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Evaluation of a Service to Strengthen Primary Care Responses to Substance-misusing Patients: welcomed, but little impact

The Consultancy Liaison Addiction Service (CLAS) is a GP-led service to provide support and training to primary health care staff in South London. Data on 136 out of 153 staff (85.3%) were obtained at the start of the project. Generally the service was well received. However, the study failed to show any statistically significant changes in behaviour or attitudes as a result of CLAS. Possible reasons for this are explored. CLAS did little training and, in those practices where it was active, the CLAS workers mainly worked directly with substance-misusing patients. Individuals from a clinical background may find it hard to move into a consultative role, given their background and in the face of a demand from GPs to see the patients. CLAS had little involvement with staff other than GPs. Although training and support for other staff could be advantageous, the training and consultancy functions of a service like CLAS are unlikely to be used appropriately without the therapeutic commitment of the whole practice and especially the backing of the GPs. However, by engaging GPs, CLAS may have been making the necessary first step of building trust as a foundation for more substantial change.