SCC Contract for the Provision of Needle Exchange Supplies and Services to Pharmacies

Surrey County Council currently commissions the Community Pharmacy Needle & Syringe Programme for the county, which incorporates pharmacies across the county. In addition to this SCC also commissions other community-based services that provide elements of NSP that could need equipment provision and support. The provider will also provide further additional levels of support to commissioners, pharmacists and community NSPs including training, data analysis and engagement.

These are minimum standards required in any setting and in the context of broader needle exchange specifications:

1. Provide Pronaxad and Nyxoid to services providing Naloxone
2. Provide people who inject drugs with sterile needles, syringes, sharps bins, other injecting equipment (including cookers, filters, water and acidifier) and non-injecting paraphernalia (e.g. foil) as appropriate to service user need.
3. The quantity provided should not be subject to a limit but sufficient to allow for a full set of sterile injecting equipment for every injecting event.
4. Make needles available in a range of lengths and gauges, provide syringes in a range of sizes appropriate to the individual’s need and type of injecting practice.
5. Provide and promote the use of the lowest possible dead space1 injecting equipment including:

• fixed needle syringes
• detachable low dead space needles with standard syringes
• detachable standard needles with low or reduced dead space syringes

The dead space of a needle or syringe is the space where fluid, including blood, is retained after injecting. Using equipment with a lower dead space reduces the risk of transmission of blood borne viruses (BBVs) such as HIV and hepatitis C virus, if the equipment is shared.

Fixed needle syringes have the lowest dead space. However, for some injecting practices equipment with detachable needles are needed. Detachable equipment with reduced dead space is available but varies across the equipment manufacturers. Broadly there are two types; modified needles which are used with standard syringe barrels and modified syringe barrels which are used with standard needles. Use of either of these types of equipment is likely to reduce BBV infection risk, compared to the use of standard (high dead space) equipment.

Further reading

• National Institute for Health and Care Excellence, Public Health Guidance 52: Needle and Syringe Programmes, published 26 March 2014 Overview | Needle and syringe programmes | Guidance | NICE
• Gledhill R, What are the facilitators and barriers to the uptake of low dead space injecting equipment for people who inject drugs? Public Health England Knowledge & Library Services Evidence Briefing, 17 June 2021. ukhsa.koha-ptfs.co.uk/cgi-bin/koha/opac-re… ↗
• Thomas C, Hickman M, Vickerman P et al. Cost-effective tools to reduce the spread of the Hepatitis C Virus in people who inject drugs. Policy Bristol Policy Report 59 June 2020. www.bristol.ac.uk/policybristol/policy… ↗