RCGP-2014-poster-abstracts

• No patient had tried to obtain opiates whilst on CDT RPs.
Relevance: CDT drugs can be dangerous if co-­‐ingested with GP prescribed medications. This discusses the issue in
practice and steps to prevent error.
Outcomes: We updates notes, educated each other and devised a safe RP for these patients. In addition a number of
other factors like Hepatitis C status were uncovered.
Discussion: A limiting factor was knowing how to enter a repeat script which GPs did not want to printed. CDT co-­working
improved vastly.
P041
Hearing the voices of the IRIS service users
Clare Ronalds; Gillian Granville; Clare McCann; Catherine Cutt
Manchester IRIS Sevice; Gillian Granville Associates; Manchester Public Health; Manchester IRIS Service
IRIS, Identification and Referral to Improve Safety, is an evidenced-­‐based training and service for GP practices, to
improve the identification of patients experiencing domestic abuse and their onward referral to a linked specialist
service. The package includes communication skills training for GPs and practice nurses.
This in-­‐depth study aimed to capture the voice and experiences of patients who accessed the local IRIS service over
an eighteen-­‐month period from 2012 – 2014, by an independent researcher using a semi-­‐structured interview.
It reports the experience of 17 women from 14 practices, across 3 CCGs, who referred 169 patients to the IRIS
advocate educator during this time.
Analysis identified four key themes:
• Accessibility of IRIS service and GP context, disclosure process.
• Referral pathway, impact of IRIS referral.
• DVA costs the health service £1.7 billion annually, excluding mental health costs. It is associated with increased
depression, alcohol and drug misuse and is a key factor in safeguarding: 73% of Child Protection Plans in this city
cite domestic abuse.
• “If I had not been asked, I would not have told anyone and who knows what would have happened to me”.
The evidence demonstrates positive outcomes for women and children through improved mental health, increased
opportunities for training and employment and the ability to take control of their lives. This study contributes to
knowledge about DVA, the effectiveness of the IRIS service, and is of value to GPs, commissioners, Public Health,
community, and voluntary sector wishing to develop DVA services.
P042
Homeless Patient Pathway
Muninder Lotay; Amy Hewett
Sandwell and West Birmingham Trust; Trident Reach the Peoples Charity
HPP is a GP led multi-­‐organisational approach for patients experiencing homelessness admitted to hospital. Care of
these patients is complex, requiring understanding of chronic interrelated problems including mental, drug, alcohol
and social ill health.
The GP within a secondary care setting is best placed at anticipating health needs in the community and gaps in
holistic care on admission. Unaddressed health issues will often become unaddressed needs that will warrant further
admission.
HPP team includes a homeless housing charity and continues floating support and outreach care for 6 months after
discharge into sustainable housing. We work alongside the admitting host team to address multi-­‐morbidity and
predict long-­‐term health needs on discharge from hospital into the community.
A multimorbidity assessment tool consists of the use of AUDIT, HADS, BBV screen, TB IGRA, harm reduction and a
sound social assessment inclusive benefits, welfare and housing. Joined up care is mediated through weekly MDT
involving mental health, addictions, social services and primary care.
Typical presentations often fall outside social services remit or the one-­‐size fits all approach, and ‘simple’ admissions
neglect the more complex issues surrounding health and social care highlighting gaps in the care of our most
vulnerable.
34