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Needle Syringe Program + Caring for the Community

Sydney Local Health District
Drug and AlcoholPrimary Care Centre for Healthcare Redesign
Project Added:
15 December 2016 Last updated:
16 December 2016

Needle Syringe Program + Caring for the Community

Summary

This project will redesign the Sydney Local Health District (SLHD) Needle Syringe Program (NSP) in partnership with service users and staff, to expand access to primary healthcare services and offer psychosocial support for service users with complex needs.

Aim

To improve the health outcomes and experience of people who inject drugs, through the delivery of an efficient and effective harm minimisation program in SLHD.

Benefits

  • Improves the health and psychosocial support offered to people who inject drugs.
  • Provides a co-designed service developed by service users, staff and key stakeholders.
  • Increases the number of people accessing the NSP.
  • Reduces the prevalence of blood borne viruses among people who inject drugs.
  • Increases access to hepatitis C treatment among people who inject drugs.
  • Increases integration of services across SLHD.
  • Improves workplace culture and staff satisfaction.
  • Improves community perception and acceptance of the NSP.

Background

People who inject drugs carry a higher burden of disease than the general population and are 50 times more likely to contract hepatitis C. However, 80% of these people experience stigma and discrimination when accessing healthcare services. Some require complex case management for issues beyond general physical health such as sexual and mental health, domestic violence, trauma, parenting support and child protection, as well as support with homelessness, housing, finance and legal issues.

The NSP in SLHD provides people who inject drugs with free sterile injecting equipment. It also acts as a gateway to healthcare services, via an onsite primary health care clinic. However, the existing model of care used by the NSP is over 20 years old and misses opportunities to engage with service users to address their health and psychosocial needs. An audit conducted in May 2016 found that uptake of primary healthcare services at the Redfern NSP was low and 49% of service users surveyed were unaware of the primary healthcare services available.

Implementation

A phased implementation of 18 key solutions will be undertaken over the next two years, with 10 core solutions identified for phase one of the project. These include:

  • development of a service users advisory group, to build trust with service users and provide advice on solutions and the expansion of services
  • development of a service delivery model and operational framework to support the improvement and expansion of services
  • establishment of referral pathways, through a network of internal and external service providers across SLHD
  • development of an internal and external communication strategy in collaboration with staff and service providers
  • expansion of clinic services, to increase access to primary healthcare services and psychosocial support for service users
  • development of service user workshops to improve health literacy in areas such as vein and dental care
  • implementation of education and training for staff to support service improvement and expansion
  • distribution of automatic dispensing machines and partnerships with secondary outlets to distribute equipment
  • development of a naloxone education and distribution program for staff and service users, to prevent overdoses
  • development of an incentive program for service users, to educate them on the risks of sharing injecting equipment.

Project status

Implementation - the initiative is ready for implementation or is currently being implemented, piloted or tested.

Key dates

March 2016 – December 2017

Implementation sites

  • Needle Syringe Program, Canterbury Hospital
  • Needle Syringe Program, Marrickville Health Centre
  • Needle Syringe Program, Redfern Health Centre
  • Primary Health Care Clinic, Redfern Health Centre

Partnerships

  • Central Clinical School, University of Sydney
  • Centre for Healthcare Redesign
  • Harm Reduction and Viral Hepatitis Branch, NSW Ministry of Health
  • NSW Users and AIDS Association

Evaluation

Key performance indicators to be achieved by 31 December 2017

  • Increase distribution of injecting equipment by 7%.
  • Increase brief interventions by program staff with service users by 50%.
  • Increase number of new people accessing the primary health care clinic by 100%.
  • Increase number of hepatitis B vaccine doses administered by 50%.
  • Increase number of people with hepatitis C who receive hepatitis C antiviral treatment in the primary health care clinic from 0 in 2015 to 50.

Results date July to November 2016

  • Brief interventions by program staff with service users exceeding the monthly target by 535%.
  • The number of new people accessing the primary health care clinic 82% of the monthly target.
  • The number of people with hepatitis C who received antiviral treatment in the Primary Health Care Clinic exceeding the monthly target by 113%.

Lessons learnt

  • Continuous consultation.
  • Open communication is key for success.
  • Identifying individuals acceptance for change.
  • The importance of working to people’s strengths.
  • The value of Express, Model and Reinforce.

Further reading

Contacts

Keren Kiel
Manager Health Systems Planning & Performance
Drug Health Services
Sydney Local Health District
Phone: 02 9378 1300
Keren.Kiel@sswahs.nsw.gov.au

Kristina Vuckovic
Clinical and Community Project Officer
Drug Health Services
Sydney Local Health District
Phone: 02 9378 1300
Kristina.Vuckovic@health.nsw.gov.au

Martin O’Donnell
Harm Minimisation Manager
Drug Health Services
Sydney Local Health District
Phone: 02 9395 0400
Martin.ODonnell@health.nsw.gov.au

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