Addiction services have made substantial changes to their ways of working and how services are delivered during the Covid-19 pandemic. For many, the changes have involved an increase in the use of digital and online offerings as lockdown and social distancing measures have meant that face-to-face contact has been significantly reduced. Colleagues from One Recovery Bucks, part of the Trust’s Inclusion service, describe how they have worked to overcome the challenges of moving to a digital service and what their future service delivery might look like as lockdown measures ease.

One Recovery Bucks is led by Inclusion (part of Midlands Partnership NHS Foundation Trust) working with the Oasis Partnership and Connection Support. Dan Harber is the Operations Manager for One Recovery Bucks, who have just over 1100 active service users. Dan explains how the move to providing a digital service has been a real learning curve for all the staff and service users: “In the first weeks of Covid-19 the focus was on staff comprehension and understanding of the digital technology and web conferencing platforms. It was quite challenging to implement at first as it was such a change for many people and, understandably, people often revert to what they know and what's comfortable. At the start of Covid 19, 5 or 6 staff across both our sites in High Wycombe and Aylesbury took part in a trial where we were able to learn more about how the technology works and which platform would be most suitable for the service that we wanted to provide. We then had staff members who were in a position to offer in-house training on the digital software and programmes. There are now training sessions available every week, sometimes daily, to promote the use of the technology. The majority of our staff have all adapted to the new way of working really well.”  

Dan explains that as well as making use of video conferencing to connect with service users, staff also use video conferencing to communicate with each other across the two sites each day: “We have a daily 9 o’clock team briefing across both sites which is focused on clients’ concerns, any non-contact clients, and any safeguarding issues. We also discuss any new clients to allocate, any issues in terms of duty assessments and any discharges coming up. We focus on the key elements for the service delivery each day. We then have another daily team meeting at 4pm which is more focused on staff wellbeing. We want to find out how our staff are, about any issues that have arisen from the day, and how they’re coping. We’re able to communicate effectively across both sites and facilitate our day to day operations because of the technology.”

Many of the counsellors have found the move to online consultations a real advantage. One of the counsellors explains that: “In many ways I prefer virtual meetings over face-to-face. I feel it gives both counsellor and client great flexibility." She goes on to say that “the online consultations really help us to be more efficient with our time. It is much easier to keep to your appointed online slot. On screen you can check your meeting length without rudely looking at your watch. It means you can make sure you cover your major points within the allocated appointment. It also allows you to check your notes, or make new ones, without looking rude by checking paperwork and scribbling. In conclusion, I would prefer that the virtual meeting option continue, maybe with the odd face to face mixed in.”

The service user response regarding the move to digital has been very positive too. One service user describes the online consultations as being: “very easy to use - there have been no technical hitches so far." The service user likes the fact that you can access the consultation via phone, so no laptop is needed. He thinks that the video calls are “better than just a phone call as you can actually see the other person and you have a good sense of their expressions.” A daily suite of online support groups is also available to service users, such as a Family Support Group, a Relapse Prevention Group and a Peer Support Group. To ensure online group privacy, attendees are emailed an online boundaries form before each group that they complete and return via email. It is made clear to service users that all parties are responsible for confidentiality. Online surveys are also used to collect service user feedback to collect their experiences of the move to digital. As Dan explains: “Some of the feedback that we're getting is that service users would like some of these online groups to stay in place as lockdown measures ease.”

Prior to Covid 19 many service users had to use public transport, sometimes a number of buses, to reach us and our groups. The online option means that we are now able to reach some service users more easily than before and they have asked for the online groups to continue. We had 67 successful attendances at our groups last week and a total of 564 successful contacts (that’s a combination of telephone and online consultations).  Since Covid 19, the number of service users that we’ve been unable to contact has gone down, which is just incredible. Dan concludes: “it's amazing how well you can completely change a service in such a short space of time.”

David Cupit is the Commercial Development and Information Lead at Inclusion and confirms that the data that has been gathered to date suggests an increase in service user contact during the lockdown period: “Last year in March we had just under 25,000 contacts with our substance misuse services, in March this year, through working digitally, over the telephone and face-to-face before lockdown, we had nearly 30,000 engagements - quite a substantial increase. The data suggests that we’re engaging more of our service users, more often, which is fantastic. I can guarantee that we are now seeing people that we’ve never seen before, because of this new digital offer.”

However David is keen to stress that as we move out of lockdown, the digital offering will become part of a “blended approach” and is not a replacement for face-to-face contact: “it's not a replacement for anything, it's just something to add to the arsenal. Once the face to face option is available again, some service users will want to use that over digital offerings, and some won’t want to come back in at all and would prefer to stick with the digital option as for them it’s more convenient. It’s a choice. We’re all about choices. It’s another way that people can get in touch and get help.” David concludes: “it’s not been a cohesive journey, there are barriers and complications with this technology and there have been problems along the way, but through the sheer good will and passion of our staff we’ve been able to get to the stage where this has worked and I am incredibly proud of how we’ve adapted what we have been able to achieve.”

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