in primary care, and/or films based on topics of wide ranging interest to the field (educational, clinical, service development, etc.) for presentation at our 2007 conference.

The conference is the largest event in the UK for GPs,shared care workers, drug users, nurses and other primary care staff, specialists, commissioners, and researchers interested in, and involved with, the management of drug uses in primary care.

600 delegates attended in 2006 and more are expected in Birmingham in 2007.

Instructions for Submissions

There are 3 options:

Your submission should be accompanied by a brief, outlining:

General information

Submissions must be sent, to be recieved by 16th February 2007, to:

Katie Belderson
Healthcare Events Limited
2 Acre Road
Surrey KT2 6EF
Fax: (020) 8547 2300

All submissions will be acknowledged. You will be informed whether your submissions have been accepted by 23rd March 2007.

Please see the Courses & Events page for more information about the conference as it becomes available.

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New Conference Presentations Available

(Posted 21st July 2006)
The following documents are now available to download in the Conference Reports & Presentations section of the Resource Library...

RCGP Methadone Prescribing Update Day, July 2006

RCGP Detox Day, June 2006

Please Note: This Detox Day event will be repeated on Thursday 18th January 2007 in York - contact Terri Myers for more details (Substance Misuse Unit, Frazer House, 32-38 Leman Street, London E1 8EW. Tel: 020 7173 6091, Fax: 020 7173 6089, E-mail:

Non-Medical Prescribing in Substance Misuse Conference
Held by the Association of Nurses in Substance Abuse (ANSA) in partnership with Substance Misuse Management Project (SMP)

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15th Edition of the "Network" Newsletter Available

(Posted 7th August 2006)
Issue 15 of "Network", the SMMGP Newsletter, is now available to read online or download in Adobe Acrobat PDF format from the Newsletters section in the Resource Library.

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New Appraisal & Supervision Documents Available

(Posted 21st July 2006)
The following documents are now available to download in the Conference Reports & Presentations section of the Resource Library...

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Library & Shared Care: New Resources Available

(Posted 17th July 2006)
The following documents are now available to download in the Resource Library...

Guidance Documents

Other Resources

The following document is available to download in the Shared Care section...

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Ongoing Shortfall in Availability of Diamorphine Injection

(Posted 9th July 2006)
An Alert from the NHS Purchasing & Supply Agency

The purpose of this Alert is to:

Temporary dip in supply

There are currently two suppliers of diamorphine injection to the UK market - Wockhardt and Novartis Vaccines (formerly Chiron Vaccines).

For the past year both suppliers have been manufacturing diamorphine injections for the UK market at their full available capacity. Even so there is a continuing shortfall against historic demand.

At the end of May 2006 Wockhardt temporarily ceased production of diamorphine injection to allow essential servicing of its freeze drying equipment. Although production has now successfully resumed this will result in the NHS experiencing a dip in supply of some strengths of diamorphine injection from mid-June to mid-July.

NHS PASA anticipates that overall the strengths most affected will be diamorphine injections 5mg and 100mg.

To compensate for this dip in Wockhardt's production Novartis Vaccines has brought forward the release of batches of diamorphine injections 10mg and 30mg. As a result the impact on these strengths will be considerably less than on the others.

Longer term supply forecast

Based on manufacturing capacity, PASA has previously forecast the UK supply position would remain unchanged for the year 2006 and currently see no reasons to alter this position.

PASA is aware though that suppliers are making considerable efforts to improve the availability of product. To achieve this they have to overcome two barriers:

As a result it is possible, though not guaranteed, the overall supply position might improve during 2007.

For the meantime it is therefore essential that doctors and other healthcare professionals maintain the prescribing and purchasing strategies established as a result of the DH guidance issued in December 2004.

Both the DH and NHS PASA are continuing to monitor the supply situation closely and are in regular contact with both companies and will provide further updates should further developments occur.

Howard Stokoe
Principal Pharmacist

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"Focus on Effective Shared Care Co-ordination" Docs Available

(Posted 29th May 2006)
Presentations and Workshop notes from the "Focus on Effective Shared Care Co-ordination" conference are now available to download in the Conference Reports & Presentations section of the Resource Library.

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RCGP 11th Conference Documents Available

(Posted 28th May 2006)
The Conference Handbook, Consensus Statement, Presentations, Workshop notes & handouts from the RCGP 11th National Conference are now all available to download in the Conference Reports & Presentations section of the Resource Library.

