Standard 7 Primary Care
All people have the option of MAT shared with Primary Care.
People who choose to will be able to receive medication or support through primary care providers. These may include GPs and community pharmacy. Care provided would depend on the GP or community pharmacist as well as the specialist treatment service.
The Orange Guidelines identify joint working across health and social care and between hospital, prison, primary care and community drug services as a key feature of effective treatment partnerships (p13). There is an ageing population of people who use drugs and many people have underlying conditions and so would benefit from MAT delivered in General Practice, due to the possibility of wider health problems being met. MAT offered in primary care can help to address issues around access to drug treatment services in rural areas. Community pharmacists are well placed to deliver scheduled or opportunistic care because they can have very frequent contact with people picking up prescriptions or attending for other reasons.
7.1 Primary care and substance use service partners have in place:
a) practice models that support people on MAT to remain in primary care, including for support and relapse prevention;
b) shared care protocols between specialist services, GP and community pharmacies for people who are on MAT. Shared care may include prescribing where competent practitioners are in place;
c) clinical and governance structures that enable people working in primary care to fully support people who are on MAT and to ensure that treatment and prescribing are managed alongside care for physical, emotional, and social needs;
d) contractual arrangements for primary care provision (GP and community pharmacy) reflect the requirements of MAT standards;
e) pathways that enable the transfer of appropriate elements of care between specialist services, local mental health services, GP and community pharmacy;
f) information governance to ensure that information can be safely transferred between specialist services, GP and community pharmacy, including child and adult protection procedures;
g) effective recording and review systems for recovery care planning for all people in treatment and care for problem drug use;
h) training on problem drug use and on awareness of local drug services, including non-statutory providers and peer support services for all staff who may encounter people with problem drug use in their work;
i) a 'primary care facilitation team', or equivalent that is responsible for auditing, monitoring, reporting and reviewing practice in primary care settings and the interface with specialist care, and for support with workforce development.
This standard will be further developed in collaboration with partners and will inform guidance on Enhanced Services for drug treatment in general practice.