HAMPSHIRE DRUG ACTION TEAM

TREATMENT PLAN SUMMARY 2003/04

1. Introduction

1.1 The Drug Action Team (DAT) is co-terminous with Hampshire County Council, with a population of 1,240,032 (Census 2001) across a geographical area of 375,000 hectares. Within the DAT area, there are 11 Local Council's (District/Borough/City), 7 Primary Care Trusts (PCTs) and 9 locality Drug and Alcohol Reference Groups (DARGs).

1.2 Over the past year, partnerships have strengthened and the DAT is pleased to be making progress. Issues of access remain the greatest challenge in a county as large and diverse as Hampshire. Our successful `Celebrating Diversity' conference raised issues which must be embedded in our contracting and commissioning arrangements. Flexibility, co-location and joint working between the statutory and voluntary sector will be essential as we shape, reshape and re-model services over the next 3 years.

1.3 The Treatment Plan that has been produced reflects both local priorities and national imperatives.

2. Local Priorities for 03/04

Following a stakeholder process, the following key priorities were identified:

i. Dual Diagnosis

ii. Criminal Justice

iii. Young Peoples Treatment

iv. Models of Care

v. User/Carer Involvement & Support

3. Planning Grids

The Treatment Plan comprises of 9 planning grids in a format defined by the National Treatment Agency (NTA). (A full copy of the planning grids can be obtained from the Drug Action Team on 01962 876347). The 9 grids are based on four tiers of service provision as defined in `Models of Care' (MoC) (a de facto National Service Framework (NSF) for substance misuse), together with supporting initiatives e.g. systems developments, user involvement.

NOTE: "Planned spend" includes slippage carried forward from 02/03.

3.1 Planning Grid 1: Tier One - Non-drug treatment specific services

3.1.1. Gap Analysis

i. Lack of basic drug awareness amongst non-drug specific staff;

ii. Lack of basic drug information for clients;

iii. Absence of referral routes into treatment services;

iv. Low availability of Hepatitis B vaccination programmes;

v. Lack of supported housing provision and floating support.

3.1.2. Objectives for 2003/04

i. Provide access to drug awareness training;

ii. Increase the availability and consistency of drug information literature;

iii. Identify and approve integrated care pathways in line with MoC;

iv. Improve equity of access to Hepatitis B vaccination programmes;

v. Develop a housing protocol for substance misuse clients;

vi. Participate in the development of supported housing schemes.

3.1.3 Planned spend 2003/04 - £80,000

3.2 Planning Grid 2 : Tier Two - Open access drug treatment services

3.2.1. Gap Analysis

i. Inequity of access to needle exchange services;

ii. Lack of Crack Cocaine information/literature;

iii. Lack of open access treatment services;

iv. No enhanced arrest referral service.

3.2.2 Objectives for 2003/04

i. To develop a model and tender for a Hampshire wide needle exchange service;

ii. To put in place contracts and service specifications for all existing service provision;

iii. To develop a new `Shop Front' provision;

iv. To commission an enhanced arrest referral service.

3.2.3 Planned spend 2003/04 - £2,340,700

3.3 Planning Grid 3 : Tier Three - Structured community based drug treatment services

3.3.1 Gap Analysis

i. DTTO services unsustainable at current level of investment to meet increased targets. No DTTO provision for under 18's;

ii. Lack of access to structured day services in rural areas and semi-rural parts of County;

iii. Absence of young peoples treatment services in parts of County;

iv. Absence of care pathway into Tier 4 provision;

v. Absence of Shared Care;

vi. Through care and Aftercare provision minimal;

vii. Dual diagnosis workers only operating in the SE;

viii. Lack of Hepatitis C testing, support and counselling.

3.3.2 Objectives for 2003/04

i. Review DTTO contracts and service structure.

ii. Contracts and service specifications in place for all existing service provision.

iii. Increase day service capacity by 50 places.

iv. Increase the participation of GP's in Shared Care to 15% in 2003.

v. Develop needs lead young peoples treatment services.

vi. Through care model identified and developing.

vii. Develop Hepatitis C testing with pre and post counselling.

viii. Provide parity across Hampshire with regard to Dual Diagnosis.

3.3.3 Planned Spend 2003/04 - £3,8799,150

3.4 Planning Grid 4 : Tier Four - Residential drug treatment specific services

3.4.1 Gap Analysis

i. Historical commissioning arrangements for in-patients detox inflexible and lacking patient choice.

ii. Insufficient care management funding for residential rehabilitation.

iii. Transition between in-patient and residential rehabilitation provision often interrupted.

iv. Use of acute mental health beds in crisis situations without co-ordinated input from specialist drug treatment services for dual diagnosis patients.

v. Childcare issues reducing and delaying access to residential provision.

vi. Absence of Young Peoples Tier 4 services.

