NDTMS Core Data Set N Secure setting February 2017

Overview CDS-N to be implemented on 1st April 2017 for new and existing clients. New clients – immediately implement CDS-N from 1st April 2017. Existing clients – episode and modality level data items (implement new interventions as and when applicable) Stakeholder Consultation 25th Jul to 2nd Sep 2016. First CDS-N submission will be in early May and contain NDTMS data from 1st April 2017. The first reports to contain the new CDS-N data items will be Quarter 1, 2017/18. NDTMS CDS N

Additional data items at episode level Adult dataset only Time since last paid employment Take home Naloxone and training information Sentenced Referred to hep C treatment Adult and YP dataset Are the client’s children (biological, step, foster, adoptive, guardian) or any of the children living with the client receiving early help or are they in contact with children’s social care? NDTMS CDS N

Time since last paid employment Episode level field. Field heading – ‘TSLPE’. Permissible responses: Code Text Less than a year 1 1-2 years 2 2-3 years n* n years since paid employment 97 Never employed 98 Currently employed 99 Client declined to answer How long has it been (in years) since the client was last in paid employment? This includes cash in hand work. If a client declines to answer then ‘client declined to answer’ should be used. Less than a year - Less than 1 year since paid employment 1-2 years - Between 1 and 2 years since last paid employment 2-3 years - Between 2 and 3 years since last paid employment n years since paid employment - n is defined as an integer between 3 and 75 Never employed - Client has never been in paid employment NDTMS CDS N

Take home Naloxone and training information Episode level field. Field heading – ‘THNALOX’. Field to be completed on release only. Permissible responses: Code Text 1 Yes 2 No NDTMS CDS N

Sentenced Episode level field. Field heading – ‘SENTENCED’. Already a data item in the Data Entry Tool (DET). Field to be completed on release or transfer only. Permissible responses: Code Text 1 Yes 2 No NDTMS CDS N

Referred to Hep C treatment Episode level field. Field heading – ‘REFHEPCTX’. Field to be completed on release only. Permissible responses: Code Text 1 Yes 2 No NDTMS CDS N

Are the client’s children (biological, step, foster, adoptive, guardian) or any of the children living with the client receiving early help or are they in contact with children’s social care? Episode level field. Field heading – ‘EHCSC’. Permissible responses: Code Text 1 Early Help 2 Child in need 3 Has a child protection plan 4 Looked after child 5 No Early Help - Early Help - the needs of the child and family have been assessed and they are receiving targeted early help services as defined by Working Together to Safeguard Children 2015 (HM Govt.). Child in need - Child in need – the needs of the child and family have been assessed by a social worker and services are being provided by the local authority under Section 17 of the Children Act 1989. Has a child protection plan - Has a child protection plan - social worker has led enquiries under Section 47 of the Children Act 1989. A child protection conference has determined that the child remains at continuing risk of ‘significant harm’ and a multi-agency child protection plan has been formulated to protect the child. Looked after child - Looked after child - arrangements for the child have been determined following statutory intervention and care proceedings under the Children Act 1989. Looked after children may be placed with parents, foster carers (including relatives and friends), in children's homes, in secure accommodation or with prospective adopters. No - Children are not receiving early help nor are they in contact with children’s services. NDTMS CDS N

New reference data items (Adult & YP) Discharge Reason Incomplete - released from court Incomplete - deported Hep B intervention status Offered and accepted but refused at a later date Deferred due to clinical reasons Hep C intervention status NDTMS CDS N

New reference data items (Adult & YP) Referral on release status 'Referred to recovery support services' instead of 'Referred to CJIT‘ 'Referred to structured treatment provider' instead of ‘Referred to treatment provider’ 'Referred to structured treatment provider and recovery support‘ instead of ‘Referred to CJIT and treatment provider‘ NDTMS CDS N

Modality / Interventions Removed reference data items Opioid reduction Opioid maintenance Other clinical intervention Drug recovery wing ALC – structured psychosocial ALC – other structured treatment NDTMS CDS N

Pharmacological Intervention Changes Applicable to adult secure setting only Instead of ‘opioid reduction’ Instead of ‘other clinical intervention’ and ‘opioid maintenance’ Code Text 107 Opioid reduction – methadone 108 Opioid reduction – buprenorphine 109 Opioid maintenance – methadone 110 Opioid maintenance – buprenorphine Code Text 103 Benzodiazepines detoxification 104 Lofexidine 105 Naltrexone pre-release 106 Opioid re-induction NDTMS CDS N

