Health and social care policy must respond to the growing demand for palliative and end-of-life care services for people with experience of problematic substance use, says a new report.

Researchers from Manchester Metropolitan University have outlined six policy standards urging policy-makers, NHS commissioners and service providers to introduce measures that would improve provision and tackle stigma towards terminally ill patients who are, or have been, problematic users of alcohol or other drugs.

The recommendations – the first of their kind in the UK – are based on consultation  with professionals in leadership and policy roles across health and social care services in Liverpool, particularly specialist palliative, end-of-life and substance use services.

It is the result of the Manchester Metropolitan’s Chancellor’s Fellowship award, which allowed the team to work with Dr Yasir Abassi, Consultant in Addictions Psychiatry from Mersey Care NHS Foundation Trust, and colleagues from Marie Curie Hospice in Liverpool.

Joe Rafferty, Chief Executive at Mersey Care, said: “This report is a great example of the work that can be done in partnership between NHS Trusts and academic institutions like Manchester Metropolitan University.

“It’s only by working together in a joint approach that we are going to be able to provide real care for some of the most vulnerable people in our society. There are very close links between deprivation, mental ill health and addictions and the recommendations in this report should be closely evaluated by all stakeholders and look towards providing a better experience for all.”

The report’s authors call on national and local strategic health bodies to begin work jointly with NHS trusts, local authorities and third-sector organisations to develop policy standards that will support service delivery and reduce health inequalities for this vulnerable group of people.

Dr Sarah Galvani, Professor of Social Research and Substance Use, said: “We hear a lot about groups of people facing health inequalities and people with alcohol and other drug problems are among that group. We anticipate that health and social care services are going to see a growth in the number of people presenting with life limiting conditions and current, or past, substance use, given our ageing population and their higher rates of hospital admissions for alcohol-related harm in particular.

“Services and the staff within them need policy and practice guidance to support both them as practitioners and also their practice response.”

The report includes case studies that demonstrate the challenges people at, or near, the end of life face when they have problematic substance use. In one case, a person hospitalised twice for severe stomach pain was treated with an alcohol detox despite no longer drinking, leaving the underlying health problems unaddressed.

The report Policy Standards: A Working Document. Palliative and End of Life Care for People with Alcohol and Drug Problems, authored by Professor Sarah Galvani and Dr Sam Wright from Manchester Metropolitan, is being launched at an event in Liverpool on Thursday, May 16.


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