SMMGP - Substance Misuse Management Good Practice

Substance Misuse Management Good Practice

Supporting good practice in drug and alcohol treatment

Post-its from Practice:
People above policies (Feb 2012)

I was pleased to be invited but very sorry to go to the leaving party of our locality manager Teresa. She had come into the area when the local specialist service was in disarray, was mainly staffed by agency staff and had a poor reputation with people who needed treatment and with local GPs.

Over the next year or so this slowly changed. The staff morale improved with increasing permanent staff, the medical lead was good and the atmosphere in the service became one of "how can I help you" rather than "what do you want". Teresa was kind, effective and supported staff. She was also able to look outwards and form good partnership working.

There had also been many improvements in the area in the preceding years, with commissioners and DAAT managers who understood drug treatment and avoided the destruction of re-tendering, instead supporting services to improve. They also "understood" and valued primary care drug treatment.

The area partnerships have been and continue to be, strengthened by monthly "Shared Care Quality Group" when the managers of all services, including me and the Primary Care Shared Care Manager, come together to discuss quality and joint working. This meeting helps us learn and improves moving people who need treatment to the most appropriate service.

With a joint philosophy of care in an area and people like these on the job, it breeds respect for each other, which filters through to users of the services. People presenting are not seen as "bad", but as individual people with complex needs who are asking for help.

During all the years I have done this job, it's been all about people not policies for me. We need guidelines and policies but more importantly we need people with humanity who care; we need open minded Teresa's rather than "Ms Buttoned Up". Even more so at this time when all the talk is about changing policies, it is easy to forget that the more important issue in drug treatment is care and supporting people to be who they want to be and get where they want to get to. And we can be the facilitators or the inhibitors of people's journeys.

I thanked my lucky stars that I work where I do, when after an hour of phone calls I still hadn't been able to get help for a patient who has moved to South London. Almost every conversation started with "no", or "we can't do that, it's not in our policy". I will continue to try, somewhat saddened by the knowledge that those staff can't possibly be getting job satisfaction.

I miss Teresa who was an important cog in the local relatively healthy local drug treatment system. We are fortunate because things look good with her replacement. I'm an optimist, but I'm aware we face changing times ahead with an emphasis on policies, with cost being more important than quality, and where staff and the people who need treatment are often treated poorly. Care for staff so we can care for others.

- Dr Chris Ford
GP Lonsdale Medical Centre, Clinical Director for IDHDP, and a Member of the Board of SMMGP