Today's Daily Dose flags the publication of a Royal College of GPs and Royal College of Psychiatrists report that explains the roles and responsibilities, titles and on-going professional development routes for GPs and psychiatrists working with substance misusers. The report acknowledges that most of the growth in doctors' involvement in substance misuse treatment in recent years is limited to drugs work and not alcohol, and suggests this will change when Models of Care for Alcohol kicks in.
The report features a table that details the various elements of advising and treating patients with substance misuse problems, and sets down who should provide what. It's fascinating to see all the things that GPs providing 'core services' (under the new GMS (nGMS) contract) are not expected to do, such as
'provide advice to patients on reducing the harm associated with their drug use'
and
'undertake biological tests for substance misuse and interpret them to form a management plan and assist in referral'
The report explicitly includes alcohol. Even though nGMS was greeted with dismay by many in the alcohol field when the details were annouced, it is still somehow shocking to see in black and white that basic advice and testing for alcohol misuse is not included in core GP provision.
Patients at practices running enhanced services for alcohol should fare better, although such services are pretty rare. There's an alcohol local enhanced service (LES) running in five practices in the London Boroughs of Kingston and Richmond (which LDAN is about to research and write-up), but any other alcohol LESs in London, if they exist, are keeping a low profile.
Here's a very quick and dirty round up of known and Googled enhanced services for alcohol in England and Wales:
Tadcaster
Vale of Glamorgan (under consideration for 2006/07)
Teignbridge
Powys
NE Oxfordshire
North Tees
Hammersmith and Fulham
Kingston and Richmond
There must be more alcohol enhanced services out there; the search will continue.
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