The GPC has called for more local enhanced services to fund drug addiction treatment in GP practices as the BMA launched a lobbying campaign to raise doctors’ education levels on drug misuse.
A BMA board of science report warned that medical schools, which set their own curriculums, do not place enough emphasis on the drug misuse. It said medical students must graduate with core knowledge of the complexities involved, including an understanding that many drug addicts are marginalised in society and may also present with other medical and social issues.
The report said: ‘Although medical schools currently include some teaching and learning about drug use, this topic is often taught within psychiatry or public health, with the result that drug use is often seen by students as a specialised or peripheral subject, rather than the common pervasive problem that it is in reality. It is essential that medical schools and medical students are encouraged to place a greater emphasis on the care of those who use drugs.’
GPs have joined in on the call, with some arguing for drug misuse to be included in the QOF.
Dr Margaret Thomas, a GP in Berkshire, said: ‘Substance misusers have very poor health and get a Cinderella service which is fragmented and delivered by non-clinicians. If vaccinating and testing for blood-borne viruses and providing harm-reduction advice was in the GP contract quality and outcomes framework, along with brief motivational interventions, the situation may improve.’
However, GPC deputy chair Dr Richard Vautrey said: ‘This is a major problem and one that GPs will be very familiar with. I don’t think addressing this through QOF would be appropriate, although it should be noted that the points for annual medication reviews will be removed by DH in England as part of their imposition proposals.’
‘There are a variety of local enhanced service schemes to support practices working in this area, and that would be a sensible route to build upon.’
It comes as the RCGP, together with the Substance Misuse Management in General Practice (SMMGP) network of GPs, has issued a paper with advice aimed at GPs, CCGs and health and wellbeing boards for how they should best manage drug and alcohol misuse in primary care when clinical commissioning goes live from April – including a check list for ensuring that treatment of addicts is safe and clinically effective.
Dr Linda Harris, substance misuse medical director at the RCGP and co-author of the report, said: ‘The paper offers practical examples of how a practice or a shared care team can benchmark the quality of their systems, and thereby provide evidence to commissioners that they are working in a recovery focused way.’