3.4.2 Objectives for 2003/04

i. Make a greater use (where appropriate) of local provision to develop the residential treatment economy and infrastructure within Hampshire for Hampshire residents.

ii. Reduce the longest waiting time for in-patient detox and residential rehabilitation.

iii. Increase community care budgets to support additional residential placements.

iv. Work with Partners to resolve child care issues.

v. Determine and document appropriate care pathways into Young Peoples Tier 4.

3.4.3 Planned Spend 2003/04 - £811,500

3.5 Planning Grid 5 : Workforce Activities

3.5.1 Gap Analysis

i. Absence of information relating to existing workforce competencies.

ii. Insufficient training resources.

iii. DAT strategy for recruitment and retention.

iv. Co-ordinated training programme.

v. Access to Tier 1&2 training, crack, diversity and dual diagnosis training.

3.5.2 Objectives for 2003/04

i. Undertake a Hampshire training needs analysis and develop a training programme.

ii. Ensure Hampshire providers participate in the NTA workforce planning activities.

iii. Offer crack awareness training at basic and intermediate level.

iv. Offer diversity training.

v. Offer Tier 1 and Tier 2 training.

vi. Offer dual diagnosis training.

vii. Ensure all partner agencies and providers contribute to the development of staff competencies.

3.5.3 Planned Spend 2003/04 - £141,500

3.6 Planning Grid 6 : Underserved groups

3.6.1 Gap Analysis

i. DAT Diversity Conference and BME needs assessment raised access issues in respect of rural communities and underserved groups.

ii. Not all service venues conform to requirements of the Disability Discrimination Act.

iii. Drugs awareness literature, advice & information in minority languages/formats

iv. Meeting the needs of stimulant users.

3.6.2 Objectives for 2003/04

i. All contracts to ensure diversity issue embedded in service provision.

ii. BME needs assessment updated to include population data from 2001 census.

iii. QUADS compliance in relation to issues of diversity by 2004.

iv. Development of services to incorporate the needs of stimulate users.

v. Drug awareness literature is available in minority languages.

vi. Diversity training for Tier 2 - 4a workforce.

3.6.3 Planned spend 2003/04 - £40,000

3.7 Planning Grid 7 : `System' Investments

3.7.1 Gap Analysis

i. Contracts & services specifications largely absent for established service provision.

ii. Performance management of services not yet sufficiently robust.

iii. Commissioning capacity insufficient.

iv. NDTMS compliance.

v. Recording and monitoring information falls short NTA minimum dataset.

vi. QUADS compliance not yet achieved.

vii. Information exchange between the DAT and treatment stakeholders not sufficiently robust.

3.7.2 Objectives for 2003/04

i. Performance management framework for all providers.

ii. To develop commissioning capacity.

iii. To appoint a part time Finance and Information Officer and a full time Commissioning Assistant.

iv. Ensure all providers complete NDTMS forms in line with existing guidance.

v. Develop a strategy for the implementation of the NTA minimum dataset.

vi. 50% of provider services to be QUADS compliant by 2004.

vii. Develop and publish a robust communication strategy.

viii. Develop a DAT website.

3.7.3 Planned spend 2003/04 - £466,000

3.8 Planning Grids 8 : User or Carer involvement

3.8.1 Gap Analysis

i. Support structures and services for users/carers are underdeveloped countywide.

ii. Opportunities to enable service users/carers to influence and participate in the planning and commissioning of services.

iii. Advocacy services.

3.8.2 Objectives for 2003/04

i. Recruit a part time service user/carer co-ordinator.

ii. Promote the development of service user/carer support groups across Hampshire.

iii. Develop a protocol for service user/carer participation and involvement on the DAT.

iv. Develop a range of formats to canvass the levels of user/carer satisfaction of the treatment & care services.

v. Encourage continued service user/carer participation in the development work of the NTA.

vi. Deliver resuscitation training to 30 service users.

vii. Develop Advocacy support mechanism.

3.8.3 Planned spend 2003/04 - £80,550.

3.9 Planning Grids 9 : Models of care Implementation

3.9.1 Gap Analysis

i. Absence of a clearly defined and approved local process to implement Models of Care.

ii. Absence of integrated care pathways and referral protocols across the treatment system.

iii. Lack of information collection and sharing protocols.

3.9.2 Objectives for 2003/04

i. Identify an implementation group and lead officer for Models of Care.

ii. Ensure Hampshire providers are fully conversant with their obligations under Models of Care.

iii. Develop, agree and implement referral and information protocols between services in Tier 2-4a.

iv. Publish treatment services and care pathways.

v. Identify the investment from DAT and partners to develop services.

3.9.3 Planned spend 2003/04 - £84,000