A proposed new model for an Adult Community Substance Misuse Treatment and Recovery System in Nottinghamshire County Dr Chris Kenny DPH Nottinghamshire.

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Presentation transcript:

A proposed new model for an Adult Community Substance Misuse Treatment and Recovery System in Nottinghamshire County Dr Chris Kenny DPH Nottinghamshire County and Nottingham City 26 September 2013

Purpose of today To describe: Importance of substance misuse The proposed model The proposed outcome measures

Importance of substance misuse Health and wellbeing Crime and disorder Housing Employment Social functioning

Why ? Strategic shift in focus – Recovery emphasis, treatment is part of that journey, not the ultimate destination Whole system never formally tendered* or subject to market exercise to test value for money *NHS Bassetlaw did undertake a formal tender process for part of the system in 2011

The current system

“If recovery is a train journey from Nottingham to London ……. treatment is the taxi that gets you to the station” Simon Jenkins 12 Step Recovery

What are we consulting on? Our vision to have an Adult Community Substance Misuse Treatment and Recovery System, which will enable individuals easy access to stigma free, high quality cost effective treatment and recovery services across Nottinghamshire, regardless of where they live or the substances used

Proposed Model Principles A model with the Recovery at its core – everyone entering substance misuse services has the potential to recover A consistent and responsive approach to treatment and recovery service provision and delivery across all seven districts of Nottinghamshire A consistent approach to outcome monitoring Equity of treatment and recovery provision regardless of whether an alcohol or drug user A consistent approach to commissioning Clarity regarding financial efficiency and value for money

Possible outcome measures Recovery – what does this mean? Health and wellbeing Reduced crime Employment Housing Support for others

ACCESS POINT Self Primary Care Hospital Criminal Justice System EXIT Planned Drop out Prison STANDARD ALL CLIENTS (including family member and carers) Triage and initial assessment Keyworker allocated Family member/carer assessment Low intensity psychological interventions/extended brief interventions Proactive/facilitated referral to housing, education, employment, personal finance, healthcare support and Mutual Aid (self-help) ENHANCED As STANDARD Plus: Comprehensive assessment Opioid Substitution/other prescribing Structured psychological interventions Harm reduction (BBV&TB testing, NSP) Planned community withdrawal/detoxification Assessment physical & mental health needs Consider residential/community rehabilitation COMPLEX As ENHANCED plus: In-patient/unplanned withdrawal or detoxification Pregnancy shared care Free of all substances Based upon: National Treatment Agency (2012) Medications in recovery: Re-orientating drug dependence treatment

Discussion points Relative importance of substance misuse Public and patient engagement in the process Impact on providers Use of resources in the context of overall LA financial plans

A proposed new model for an Adult Community Substance Misuse Treatment and Recovery System in Nottinghamshire County Dr Chris Kenny DPH Nottinghamshire County and Nottingham City 26 September 2013