FDS Insight Magazine Nov - Dec 2022

45 confirm community prescriptions. Delays to accessing prescriptions can increase the risk of someone discharging themselves early, worsening illness, and death. This is a group who already experience considerable health inequalities. Policies often directly or indirectly recommended treating people who use drugs with suspicion. This could reduce the willingness of people who use drugs to access healthcare. The researchers stress the need to challenge the stigma promoted by these policies. The researchers believe the Omitted and Delayed Medicines Tool did not reflect the danger patients face when they discharge themselves from hospital. The researchers say the low- risk rating for substitute drugs probably contributed to hospital policies that did not prioritise the management of opioid withdrawal. The researchers are not certain that all relevant policies were shared with them. Also, since the study did not examine practice, people may have received care that was better or worse than recommended in the policies. What’s next? Better local guidelines, informed by people with lived experience, are needed. They should improve the continuity between hospital and community care. For example, finding alternative ways to confirm prescriptions if community drug treatment services cannot be contacted. This study led to the Improving Hospital Opioid Substitution Therapy (iHOST) project. The iHOST project aims to improve care for people dependent on opioids. The barriers identified in this study are informing the development of a policy template that trusts will be able to adapt for local use. This template will be improved during the iHOST study before being shared with NHS trusts by Autumn 2024. Other iHOST resources include training materials for professionals, a helpline for people with opioid dependence, and a card patients can present to highlight their need for prompt access to substitute opioids. The programme will be trialed at University College London Hospital from November 2022, before expanding to Leeds and Staffordshire. The researchers also reviewed the Omitted and Delayed Medicines Tool, in collaboration with people with lived experience of opioid dependence, and with the Specialist Pharmacy Service that developed the tool. The tool was changed substantially as a result. This demonstrates that organisations are open to change, which could improve the care received by people who use drugs. Ultimately, however, this tool was discontinued and a new tool is being developed. National Institute for Health and Care Research (16/11/22)