Background: Methadone is a synthetic, narcotic analgesic used in the treatment of drug misuse. Tragedies involving children being poisoned by the accidental ingestion of methadone are no longer a rare occurrence. Following an audit of the effectiveness of the provision and recall of information to patients attending an NHS Methadone Clinic a protocol was introduced to ensure that staff documented the provision of such information and patients gave a written confirmation that they had received the information.

This article considers the results of a retrospective study comparing pregnancy rates in one Drug Testing and Treatment Order (DTTO) service in the United Kingdom with pregnancy rates in a generic substance misuse service and national conception rates. Conception rates were found to be six times higher in the coerced drug treatment group compared to the general population and generic drug services over the same period. These higher pregnancy rates may possibly be accounted for by an interplay of several factors including improved physical health, improvements in menstrual cycle regularity, better social interactions or intrinsic nature of the treatment regime in the clinics. The results of the study have implications for the criminal justice, health and other services involved in the care of these patients.

Background:The discharge letter is the principal means of communication between the inpatient and the primary care physicians in the UK health care system. Good-quality correspondence between specialist services and general practitioners (GPs) is fundamental to patient care and makes transition from secondary to primary care as smooth as possible for patientsAim:The aim of this study was to assess and improve the quality of discharge communication from the specialist substance misuse inpatient unit to general practitionersMethod:This study was carried out in North Staffordshire Combined Healthcare NHS Trust in July 2013, UK. Fifty three Patients who were admitted to the inpatient unit between March & May 2013 were randomly selected from the Health Informatics Service. A proforma was designed based on approved mental health discharge summary headings from the Royal College of Psychiatrists UK and the results were compared against a previous audit done in 2012 which only looked into some of the component included in the present studyResults:The study showed that most components of GP details, Patient Demographics, Admission Details, Clinical Details and discharge recommendations were well documented in the discharge letters analysed. The sub components where documentation were not adequate included Gender (0% documented), discharge destination (34% documented), mental capacity (1% documented), allergies (0% documented), Risk assessment (68% documented). However the findings were significant better than the previous audit in most areas.Conclusion:This re-audit revealed that the quality and standards achieved for most aspects of discharge summaries were high. However not all aspects met the standards, some very important aspects including risk assessment, drug allergy, details of care coordinator and discharge destinations recordings were poor. There may be reasons for failure to meet the standards; Gender was never recorded in the discharge letters but one could easily assume the gender of the patients from the narrative of the discharge letters. It was noted that discharge destinations were more likely to be recorded if patients were not discharged home. Mental Capacity was not recorded in 98% of cases, as most admissions to the Inpatient unit are planned and patients come on a voluntary basis and have capacity regarding the admission and treatment

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AimsTo explore and monitor experience of hospital care provided to patients of Stoke Community Drug and Alcohol Services (CDAS) and Edward Myers Unit (EMU; detox inpatient based unit).MethodThe sample was collected from patients who attended face-face clinics at CDAS and patients living in Stoke-On-Trent who were admitted to the Edward Myers Unit. The survey pertains to four locations, which include Royal Stoke Hospital, A + E, Harplands Hospital (Mental Health Unit), and EMU.We collected data of over two months from September–November 2020. The cohort of patients from CDAS included new presentations or restart Opioid Substitution Treatment (OST) clinics and people known to the alcohol team at CDAS.We delivered a survey pertaining to experience of hospital care in the last 12 months. This includes treatment at A&E Royal Stoke Hopital, any of the wards at Royal Stoke Hospital, Harplands Hospital and Edward Myers Unit.ResultThe uptake for the survey was 53/83 (64%) at CDAS clinic and 23/44 (52%) at Edward Myers Unit. The sample comprised more men than women. The majority were aged 31–40 years. Most common substances used were alcohol.Majority of patients has been admitted to the general hospital, either in the ward or seen at A + E. Most people were very satisfied with their treatment in all four locations. This include withdrawal symptoms, pain, mental health, and discharge plan. There were diverse reasons given of the satisfactory scores. EMU seems to have the best overall scores comparatively to the other units, with Harplands Hospital seems to be doing worse.The free text comments revealed that the staffs' courtesy, respect, careful listening and easy access of care was particularly the strongest driver of overall patient satisfaction. Patients look for supportive relationships, to be involved in treatment decisions, effective approaches to care, easy treatment access and a non-judgemental treatment environment. In some aspects, patients were dissatisfied with pain management, longer waiting times and inability to treat them as equal to non drug/alcohol users.ConclusionOn objective measures, patients were satisfied with treatment received, however, some has point out their dissatisfaction, particularly in the mental health setting. This project calls for greater attention and support for addiction service provision in emergency departments and hospital wards. Although these findings do not represent the views of all patients in SUD treatment, findings give insight into the ways treatment providers, service managers and policy makers might enhance the patient experience to improve patient treatment prognosis and outcomes