Psychosocial Interventions Changes Applicable to adult secure setting only ‘Other Formal Psychosocial Therapy’ changed to ‘Other Structured Psychosocial Intervention’ NDTMS CDS N

Other Intervention Changes Applicable to adult secure setting only ‘ALC – structured psychosocial’ and ‘ALC – other structured intervention’ removed Provided clarity regarding ‘Structured Day Programme’ applying to drug and alcohol Therefore… ‘Psychosocial Intervention Mental Disorder’, ‘Other Structured Psychosocial Intervention’, ‘Other Structured Intervention’ and ‘Structured Day Programme’ are all now applicable to drug and alcohol clients. NDTMS CDS N

TOP / YPOR Introduction to NDTMS - Data Capture for Adults

Outcomes records The prison outcomes framework will utilise outcome records. TOP was introduced in 2007 and YPOR in 2013, and are national outcome monitoring tools currently collected by structured treatment teams in the community. TOP/YPOR measures change and progress in key areas of the lives of individuals accessing structured treatment. TOP/YPOR are a brief set of items measuring Substance use Injecting risk behaviour Crime Health and social functioning NDTMS CDS N

Outcomes records Outcomes will be measured between entry to prison (‘reception TOP/YPOR’) and when the client is released in to the community (‘post release TOP/YPOR’). The ‘reception TOP/YPOR’ will provide a baseline record of behaviour in the 28 days leading up to the custodial stay and commencement of a new prison treatment journey. NDTMS CDS N

Outcome records TOP applies to adults secure settings and YPOR to YP secure settings. Expected to be complete within 2 weeks of ‘Initial Reception’. Ideally complete when the individual is being assessed for their treatment need. The timeframe (known as the recall period) of the TOP/YPOR questions should cover the 28 days immediately prior to reception. NDTMS CDS N

TOP question types Yes or No - a simple yes or no answer. Timeline - the client recalls the number of days in each of the four weeks (28 days) on which they did something. For example, how many days have they used heroin? Rating scale - a 20-point scale from poor (0) to good (20) where the client can rate aspects of their life. Remember: When completing TOP NA means ‘not answered’ and not ‘not applicable’. NA should be used if the client cannot recall or does not wish to answer a specific question. Introduction to NDTMS - Data Capture for Adults

Substance use in the last 28 days ‘Tobacco Use’ added from the 1st April 2016: Definition: Number of days in the previous 28 days that the client smoked tobacco, in whatever form (ready-made cigarettes, hand-rolled cigarettes, cannabis joints with tobacco, cigars, pipe tobacco, shisha/waterpipes, etc), but not including nicotine replacement therapy and e-cigarettes. Permissible responses : 0-28 or NA = Not Answered ‘Tobacco Use’ added from the 1st April 2016: Definition: Number of days in the previous 28 days that the client smoked tobacco, in whatever form (ready-made cigarettes, hand-rolled cigarettes, cannabis joints with tobacco, cigars, pipe tobacco, shisha/waterpipes, etc), but not including nicotine replacement therapy and e-cigarettes. Permissible responses : 0-28 or NA = Not Answered Introduction to NDTMS - Data Capture for Adults

TOP - Injecting risk behaviour Introduction to NDTMS - Data Capture for Adults

TOP – Crime questions Introduction to NDTMS - Data Capture for Adults

TOP - Health and social functioning Introduction to NDTMS - Data Capture for Adults

Young Person’s Outcomes Record (YPOR) Types of question asked: Yes or No Timeline – the YP recalls the number of days in each of the past four weeks (28 days) on which they did something. Quantity – the amount used of a particular substance on a using day Age – the age the YP first used the substance in question Rating scale Remember: When completing a YPOR, NA should be used if the client cannot recall or does not wish to answer a specific question. Timeline - For example, how many days have they used cannabis? Quantity - other than cannabis or alcohol for quantity use whichever measurements you find most useful for that substance. Rating - a 10-point scale where the young person can rate certain aspects of their life. Introduction to NDTMS - Data Capture for Young People

YPOR – substance use Areas marked with quotation marks do not get submitted to NDTMS are for treatment provider’s use only Introduction to NDTMS - Data Capture for Young People

YPOR – substance specific risk behaviour Note: Difference to question 2b and 2c. If yes to ‘ever injected’, have you injected a substance in the past 28 days/28 days prior to custody? Introduction to NDTMS - Data Capture for Young People

YPOR – patterns of use Introduction to NDTMS - Data Capture for Young People

YPOR – health and wellbeing Introduction to NDTMS - Data Capture for Young People

