London Meeting (April 2004)

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Meeting held at: Meeting Room J, Regents College London on 1st April 2004.

Chair: Jim Camp

Welcome and Introduction to the Day:

Jim Camp welcomed everyone to the forum and Terry Shields thanked the sponsors.

Presentation: Injecting Paraphernalia – Andrew Preston (Exchange Supplies):

Andrew gave a presentation about the regulations surrounding distributing needle exchange paraphernalia, including citric acid, vitamin c, spoons, filters and water for injection. He referred to the fact that although distributing certain items of paraphernalia is illegal, many needle exchanges may be still doing it, because of a lack of alternative options. He explained that Exchange Supplies will be applying for a license from the MHRS to make water ampoules for injecting, and hope to release these by summer this year.

Presentation: Quality of BD Insulin Needles – Heather Gibson (KCW Pharmacy Needle Exchange Co-ordinator)

Heather spoke about the difficulties she has experienced in trying to get refunds from Beckton Dickenson of faulty “Microfine” 1ml syringes. She explained that particular batches had been faulty and she had been in negotiations with BD to get the situation remedied, but found they were not being very helpful. The faulty batch numbers are:

3191797 (Manchester)
3191796 (Vernon Carus)

Heather recommended that anyone who has experienced problems to contact Gemma Bianchini at Beckton Dickenson on 01865781634, or email Heather also encouraged people to report any incidents of faulty needles to the MHRA, which can be done on the internet at, by emailing , or by phoning 020 7972 8273.

Many other attendees also had experienced these faulty needles, with some people mentioning that there were other batches involved. Many people expressed their difficulties in getting the situation remedied. Nik Howes explained that he had been told the problems were due to camera alignment in the manufacturing process. He had also had difficulties in getting the situation resolved with BD.

Heather called for the forum’s support in sending a letter of complaint to BD to express concerns about their treatment of this issue. It was agreed that Mari Ottridge and Heather would put a letter together around this issue, based on the comments of forum members. Jim asked members to forward any incidents to Brenda Nash at DrugScope so that they could be included in the letter to BD.

There was a call for forum members to have closer links with each other, to enable communication about issues such as this.

Presentation: Mike Ashton – Drug and Alcohol Findings

Mike gave a presentation about the latest research findings on Hepatitis C. He talked about how prevalence levels of Hepatitis C are a good reflection of how well needle exchange is achieving harm reduction within the injecting community. Mike recommended that people read Drug and Alcohol Findings’ four-part series exploring research on the role and record of needle exchange in preventing the spread of Hepatitis C. The four parts are:

  • Part 1, issue 8 – The dimension of the challenge
  • Part 2, issue 9 – Case studies
  • Part 3, issue 10 – The British record
  • Part 4, issue 11 (forthcoming) – Conclusions and themes

The whole series can be obtained by subscribing to Drug and Alcohol Findings, via Alcohol Concern (telephone 020 7928 7377, email, or visit Part three is available free from the website (for a limited time). Mike can be contacted personally at

This research showed that the current level of needle exchange is not sufficient to have an impact on the levels of Hepatitis C among injecting drug users, and has highlighted the need for a large increase in the number of needle exchange services available, to “flood the market, rather than drip-feed”. Mike also recommended that needle exchanges be less restrictive, in terms of one-for-one exchanges, opening hours, outreach etc.

Regional Roundup

Due to limited time, the chair asked for comments on specific topics, rather than a typical regional roundup. These topics were:

  • Needle exchange and Models of Care – implementation issues
  • CJIP pilot areas and needle exchange
  • Mari Ottridge commented that she has used various documents to help her reassess her organisation’s focus and strategies, to enable them to better meet the Models of Care framework. These documents included QuADS, DANOS, Drug Related Deaths, Hidden Harm, and Every Child Matters. She encouraged all attendees to take these documents into account when they are reviewing their service’s goals and strategies.
  • Jim Camp explained that he had been asked by the local CJIP team in his area to provide contact information for clients of the needle exchange, which was inappropriate. He asked the group to let him know if they have had similar experiences, because he is able to take this feedback to the relevant Home Office and NTA people and ensure that this kind of inappropriate request does not happen in the future. He provided his mobile phone number for people to contact about this issue – tel 07956346097.
  • A forum member from Yorkshire pointed out that clients of her needle exchange service had been expressing their unhappiness with the CJIP program, and that it did not seem to be meeting their needs. Another forum member commented that CJIP was placing further pressure on resources in services, as clients are being “pushed” into treatment when they may not be ready, and often do not attend treatment after having been forced to undergo an assessment.

