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GPs need better access to ‘patchy’ substance misuse services in Wales, report says

GPs need faster pathways to specialist services for those with addiction problems alongside additional training, a three-year plan from the Welsh government has concluded.

It comes after responses to a consultation earlier in the year raised concerns about people with substance misuse problems not feeling properly supported by their general practice.

A range of issues were flagged in the consultation, including patients with substance misuse problems feeling stigmatised when seeing their GP and a lack of joined-up care between general practice and other services.

But GP leaders said the problem was not GP training but availability of services which were currently ‘patchy at best’ with general practice left to plug the gap.

The updated delivery plan announced by Welsh Government comes with an extra £2.4m of funding for front-line substance misuse services, health minister Vaughan Gething announced.

Recommendations included more work on prevention and additional support for children and young people as well as a commitment to further improve access to treatment and cut waiting times for services. 

It also included plans to tackle dependence on prescription and over the counter medicines.

Mr Gething said: ‘There were a range of issues raised around the links with GPs, particularly around stigmatisation when attending a GP appointment, availability of training for GPs on substance misuse and also the need to ensure there are care pathways between primary care and substance misuse services.’

He added that respondents had also raised difficulties in accessing mental health services for individuals with a substance misuse problem.

The number of drug-related deaths rose last year in Wales from 185 in 2017 to 208 in 2018.

Hospital admissions for alcohol-specific conditions and illicit drugs places ‘significant pressure on the NHS’ with over 20,000 hospital admissions related to drugs and alcohol in 2017-18, the report said.

Dr Ian Harris, member of GPC Wales, said they welcomed the spotlight on substance misuse services.

‘The availability of substance misuse specialist services across Wales for GPs to refer into is patchy at best and that general practice rarely had access to funding to address the problems.

‘The issue is not primarily a lack of training for GPs, it’s a lack of a joined-up service. Whilst some areas in Wales have an open access service, some have limited services and in those areas, GPs are plugging the gap.’

But Dr Jim O’Toole from RCGP Wales said: ‘It is important that patients seeking support for substance misuse issues are comfortable attending a general practice, the College is keen to work with Welsh Government and the third sector to ensure this is the case.’