Quality statement 1: Needle and syringe programmes

Quality statement

People who inject drugs have access to needle and syringe programmes in accordance with NICE guidance.

Rationale

Needle and syringe programmes can reduce transmission of blood-borne viruses and other infections caused by sharing injecting equipment. High quality programmes may reduce other harm associated with drug misuse, for example by advising on safer injecting practices, access to drug treatment and testing, vaccination and treatment for blood-borne viruses.

Quality measure

Structure: Evidence of local arrangements to ensure people who inject drugs have access to needle and syringe programmes in accordance with NICE guidance.

Outcome:

a) Proportion of people who inject drugs who access needle and syringe programmes.

Numerator – the number of people who access needle and syringe programmes.

Denominator – the estimated prevalence of injecting drug users.

b) Incidence of blood-borne viruses among people who inject drugs.

What the quality statement means for each audience

Service providers ensure systems are in place for people who inject drugs to have access to needle and syringe programmes in accordance with NICE guidance.

Needle and syringe programme staff ensure people who inject drugs have access to needle and syringe programmes in accordance with NICE guidance.

Commissioners ensure they commission services for people who inject drugs to have access to needle and syringe programmes in accordance with NICE guidance.

People who inject drugs have access to needle and syringe programmes that are nearby, have suitable opening hours and provide injecting equipment and advice on reducing the risk of harm.

Source guidance

NICE public health guidance 52 recommendations 1–4 and 6–9.

Data source

Structure: Local data collection.

Outcome:

a) Local data collection and Glasgow prevalence data from National Treatment Agency for Substance Misuse.

b) Local data collection.

Definitions

NICE public health guidance 52 defines the type of needle and syringe programmes which should be available.

NICE public health guidance 52 recommends that needle and syringe programme services should meet local need, for example they should take into account opening times, location and geography of the location (rural or urban) as well as the level of services needed.

NICE public health guidance 52 recommends that pharmacies, specialist needle and syringe programmes and other healthcare settings should be used to provide a balanced mix of the following services:

  • level 1: distribution of injecting equipment either loose or in packs with written information on harm reduction

  • level 2: distribution of 'pick and mix' injecting equipment plus health promotion advice

  • level 3: level 2 plus provision of, or referral to, specialist services.

Blood-borne viruses include hepatitis B, hepatitis C and HIV.

Equality and diversity considerations

A number of specific groups of injecting drug users may require special consideration. These groups include:

  • homeless people, who are more likely to share needle and syringe equipment on a regular basis than others who inject drugs

  • women, whose drug use may be linked to specific behaviours and lifestyles that put them at an increased risk of HIV and hepatitis infections

  • users of anabolic steroids and other performance- and image-enhancing drugs

  • the prison population, which contains a higher than average number of injecting drug users.