Next, analyses of SIF outcomes are presented. The introduction of restrictions meant that fewer SIFs were operating, and this was reflected in the number of clients that attended and engaged with staff during the period. This was at least partly a reflection of the reduced capacity of SIFs to support injections. The number of staff also declined, which was consistent with the requirement to reduce the number of staff at each site. SIF staff managed to show the presence of the facilities through social media platforms in the absence of physical spaces, and this had positive consequences for safer injecting practices. At one site, the local authorities provided subsidised accommodation for SIF staff. However, this support proved unsustainable, and the social environment at a SIF was reported to have suffered in the absence of regular client visits
Methods to assess service delivery (i.e. experiences of service delivery) were developed. Efficacy of the SIFs in preventing problematic injecting behaviour was measured before the introduction of the national restrictions using single items from the Measure of Harm Reduction Services and Efficacy (MORSE) questionnaire (Hill et al. 2008). The changes in service delivery were assessed using the Social Difficulties Scale (Stabler and Brody 1989), which measures both positive and negative aspects of social life, and importantly, the perceived safety of the social environment.
The SIFs also collected a series of qualitative data using a focus group via telephone. The focus group was conducted prior to the imposition of the restrictions to validate the measurement tools used to gauge service evaluation, and it was used to investigate client attendance and engagement with the facilities. Focus group transcripts were also analysed to identify emerging themes relating to the challenges of operating SIFs under lockdown.
The findings will be discussed in the context of other literature that has noted the importance of SIFs in particular contexts. Further research is required to examine the effectiveness of SIFs under different service conditions, such as those that are implemented during social distancing-inducing lockdowns. d2c66b5586