1. DTMU is delivered by Solutions for Public Health Confidential & Proprietary, Copyright 2010, Solutions for Public Health March 2 nd 2010 NATMS Core Dataset Training for Alcohol Treatment Providers and Commissioners Michael Wallington & Regina Lally Drug Treatment Monitoring Unit

2. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 2 October 12, 2014 Ground Rules Please respect those around you by not holding individual conversations whilst the sessions are in progress Please put mobiles on silent/vibrate Please take any calls outside of the meeting Today will focus on Alcohol Only. Discussions in relation to NDTMS will be covered at local DAAT Training.

3. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 3 October 12, 2014 Aims Clarify situation with regards to alcohol specific data items within Core Data Set G (CDS-G) Clarify requirements and definitions of Core Data Set in relation to Alcohol Treatment Providers Review Data Quality and uptake of TOP Provide information around current reporting and monitoring Clarify numbers in treatment, successful completions and waiting times calculations

4. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 4 October 12, 2014 NATMS Core Dataset G Four proposed new data items: –Audit Score –Smoking Status –Treatment Goal –Days drinking above the binge limit Data items not approved by Department of Health –Discussions continuing, but no final decision reached –Therefore, not required for completion or submission from 1 st April 2010

5. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 5 October 12, 2014 NATMS Core Dataset G Four proposed new data items: –Audit Score –Smoking Status –Treatment Goal –Days drinking above the binge limit DH want to consider –Relevance to providers –Relevance to commissioners –Impact of collection on providers

6. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 6 October 12, 2014 NATMS Core Dataset G Four proposed new data items: –Audit Score –Smoking Status –Treatment Goal –Days drinking above the binge limit Group discussion –Benefit of collecting these items –Implications of collecting these items –Impact of collecting these items

7. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 7 October 12, 2014 NATMS Core Dataset G Four proposed new data items: –Audit Score –Smoking Status –Treatment Goal –Days drinking above the binge limit Feedback to DH –DTMU will take the summary of this session and provide as feedback to DH, to inform their discussions.

8. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 8 October 12, 2014 NATMS Core Dataset G Four proposed new data items: –Audit Score –Smoking Status –Treatment Goal –Days drinking above the binge limit Do not submit these fields to NATMS until further notice Liaise with software suppliers to ensure fields are hidden in the front end of your system

9. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 9 October 12, 2014 NATMS Referral Sources Updated alcohol specific referral sources from 1 st April 2010 Applicable to primary alcohol clients only: –Employer –Alcohol Treatment Requirement (ATR) –Peer

10. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 10 October 12, 2014 NATMS Data Items Four groupings of items –Client Information –Episode Information –Modality Information –[Treatment Outcome Profile (TOP) Information]

11. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 11 October 12, 2014 NATMS Data Items TOP Information Client Information Episode Information Modality Information Episode Information Modality Information Modality Information Modality Information Modality Information Modality Information TOP Information TOP Information TOP Information TOP Information TOP Information

12. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 12 October 12, 2014 Client Information Agency ID: P0000 First Initial: A Second Initial: W DOB: 22/10/1973 Gender: Male Referral Date: dd/mm/yyyy T3 Assessment Date: dd/mm/yyyy Main Problem Substance: Alcohol PCT of residence: Kent DAT of residence: Kent Postcode: ME14 1HH Referral Source: Self Client Ref: 123 Previously Treated: No Consent for NATMS: Yes Sexuality: Heterosexual Ethnicity: White Local Authority: Maidstone Nationality: GBR

13. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 13 October 12, 2014 Referral Date Definition Referral date –(referral to agency date) date agency becomes aware that the client is waiting. –Date of receipt of phone-call, letter, client walks through door asking to be seen etc.

14. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 14 October 12, 2014 Consent Clients should give written consent to share information about their care plan. This consent should specifically state which agencies the client consents to have information received about them and which they do not. A form recording the client’s consent should be kept in the notes. Consent should be reviewed at the time of reviewing the care plan.

15. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 15 October 12, 2014 NTA Confidentiality Toolkit Confidentiality policy should be clearly explained to client (verbally and written form), before assessment for treatment. Should cover: –What information will be collected by the agency –When and what information will be shared with other services and organisations –Who information will go to and why (NATMS) –When the confidentiality may be breached –(NTA Confidentiality Toolkit, September 2009 NTA)

16. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 16 October 12, 2014 Confidentiality Agencies should have clear policies about how assessment information and care plans are shared. Good information sharing protocols help the care planning process to be smoother and prevent the hold- ups and misunderstandings that might arise if all the relevant information for the client was not available to practitioners and keyworkers in different agencies. (Good practice in care planning, July 2007 NTA)

17. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 17 October 12, 2014 Care Planning “As soon as possible, the allocated keyworker will ensure that the client undergoes a comprehensive assessment of needs. Following this a comprehensive care plan is drawn up”. (Care Planning Practice Guide, August 2007, NTA) “…service user involvement [is] an integral part of the development of care plans, with the users as the central focus of care planning, review and ongoing treatment.” (Good Practice in Care Planning, July 2007, NTA)

18. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 18 October 12, 2014 Care Planning Domains Care Plan Start Date: dd/mm/yyyy Drug & Alcohol Use Route of Administration of Primary Substance: Oral Age of first use of Primary Substance: 23 Problem Substance Two: Cannabis Problem Substance Three: Amphetamines Unspecified Injecting Status: Never Injected in last 28 Days: No Ever shared: No Drinking Days: 28 Units of Alcohol: 17 If “Drinking Days” completed, “Units of Alcohol” MUST be completed as well “Units of Alcohol” is typical number of units consumed on a drinking day

19. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 19 October 12, 2014 Care Planning Domains Physical & Psychological Health Hep C Latest Test Date: dd/mm/yyyy Hep C Intervention Status: Offered and accepted Hep C Positive: No Hep B Intervention Status: Offered and accepted Hep B Vaccination Count: One vaccination Previously Hep B Infected: No Referred to Hepatology: No Dual Diagnosis: No Not likely to be as relevant for Alcohol only clients. Report if it is relevant for the client.

20. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 20 October 12, 2014 Care Planning Domains Social Functioning Accommodation Need: Housing Problem Employment Status: Regular Employment Children: 3 Pregnant: Yes Parental Status: All the children live with client

21. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 21 October 12, 2014 Parental Status Priority for many Partnership areas Reference Data from 1 st April 2009: –All the children live with the client –Some of the children live with the client –None of the children live with client –Not a parent –Client declined to answer Data Completeness being monitored, along with “Children Living with” field.

22. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 22 October 12, 2014 Adult Alcohol Modalities Tier 4 ALC - Inpatient Treatment ALC - Residential Rehabilitation Tier 3 ALC - Community Prescribing ALC - Structured Psychosocial Intervention ALC - Structured Day Programme ALC - Other Structured Treatment Tier 2 ALC – Brief Interventions Will NOT count towards numbers in Treatment. Modalities being delivered should be reported against the client episode Do not use the old “Structured Alcohol Intervention”. This is monitored by data quality reports and should be amended to a new code as above

23. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 23 October 12, 2014 Modality Data Referral Date: dd/mm/yyyy T3/4 Assessment Date: dd/mm/yyyy Referral Source: Employer Referral to Modality Date: dd/mm/yyyy Date of First Appointment Offered: dd/mm/yyyy Modality: ALC- Community Prescribing Modality Start Date: dd/mm/yyyy

24. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 24 October 12, 2014 Treatment Outcomes Profile No requirement by DH or NTA to complete TOPs at Alcohol Only agencies. Validated for clients with Alcohol as main problem substance No central NTA analysis on TOP completed for primary Alcohol clients How is TOP being used across the region in relation to Alcohol Treatment?

25. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 25 October 12, 2014 Treatment Outcomes Profile Short, validated outcome monitoring tool released by the NTA June 2007 Intended for implementation in all Drug services that provide structured Tier 3 & Tier 4 treatments Data to be reported to NDTMS from 1 st October 2007 Should be completed at: –Modality Start –Care Plan Review –Discharge –Post Discharge [Optional] www.nta.nhs.uk/areas/outcomes_monitoring/

26. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 26 October 12, 2014 TOP NDTMS Data You should aim to ask and complete every question. Do not leave any of the blue boxes blank Enter “NA” if a client refuses to answer a question or cannot recall.

27. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 27 October 12, 2014 TOP NDTMS Data Modality Start Date: dd/mm/yyyy [Trigger for first TOP] TOP Date: dd/mm/yyyy TOP Treatment Stage: Treatment Start TOP Care Co-ordination: Yes When multiple agencies are providing treatment, it is envisaged that responsibility for reporting TOP data will lie with the agency responsible for care co-ordination. DAATs should have agreed care co-ordination pathways locally.

28. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 28 October 12, 2014 TOP NDTMS Data Section 1: Substance Use Alcohol Use: 15 Opiate Use: 0 Crack Use: 0 Cocaine Use: 15 Amphetamine Use: 4 Cannabis Use: 10 Other drug use: 0 Information sought: Number of days out of last 28 client has used each drug. Permissible values: Number in range “0-28” “NA” if client is unable to or refuses to answer question

29. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 29 October 12, 2014 TOP NDTMS Data Section 2: Injecting Risk Behaviour IV Drug Use: 0 Sharing: N Information sought: Number of days out of last 28 client has injected non-prescribed drugs. Permissible values: Number in range “0-28” “NA” if client is unable to or refuses to answer question Information sought: Has client shared needles or paraphernalia in last 28 days. Permissible values: Y or N “NA” if client is unable to or refuses to answer question

30. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 30 October 12, 2014 TOP NDTMS Data Section 3: Crime No details of specific crimes should be shared by client with keyworker. General information about type of crimes funding drug or alcohol habit should be shared and recorded to address all client needs and evidence improvement in lifestyle. The information shared with NDTMS is subject to the same confidentiality as all client information currently / previously received. Data is used for performance / outcome monitoring only.

31. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 31 October 12, 2014 TOP NDTMS Data Section 3: Crime Shop Theft: 18 Drug Selling: 6 Other theft: Y Assault / Violence: N Information sought: Number of days out of last 28 client has been involved in each crime. Permissible values: Number in range “0-28” “NA” if client is unable to or refuses to answer question Information sought: Has client been involved in each crime in last 28 days. Permissible values: Y or N “NA” if client is unable to or refuses to answer question

32. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 32 October 12, 2014 TOP NDTMS Data Section 4: Health & Social Functioning Psychological Health Status: 9 Paid work: 3 Education: 1 Information sought: Self reported score from scale. Permissible values: Number in range “0-20” “NA” if client is unable to or refuses to answer question Information sought: Number of days out of last 28 client has had paid work or been in education. Permissible values: Number in range “0-28” “NA” if client is unable to or refuses to answer question

33. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 33 October 12, 2014 TOP NDTMS Data Section 4: Health & Social Functioning Physical Health Status: 5 Quality of Life: 4 Acute Housing Problem: N Housing Risk: Y Information sought: Self reported score from scales. Permissible values: Number in range “0-20” “NA” if client is unable to or refuses to answer question Information sought: Client has been homeless / risk of eviction in last 28 days. Permissible values: “Y” or “N” “NA” if client is unable to or refuses to answer question

34. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 34 October 12, 2014 Modality End / Discharge Data Modality End Date Modality Exit Status –Can be entered as modalities are completed, client episode remains open –MUST be entered for all modalities on discharge from agency Discharge Date Discharge Reason –If a Discharge Date is entered, then a Discharge Reason must be given and vice versa. –Discharge information must be reported accurately and in a timely fashion as it is used to monitor successful completions.

35. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 35 October 12, 2014 Alcohol Discharge Reasons Successful Completions Treatment completed - alcohol free Treatment completed - occasional user

36. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 36 October 12, 2014 Alcohol Discharge Reasons Transfers Transferred – not in custody Transferred – in custody

37. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 37 October 12, 2014 Alcohol Discharge Reasons Incomplete Incomplete – Dropped Out Incomplete – Treatment withdrawn by provider Incomplete – Retained in Custody Incomplete – Treatment Commencement Declined by Client Incomplete – Client Died

38. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 38 October 12, 2014 Discharge Data and TOP Complete TOP at discharge from treatment system. –This should be done face-to-face between keyworker and client where possible –May be done over telephone where no other option available (i.e in unplanned discharges). –NOT acceptable to complete on clients’ behalf without client present.

39. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 39 October 12, 2014 LUNCH

40. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 40 October 12, 2014 Data Collection Purpose Enables national, regional and local-level reporting on alcohol treatment. Supports the National Alcohol Strategy and needs analysis Facilitate policy formulation Supports development of efficient commissioning systems at local level

41. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 41 October 12, 2014 Performance Monitoring Key areas of performance for Alcohol Services are. –Numbers in Treatment –Waiting Times –Successful completions of treatment

42. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 42 October 12, 2014 Reporting and Monitoring Monthly: www.ndtms.netwww.ndtms.net –Numbers in treatment (YTD) Quarterly: “Purple Reports” –PCT level reports –Agency level reports

43. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 43 October 12, 2014 www.ndtms.net

44. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 44 October 12, 2014 www.ndtms.net

45. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 45 October 12, 2014 Numbers In Treatment PCTNumber in Treatment YTD Dec 2009 Berkshire East PCT 625 Berkshire West PCT 259 Brighton & Hove PCT 676 Buckinghamshire PCT 604 East Sussex Downs and Weald PCT 375 Eastern & Coastal Kent PCT 1033 Hampshire PCT 1459 Isle of Wight PCT 163 Medway PCT 588 Milton Keynes PCT 211 Oxfordshire PCT 726 Portsmouth Teaching PCT 470 Southampton PCT 358 Surrey PCT 1900 West Kent PCT 715 West Sussex PCT 1283

46. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 46 October 12, 2014 Quarterly “Purple Reports” Explanation / Discussion Who accesses / uses these reports regularly?

47. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 47 October 12, 2014 What should you expect from DTMU? Agency Training and Support: Dedicated Liaison Officers and Database Administrator providing telephone and in-house training on Current Core Datasets. Monthly Validation and Data Quality Reports via DAMS: Reporting erroneous client records, requiring correction. Newsletter Access to DTMU documents online www.dtmu.org.uk

48. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 48 October 12, 2014 DTMU Data Quality Standards All monthly agency submissions must contain at least 100% valid records. All monthly agency submissions must reach 99.9% data quality Files must be in a CSV format. All agencies must submit via the Drug and Alcohol Monitoring System (DAMS): https://www.ndtms.org/dams/

49. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 49 October 12, 2014 SE DTMU Team Based in Oxford with SEPHO Team consists of: Kellie Peters: Head of Data Management Regina Lally: Manager Michael Wallington:Technical Liaison Project Manager Dami Omole:Project Manager Sue Dales: Database & QA Administrator (NDTMS) Caroline Ridler: Information Analyst Rachel Johnson:Information Analyst Jo Frank:Project Administrator Lucy Nicholson:Database & QA Administrator (Prisons) Laura Kesseboom:DIR Administrator

50. DTMU is delivered by Solutions for Public Health (SPH). © Copyright SPH, 2010 50 October 12, 2014 ANY QUESTIONS