4. The role of Primary Care in the prevention of drug-related deaths: service provider perspectives

Efforts to prevent and reduce high rates of drug-related deaths (DRDs) in Scotland has become a policy and practice priority. As part of the UK National Health Service, general medical practitioners (GPs) are often the first service where people with drug use problems and/or their family seek help. Little is known about their role, or potential role, in the prevention of DRDs. This paper presents the findings from practitioner accounts

Underpinned by complex systems thinking and a case study approach, semi-structured interviews (n=26) and focus groups (n=4) were conducted in two GP practices with patients, affected family members, GPs and other local health and social care professionals. Each system and model of care was ‘mapped’ using Kumu software. Thematic and framework analysis was conducted using NVivo.

The extent to which GPs and Primary Care could contribute to reducing harms and risks of DRD is influenced by their relationships with other services and professionals, the availability of functioning referral pathways to wider systems of care, and national and local policy contexts. Resources (time, skills, IT systems) and the degree to which they were embedded within an integrated systems approach were important also.

The design and delivery of care for people with drug use problems should include GPs and primary care teams and address the broader needs of local communities. Removing barriers to the integration of primary care teams in local systems of care for people with drug use problems, and their families, would improve the quality of care.

This work was supported by a research grant from the Scottish Government’s Drug Deaths Task Force.