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Forums: New North East Regional Forum Now Open

(Posted 18th May 2006)
A brand new North East Regional Forum is now open in the Online Forums section. This forum is intended for the use of stakeholders in the development of primary care based treatment in the north east

Remember that all the online forums are completely free to use, and you can browse many of them without even having to register. For more information about what forums are available, please see the Descriptions of Current Forums page.

If you decide you'd like to take part in any of the forums by posting messages yourself, then all we ask is that you take a moment to register - you do not need to provide your name or address, just a valid e-mail address which we will use to confirm registration. This e-mail address will not appear anywhere on the forums themselves unless you specifically choose for this to happen, so you can remain totally anonymous if you wish.

Answers to the most frequently asked forum questions can be found in the Help with the Online Forums section.

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New Legislation on Nurse Prescribing

(Posted 17th May 2006)
Independent Nurse Prescribing

From 1 May 2006, the Nurse Prescribers' Extended Formulary was discontinued and qualified Nurse Independent Prescribers (formerly known as Extended Formulary Nurse Prescribers) are now able to prescribe any licensed medicine for any medical condition within their competence, including some Controlled Drugs.

Full details of this new legislation are available on the Department of Health web site, including Frequently Asked Questions (FAQs) about nurse prescribers, which medicines they can supply for which conditions, and what training is involved.

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14th Edition of the "Network" Newsletter Available

(Posted 7th May 2006)
Issue 14 of "Network", the SMMGP Newsletter, is now available to read online or download in Adobe Acrobat PDF format from the Newsletters section in the Resource Library.

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Practice Based Commissioning (PbC) Overview

(Posted 10th April 2006)
The following presentation is now available to download in the Other Resources section of the Resource Library...

Practice based commissioning - another tool for improving primary care substance misuse services.

Dr Linda Harris, Acting Director of the RCGP SMU calls for GP champions to work closely with new PCTs to ensure their patients get the most from their new found commissioning powers.

Practice based commissioning is being hailed as the "best vehicle for ensuring clinical leadership from primary care professionals in redesigning services" (ref. "Practice based commissioning: early wins and top tips", DH 2006). GPs are at various states of readiness to embrace their new found responsibilities as part of "shifting the balance" of power back toward primary care.

Many localities have been able to harness local enhanced services (LES) as a means of developing shared care and there is evidence of improvements in treatment effectiveness as measured by waiting and retention times and average methadone doses. Much of this is down to primary care service development, however, much more needs to be done to improve those areas yet to develop good shared care and to ensure improvements thus far are sustained especially as PCTs tackle the problems of financial deficits.

With the launch of practice based commissioning there is now a mechanism for PCTs to work in partnership with GPs to commission local substance misuse services that are "in touch" with the needs of their patients.

Sensing the speed at which changes are being introduced throughout local NHS Trusts many GPs with an interest in substance misuse are already seeking information as to how to take things forward, and understand the opportunities (and threats) practice based commissioning may offer local services.

In line with the objectives of both the SMU and SMMGP we want to hear from any GPs who are already using PbC as the vehicle to achieve improvements in their local shared care or community treatment services. This will be fed into a more detailed joint SMMGP/SMU Briefing on Practice Based Commissioning which we aim to publish later in the year.

In advance of this and for those seeking a quick summary guide, Dr Linda Harris has produced a presentation on PbC detailing policy context, emerging governance arrangements and how to make the most of partnerships with local PCTs ot take Pbc forward in your local area.

Dr Harris and SMMGP are keen to receive information on any emerging models of PbC to inform the briefing document and disseminate as part of sharing good practice. Please contact or

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RCGP Questionnaire - Apraisal & Supervision (Substance Misuse)

(Posted 17th March 2006)
Questionnaire on Appraisal and Supervision - Substance Misuse

The purpose of this questionnaire is to establish a picture of current practice regarding appraisal and supervision for General Practitioners involved in substance misuse work from generalist to intermediate level and beyond.

In an attempt to get a representative sample of locally active practitioners in the field who are aware of practice in their district we are inviting those clinicians who have leadership, strategic or educational roles in their localities to complete this questionnaire.

Who should complete this questionnaire?