Outcome Records TOP/YPOR introduced in secure settings Additional data items at TOP level (adult only) Days in unpaid structured work placement - Between 0 and 28 or NA Days in volunteering - Between 0 and 28 or NA Unsuitable housing – Yes, No or NA Additional data items at YPOR level (young persons only) Injected in the past 28 days/ 28 days prior to custody – Yes, No or NA NDTMS CDS N

Recap - Outcome records in secure settings Adult Secure Setting - Complete a Reception TOP within 2 weeks of the initial reception date to cover the 28 days immediately prior to reception. YP Secure Setting - Complete a Reception YPOR within 2 weeks of the initial reception date. For clients that have been discharged from a Secure Setting as ‘transferred – not in custody’ (community provider has been contacted by the secure setting and is expected to continue the client’s journey) Community provider - Complete a Post Release TOP/YPOR within 28 to 56 days following transfer from Secure Setting to cover 28 days post release. NDTMS CDS N

Scenarios - Outcome records If a detainee has transferred from another establishment, and was assessed in the sending prison, a TOP/YPOR may not need to be completed by the receiving establishment as the establishment where they were first received into custody should already have completed a TOP/YPOR. However if a detainee has transferred – in custody within 2 weeks of their ‘initial reception date’ then an ‘initial reception TOP/YPOR’ should be completed by the receiving establishment. If the transfer was more than 2 weeks after initial reception a TOP/YPOR does not need to be completed by the receiving establishment. If a detainee starts the sentence at your establishment (no transfers in this example) and is assessed more than 2 weeks after initial reception, e.g. because they chose not to engage with treatment when they first came into custody, a TOP/YPOR does not need to be completed. This is because it will not be possible to robustly capture behaviour in the 28 days prior to entering custody. NDTMS CDS N

Community - Outcome records In the community, treatment providers record TOP/YPOR with clients at treatment start and TOP at regular review points, this supports the individuals recovery care plan. Community treatment providers also complete TOP/YPOR at treatment exit. This does not apply to secure settings. Secure settings are expected to complete one TOP/YPOR within 2 weeks of ‘Initial Reception’. NDTMS CDS N

Community - Outcome records Following release from custody, a ‘post release TOP/YPOR’ is expected to be completed by community providers, where the client has been transferred to and engaged with structured treatment and / or taken onto a CJIT caseload. Community providers ‘post release TOP/YPOR’ should be complete at least 28 days after the client leaves custody (and within 56 days of release). To support this, please ensure that the ‘Prison Exit Date’ is shared with the community provider. NDTMS CDS N

Continuity - Outcome records By collecting TOP/YPOR information at prison entry, NDTMS will be able to monitor treatment outcomes post release and across a client’s entire treatment journey. Under Transforming Rehabilitation, all sentenced prisoners will be supervised post release, therefore it will be possible to monitor outcomes for all clients, not just those engaging with structured treatment in the community. NDTMS CDS N

Continuity - Outcome records To ensure compliance levels are sufficiently high to robustly report on prison outcomes, it is vital that key NDTMS data items are accurately handed over to community providers who are continuing care for recently released prisoners. In order to do so, there needs to be a strong link between the prisons and community services. Matching from Prison NDTMS to Community NDTMS / CJIT is based on the prison data items…Discharge Reason of ‘Transferred – not in custody’ and Prison Exit Reason of ‘Released’. Key fields as reported on your NDTMS reporting database (DET): initials / dob / sex / prison exit date It may be best to share this information via release plans. NDTMS CDS N

Important Note NB. Please be aware that family and friends of clients seeking substance misuse treatment should not be included in NDTMS systems. NDTMS CDS N

Documentation Reference data Business definitions Technical definitions Lists all NDTMS data items and all possible answers Describes all items in dataset Guidance to IT managers NDTMS CDS N www.nta.nhs.uk/core-data-set.aspx

Any Questions? If you have any questions, please contact your local NDTMS team, the contact details of which are on next slide. NDTMS CDS N

Regional Contacts Region Contact Details Yorkshire and the Humber NDTMS.YH@phe.gov.uk North East NDTMS.NorthEast@phe.gov.uk North West NDTMS.NorthWest@phe.gov.uk West Midlands NDTMS.WestMidlands@phe.gov.uk Eastern (East Midlands and East) NDTMS.Eastern@phe.gov.uk South East NDTMS.SouthEast@phe.gov.uk South West NDTMSSouthWest@phe.gov.uk London NDTMS.London@phe.gov.uk The NDTMS fair processing notice can be found at: http://www.nta.nhs.uk/uploads/phe-ndtms-personal-information-leaflet-v2-march-2016.pdf NDTMS CDS N