UHNM in national project to improve hospital care of reported opioid-dependence patients

A national project aimed at improving the hospital care and experience of patients who report opioid-dependence has been launched at University Hospitals of North Midlands NHS Trust (UHNM).

UHNM is one of just three hospital Trusts in the country taking part in the ‘improving Hospital Opioid Substitution Therapy’ (iHOST) project.

The project, funded by the National Institute for Health and Care Research (NIHR) and led by the London School of Hygiene & Tropical Medicine, collaborating hospitals and community and academic partners, seeks to improve access to opioid substitution therapy for those in need during the hospital admission process.

Erica Smith, Advanced Clinical Practitioner and UHNM project-lead said: “People who are dependent on drugs can have negative views about hospital treatment, often based on their own personal experiences. Hospital admission is often seen as a last resort, with people dependent on opioids often scared of experiencing withdrawal symptoms during their stay. They delay attending in the hope that their condition will improve without treatment, or self-discharge against medical advice.  
 
“OST is an intervention where patients are given small doses of opioids such as methadone whilst in hospital to alleviate symptoms of withdrawal and help improve stability. Hospital therapeutic doses of OST will not produce a euphoric effect on people dependent on opioids. Delaying or failing to offer OST can contribute to decreased patient tolerance, putting the patient at risk of emergency readmission or fatal overdose after discharge.

“Removing some of the barriers to OST and changing our current guidelines to help provide it in a timelier way, will prevent the need for patients reported as dependent on them to seek out illicit drugs, improve treatment compliance and reduce conflict with hospital staff, helping ensure some of the most vulnerable members of our community will now seek our help and remain in our care.

As part of the iHOST project, staff across UHNM are encouraged to access an eLearning training which provides core competencies in care for people who use drugs in acute hospital settings. An additional training component is available for staff who would like to become an iHOST champion, a crucial role in helping spread awareness of the project and promoting confidence among colleagues in developing therapeutic relationships with people who use drugs. 

Patient advocacy cards have also been produced along with a helpline set up for anyone with an opioid dependence including people receiving community OST and using opioids such as heroin, it is also accessible for staff.   
 
Steve Parkin, Research Fellow at the London School of Tropical Medicine said: “We’re delighted to partner with UHNM on this project, helping to deliver high-quality care to some of the most vulnerable people in the community. There’s an element of health inclusion built into this project, getting patients the healthcare they need regardless of their circumstances and dependence on opioids.

“As UHNM is located in a city with levels of deprivation, we wanted to get an understanding of how the project could work outside of London. UHNM has excellent links with the community drug service and showed high levels of interest and an appetite for change.”