Calderdale PCT NO Freedom of Information Act 2000 I am writing in respect of your recent enquiry for information held by NHS Calderdale under the provisions of the Freedom of Information Act 2000. You asked for the information relating to the patients who are dependent upon prescribed only benzodiazepine and z drug tranquillisers and sleeping tablets. In response to your request, please find details below. Please can you tell me what services your PCT/CCG provides for patients who are dependent upon prescribed only benzodiazepine and z drug tranquillisers and sleeping tablets and who do not abuse these or other substances. Would you please include details of the availability of withdrawal advice and support including: 1. Conversion to a longer-acting benzodiazepine like diazepam. 2. Provision of withdrawal schedules. 3. Knowledge of the Ashton manual. 4. Provision of appropriate psychological support. 5. Provision of a help-line. 6. Any details of such referral processes. We do not commission a benzodiazepine/tranquilliser service as such. The substance misuse service will manage people with this type of addiction if they are also addicted to street drugs but do not take referrals for this type of addiction only. The Medicines Management Team have run initiatives (benzodiazepine reduction clinics) with some GP practices to inform and encourage good management and to help patients withdraw from benzodiazepines. But day to day management will be down to the individual GP. Chair: Angela Monaghan Chief Executive: Mike Potts Clinical Commissioning Executive Chair: Dr Alan Brook There is no current guidance in place to support practices with benzodiazepine reduction but practices would be signposted to suitable UK guidelines and information sources as required. Yours sincerely Anna Lewandowska Information Governance Officer Camden PCT PARTIAL – patients have access to the Minor Tranquilliser Project at Camden MIND managed by Melanie Davis which has over 20 years experience but this is only through part-funding of an outside/voluntary/charitable organisation, insufficient compared with the magnitude of the problem and not an in-house service provided by the NHS. Central and Eastern Cheshire PCT NO Also see Wirral. This is substance misuse treatment and anyone who refers patients to “Talk to Frank” (misuse helpline) as a specialist helpline as the author of this response has done, does not understand ITA treatment.
FREEDOM OF INFORMATION ACT REQUEST Please find detailed below Central & Eastern Cheshire PCT’s response to your FOI request. You asked: Please can you tell me what services your PCT/CCG provides for patients who are dependent upon prescribed only benzodiazepine and z drug tranquillisers and sleeping tablets and who do not abuse these or other substances. The Drugs and Alcohol Team (DAT) commission a Health Trust to provide a substance misuse service and Shared Care scheme to dependent drug users which meets the need for identified-referred patients who are drug dependent. The DAT also commissions inpatient detoxification provision.There is a number of patients who are abusing prescription medicine but who are not in the drug treatment service or working outside of the Shared Care scheme. Wider services to provide support include IAPT services, reablement and pain management services. General Practice is encouraged and supported to prescribe hypnotics in line with NICE guidance. From time to time, practices will review patients prescribed hypnotics for longer than the recommended 2-4 weeks and offer encouragement to reduce the use of hypnotics. This will include advice on good sleep hygiene and a programme of conversion to diazepam and reduction in dose if needed, together with the option of referral into more specialist services. Overall, the PCT prescribing of hypnotics is below the national average.Would you please include details of the availability of withdrawal advice and support including: 1. Conversion to a longer-acting benzodiazepine like diazepam. All contracts with commissioned providers stipulate the need to meet the aim to provide a range of interventions for individuals with drug misuse problems in line with the national 2007 Drug Misuse and Dependence UK Guidelines on Clinical Management and NICE 2007 Drug Misuse guidance. 2. Provision of withdrawal schedules. As above - policies are held by commissioned providers on withdrawal schedules and conversion of prescription where assessment indicates in line with national guidance. 3. Knowledge of the Ashton manual. There is knowledge of the Ashton manual but we do not refer to this in contracts as it is not in the above national guidance. 4. Provision of appropriate psychological support. As above - in line with national guidance and stipulated in contracts. Psychological support available through drug services, mental health services and wellbeing activities. 5. Provision of a help-line. No specific local help line for prescribed benzodiazepine, z drug tranquillisers or sleeping tablets only. Talk to Frank website available nationally. 6. Any details of such referral processes. Referral pathway to the drug service from all universal and specialist services. In my experience the Drugs and Alcohol Teams routinely do not treat involuntary tranquilliser addiction but only illicit addiction. – Cheshire DAT have included in the 2012-13 Direction of Travel Strategy focus to this area of work. Some DATs do treat tranquilliser addiction and we realise we need to address this locally in line with the National Drug Strategy and emerging health pictures. We are aware that prescription medicine (POM) and Over the Counter (OTC) medicine can bring comfort to many people suffering from a wide range of ailments and the overall