The answers will be collated by Dr Susi Harris from Calderdale Drug Service and Christina McArthur from SMMGP and the results will inform the basis of a workshop presentation and discussion to be delivered at the forthcoming RCGP Conference on the Management of Substance Misuse in General Practice in April 2006. We would be very grateful if you could spare no more than 15 minutes to answer the questions, and return your answer as soon as possible, and no later than:

Friday March 24th 2006

The questionnaire can be downloaded below in Adobe Acrobat PDF format:

Further information can be obtained from:

Christina McArthur
Bolton, Salford & Trafford MHT
Bury New Road
M25 3BL
Tel: (0161) 772 3546

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RCGP Methadone Prescribing Update Presentations Available

(Posted 23rd February 2006)
The following presentations from the RCGP Methadone Prescribing Update Day, held in York in January 2006, are now available to download in the Conference Reports & Presentations section of the Resource Library...

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13th Edition of the "Network" Newsletter Available

(Posted 20th February 2006)
Issue 13 of "Network", the SMMGP Newsletter, is now available to read online or download in Adobe Acrobat PDF format from the Newsletters section in the Resource Library.

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Crushing Buprenorphine Guide Available

(Posted 15th February 2006)
The following item is now available to view online in the Other Resources section of the Resource Library...

It describes (with the aid of photographs) the procedure for crushing and administering supervised buprenorphine doses, as well as briefly discussing the pros, cons and legalities of doing so.

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Shared Care: Poppy Project Report

(Posted 15th February 2006)
The following document, concerning the Corby based Poppy Project, is now available to view online or download from the Shared Care section...

The Poppy Project has been an exciting development for one of the major health risks in the Corby area. It allows rapid access to treatment and encapsulates all the needs of a patient in one place. Additionally it has had the added bonus of demonstrating how the closer working of drug specialists and primary care can benefit the overall health of individuals and how better partnerships can help achieve a change in lives and a safer community for all.

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Web Site Welcomes its 100,000th Visitor!

(Posted 14th February 2006)
In Jan 2006 the SMMGP web site welcomed its 100,000th visitor.

The site grows constantly, adding new resources for GPs and others dealing with drug use in primary care. Our online Resource Library now contains over 200 free-to-use documents.

Nearly 500 people subscribe to the free e-mail Mailing List, 900 use the thriving Online Forums, and the site receives over 2,500 weekly visitors.

You can learn more about the web site and its current desing on the "About the SMMGP Web Site" page.

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DANOS Level 4 Project Information

(Posted 7th February 2006)
The following documents, concerning the DANOS Level 4 Project, are now available to view online or download from the Shared Care section...

Skills for Health is the Sector Skills Council for the whole of the health sector. On behalf of other sectors (eg criminal justice, education, social care) it takes the lead on developing and implementing the standards and qualifications for the drugs and alcohol field.

Drugs and Alcohol National Occupational Standards (DANOS) describe the standard of performance required of those working to tackle substance misuse, and the knowledge and skills they need. They cover service delivery, management and commissioning.

DANOS are widely used and recognised and candidates are beginning to register for the new Level 3 Health and Social Care Scottish and National Vocational Qualifications (S/NVQs) which contain the DANOS units. Skills for Health has been funded by the UK Coordinating Group of the Education Regulatory Bodies to investigate whether there is a need for Level 4 qualifications for advanced practitioners in the drugs and alcohol field and, if so, how such qualifications should be structured.

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Safer Management of Controlled Drugs - Early Action

(Posted 11th January 2006)
The following document, concerning new controlled drug regulation implementations and proposals from the Department of Health, is now available to view online or download from the Other Resources section of the Resource Library...

This document describes the action taken so far based on the government's December 2004 response to the Shipman Inquiry, as well as describing future steps. It also summarises the current Health Bill's clauses intended to strengthen the monitoring and inspection of controlled drugs in health and social care settings.

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SCANbites Newsletters Now Available in the Resource Library

(Posted 2nd January 2006)
The SMMGP are happy to announce the addition of SCANbites Newsletters to the Resource Library as part of joint working with SCAN (Specialist Clinical Addictions Network).

The Specialist Clinical Addiction Network (SCAN) is a national network for UK addiction specialists. At present this includes Consultant Psychiatrists, Specialists Registrars and Associate Specialists who work in the field of addiction. Staff grade doctors in addiction psychiatry may be registered as affiliate members. SCAN's main aims are to provide support and promote networking to enable specialists to maximise treatment effectiveness.

For more information, please see the "Who are SCAN?" section of the SCANbites Newsletters page.