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Infection fears raised for substance abusers

More than 100% rise in specialist drug treatment

OnMedica staff

Wednesday, 07 May 2008

Drug users are still too vulnerable to dangerous infections despite well performing drug treatment services, says a national report.

A report showing results from the second of three annual reviews to assess the performance of substance misuse treatment services in England found inconsistent practice across the country for testing for and treatment of hepatitis B and C.

The report, produced by the Healthcare Commission and the National Treatment Agency (NTA) for substance misuse, reviewed 149 “local drug partnerships” in England – which include representatives from PCTs, local authorities, the police and the probation service.

The two bodies found that the number of people receiving specialist drug treatment had more than doubled from 85,000 in 1998-99 to 195,400 in treatment during 2006-07, while estimates for 2007-8 show 210,800 people will receive treatment.

Overall, the review showed there had been considerable improvement in the commissioning and performance management of drug treatment services, resulting in more service users receiving better treatment.

However, there were significant deficits, particularly in the provision of vaccination for hepatitis B and testing and treatment for hepatitis C.

This is a particular concern, they say, because 90% of all hepatitis C diagnoses are associated with injecting drug use.

Local drug partnerships were asked 45 questions across 10 criteria, resulting in 34% of them gaining an overall score of “excellent”, 45% “good” and 21% “fair”.

Anna Walker, chief executive of the Healthcare Commission, said: “As the UK has one of the highest recorded drug-related death rates in Europe, it is a clear national priority to minimise the impact of substance misuse.

“It's very encouraging that thousands more people are now getting the treatment they need, and this review shows there is much to celebrate about the progress made.

“However, it is worrying that the majority of hepatitis C cases are associated with injecting drugs, yet we know access to testing and treatment for the disease is patchy across the country.

“Similarly, access to clean needles provided by out of hours exchanges varies considerably. These are the areas that need to improve if the health of those who inject drugs is to be tackled effectively, and drug-related deaths reduced.”

Paul Hayes, the chief executive of the NTA for substance misuse, said: “The review highlights inconsistent practice across the country in key areas of delivery such as testing for and treatment of hepatitis B and C.

“The NTA will be working with all partnerships to spread best practice more consistently and has agreed action plans for improvement with the poorest performing areas.”

Following the results of this review, work has been carried out by the Commission and the NTA with the 25 lowest performing partnerships. Action plans were developed to improve performance and good progress has already been made in implementing this.

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