Presentation: Professor Gerry Stimson (Dept of Social Sceince and Medicine, Imperial College) – “Trends in HCV and HIV infection – Implications of national and local harm reduction strategies”

Professor Stimson explained the main findings from his recent research into the prevalence and incidence of HIV and HCV among new injecting drug users in London.

This research was conducted with participants from a range of community settings and used a twelve-month follow up after the first interview to measure the levels of prevalence. The research indicates:

  • There is a higher prevalence of HCV than was expected
  • There is an extremely high HCV and HIV incidence, with an increase in transmission recently, and a very short window for prevention
  • 30% of participants who were infected with HCV were infected within 2 years of injecting
  • There were high levels of injecting risk behaviour
  • There was an increased risk of HCV with crack/cocaine injecting
  • The lack of coverage of needle exchange may not be sufficient to reduce transmission of HCV
  • There is a lack of targeted HIV/HCV prevention initatives
  • Health education, prevention of injection, increased accessibility of HCV testing, and treatment of those infected, are all urgently required.
  • Professor Stimson recommended that blood be tested rather than saliva, and commented that potentially fingerprick testing might be a way forward.

There was a question about how the participants were selected. Prof. Stimson reported that community networks were used to attract participants, and participants were required to have a home address (ie not be homeless), in order to be followed up after twelve months.

It is not yet known when this study will be published, or where it will be published.

Andrew Preston asked Prof. Stimson what he felt needed to be done in order to remedy the situation of high prevalence of HCV. He felt that there needed to be more needle exchange services, and that syringes needed to be provided to young people in much larger numbers. Jim Camp also raised the issue of using secondary distribution as a way of increasing the coverage of needle exchanges, which was generally supported by the group, but all expressed the difficulties they would have in actually doing this.

There was a feeling amongst attendees that needle exchange had slipped down the list of priorities of government, and that the whole issue needed to be revived and to be put “on the health agenda”, rather than being seen as a criminal justice issue. Professor Stimson encouraged attendees to watch out for the Department of Health’s Action Plans, and to liaise with local DH contacts in order to make sure needle exchange is included in these Action Plans. Jim also commented that partnerships and networking were very important factors, and that this needed to be highlighted to funders and commissioners.

Mari Ottridge – Action on Hepatitis C Update

Mari spoke about how Action on Hepatitis C has fought for a long time for a national strategy for Hepatitis C, but now that there is one, more needs to be done to implement it. There is currently no action plan, and Mari expressed a desire that everyone working in the harm reduction field needs to encourage and support the development of the plan, and monitor its implementation.

Mari announced the loss of the founder of Action on Hepatitis C, who was a huge supporter of needle exchange services. Nigel Hughes and Graham Foster have also left. Paul Wells has now accepted the role as chair.

The Action on Hepatitis C group has met twice since the last National Needle Exchange Forum meeting. The next meeting with be on 6th May in London, and Mari asked for feedback from forum attendees to take to this meeting.

Mari outlined a letter she had sent to Dr Vicky King from the Department of Health, asking for clarification about when the Action Plan for Hepatitis C would arrive. Dr King replied to her and outlined the government’s plans, but did not imply that Hepatitis C was high on the agenda.

Mari welcomed the “Shooting Up” report by the Health Protection Agency, which is available online.

She also informed attendees that the 8th International Hepatitis C conference will be held on 23-24th September in London at the Imperial College.

Amendment of NNEF Cheque Signatories

Jim Camp announced that himself and Terry Shields would be taking over the positions of National Needle Exchange Forum cheque signatories, unless there were any objections. There were no objections and so they were sworn in as the new signatories.

Deputy Chair and Treasurer’s Vacancy

The chair called for assistance in the above posts, and also for other assistance from forum members, to enable the National Needle Exchange Forum to run efficiently and to meet the needs of participants. He asked that people contact him directly either via telephone 0208 8807 780 or 07956 346 097, or by emailing him or


The chair thanked attendees for coming to the forum meeting and announced that the next forum was likely to be held in the Midlands.

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