NICE PUBLIC HEALTH GUIDANCE. Needle and Syringe Programmes (update of PH18) 2nd Meeting of the Public Health Advisory Committee.

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PUBLIC HEALTH GUIDANCE Needle and Syringe Programmes (update of PH18) 2nd Meeting of the Public Health Advisory Committee 19 th July 2013 Royal College of Paediatricians, 5-11 Theobolds Road, London Final Minutes Attendees: PHAC Members Core members Susan Jebb (Chair), Mireia Jofre Bonet, Chris Packham, Amanda Sowden, Lucy Yardley, Joyce Rothschild Topic members Vicky Fenwick, Adam Mackridge, Tony Margett, Fortune Ncube,, April Wareham, Paul Wells Co-optees Joe Kean, Steroid Project Lead, Lifeline and Senior Trainer, Nine Zero Five Team Simon Ellis, Chris Carmona, Emma Doohan (minutes), Alastair Fischer, Suzi Peden, Louise Millward Review Teams Liverpool John Moores University: Lisa Jones, Geoff Bates, Jim McVeigh London School of Hygiene and Tropical Medicine: Lucy Platt, Bethan McDonald, Neil Hunt Observers Craig Moss (Addaction), Natalie Wood (Tiny Sparks project) Apologies: PHAC Members Toby Prevost, Alison Lloyd James Jagroo Author Emma Doohan, Project Manager File Ref Version Audience Final (Chair approved) PHAC members, team, members of the public 1

Item Action 1. Welcome and objectives for the meeting The Chair welcomed the Public Health Advisory Committee (PHAC), the team, the review team and the observers to the 2nd meeting on Needle and Syringe Programmes (update). The Chair also welcomed the members of public to the The Chair outlined the general housekeeping for the venue. The chair outlined the aim of the meeting which was to agree the draft updated guidance on Needle and syringe programmes, to be released for public consultation on 24 th September 2013. The objectives were outlined as follows: To hear the final findings from the survey of commissioners and providers To consider the health economic issues To agree revisions to the current PH18 To agree any new To agree any new considerations To agree the gaps and research. The Chair informed the PHAC that apologies had been received. These are noted above. 2. Declarations of Interests The Chair explained that verbal declarations of interest are a standing item on every agenda and are recorded in the minutes as a matter of public record. The Chair asked the PHAC to declare any changes to their conflicts of interest. Previous declarations of interest can be viewed in the minutes of meeting 1 on the website here: http://guidance.nice.org.uk/phg/72 The Chair and Associate Director of CPH had reviewed these interests previously and determined that the interests declared did not prevent the attendees from fully participating in the 2

The following additional DOIs were made: Personal non pecuniary Adam Mackridge Has previously published papers in which he has concluded that community pharmacies could provide extended services to NSP users and stating that appropriate training is needed for community pharmacy staff providing NSP services. The Chair confirmed that this interest did not prevent Adam from fully participating in the 3. Presentation by Geoff Bates, LJMU Geoff Bates from the Liverpool John Moores University (LJMU) gave a presentation entitled Survey of NSP providers and commissioners re implementation of PH18: presentation of final report. The committee were given an opportunity to ask any questions about the report. 4. Presentation by Alastair Fischer, 5. Questions and discussion Alastair Fischer from gave a presentation about the health economics for the topic. He outlined why the health economic work from the previous guidance had not been extended to include PIEDs and young people. The committee were invited to ask any questions in regard to the presentation. A number of issues were raised and discussed. The chair asked the committee to consider the following: Young people under 16 are the committee satisfied that the cost effectiveness of NSP for young people will be the same or greater than for the general population of people who inject drugs? Performance and image-enhancing drug users (PIEDs) are the committee happy to make even though the cost effectiveness of NSP for this group is unknown? The following actions were agreed: team to extract further information on cost effectiveness from the modelling work that supported the original guidance. A research recommendation about costs and benefits of extending services to PIEDS may team team 3

be suggested in the final guidance. 6. Revisions to the original The committee considered the revisions to the original from the NSP guidance published in 2009. The committee suggested amendments and additions to the which were noted by the team. 7. Considering the new The committee considered and made revisions to the two new that were drafted following the June The committee agreed on the changes to the young people s recommendation. The committee discussed whether to have a specific recommendation on PIEDs. It was agreed that a specific recommendation should be taken forward and the committee discussed the amendments to the recommendation that had been drafted following the June The committee suggested some further research. The committee suggested a new recommendation on monitoring. 8. Revisions to the considerations The committee were asked to look at the new considerations that were drafted following the June The team noted the suggested revisions and additions. 9. Revisions to gaps and research The committee worked through the research that were drafted following the June meeting and made changes and additions. Action: team to highlight the research that are new and ones that have been carried forward from the last guidance. 10. Next steps Simon Ellis outlined the next steps in guidance production as follows: team to complete the revisions and additions to the. These will then be edited. The complete pre-consultation draft guidance will be circulated to committee members on 9 th August for comment by 3 rd September. 4

The team will meet with the Chair on 6 th September to agree final revisions. Draft guidance will be released for consultation on 24 th September. 11. AOB The committee were reminded that expenses should be submitted within 3 months of the The next meeting of PHAC A is being held on Wednesday 4 th September to discuss the guidance on Vitamin D. Needle and Syringe topic members will not need to attend this The next Needle and Syringe PHAC meeting is being held on Friday 22 nd November. 12. Close The meeting closed at 4.15pm. 5