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Sexual Health Prescribing Scheme

One of the client groups that we have worked with since the opening of the Drug service are those men and women who work as prostitutes and who also have a drug problem. Many of this group have regular contact from Outreach workers involved in supplying condoms, clean injecting equipment etc. but find it difficult to access the conventional drug treatment service with their system of appointments and timetabled clinic times.

While this system works with the vast majority of clients this group of sex workers often lead particularly chaotic lifestyles and even when referred into the clinic system more often than not fail to keep appointments and find that they have been discharged very quickly. A certain amount of flexibility can be allowed but a more flexible system needed to be designed in order to accommodate this group of high risk clients.



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Since the scheme has been in operation 59 sex workers have accessed healthcare for the first time.


	The scheme provides a prescription of oral methadone, a low dose of 40mls, dispensed three times a week from two convenient chemists. The prescriptions are delivered every month by the lead worker and a check made as to who is, or who is not, picking up regularly. The prescription is started after a positive urine result has been obtained, usually taken from the client by the outreach worker, on the street or in the clients home. The prescription is guaranteed to always be in the chemist for theclient for a minimum of three months when we would expect their attendance at a sexual health clinic. If the client attends these clinics then the prescription will continue to be delivered. These clinics are set-up for a specific 'Sexual Health' day at our primary healthcare unit, no appointments are sent out, word of mouth and the occasional lift is all that is needed to ensure attendance.

Obviously there are a few non attenders, and their prescriptions are held until seen. In the three years of the schemes operation this has been a rare event. At the clinic day all the clients are seen by a doctor, a specialist nurse practitioner, and if requested counselling and blood tests can be provided for Heptitis C, HIV etc. A whole range of screening services are catered for, smears, breast screening etc., in fact all the services provided

for the more 'normal' patient at GP Surgeries and community health clinics, places not readily frequented by this client group.
The scheme has been in operation now for over five years and has proved to be extremely successful, not only in attracting a particular group to a relevant health agency, but in improving their health and in improving their own attitude to seeking better health care for themselves.

Drug Service [Wirral] [Chester] [Ellesmere Port] [South Cheshire]
Alcohol Service [Wirral] [Chester] [Ellesmere Port]
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