1. Delivering independent intelligence for health and wellbeing National Drug (and Alcohol) Treatment Monitoring System Jill Smith Public Health Liaison Manager North East Public Health Observatory NDTMS Data Fields

2. Delivering independent intelligence for health and wellbeing NDTMS Data Fields Current issues in the North East:- Pregnant Males – still got 3 4 people are smoking alcohol Try and get the data right, use the reference sheets if you are unfamiliar with responses and if you get it wrong please respond to Data Quality requests!!

3. Delivering independent intelligence for health and wellbeing NDTMS – YP Interventions 6 YP Interventions First four describe the delivery:- Psychosocial Intervention Specialist Harm Reduction (Including injecting behaviour, overdose and accidental injury advice) Family Work (Only if YP is in specialist SM treatment) Pharmacological Interventions Fifth describes setting: Access to Residential Treatment Sixth is for Tier 2 only (optional) Non structured intervention Use of combined Tier 2 and Tier 3 interventions can lead to performance measurement errors with serious consequences

4. Delivering independent intelligence for health and wellbeing NDTMS Data Fields 1Dates - Time is of the essence!: Enter all dates accurately – performance e.g. waiting times can be affected. 2Accommodation Need: If NFA then leave postcode blank but complete DAT of residence and PCT of residence for treatment provider (if Tier 3) or referring partnership (if Tier 4). 3Employment Status: Try not to use Other – growing importance of treatment~employment services. 4Sensitive Questions: Sexuality? Children living with? Use professional skills to obtain appropriate answers.

5. Delivering independent intelligence for health and wellbeing NDTMS Data Fields 1Dates - Time is of the essence!: Enter all dates accurately – performance e.g. waiting times can be affected. 2Accommodation Need: If NFA then leave postcode blank but complete DAT of residence and PCT of residence for treatment provider (if Tier 3) or referring partnership (if Tier 4). 3Employment Status: Try not to use Other – growing importance of treatment~employment services. 4Sensitive Questions: Sexuality? Children living with? Use professional skills to obtain appropriate answers. Referral Date: Date referred to the agency e.g. date of letter/phone call/fax or date self-referred Triage/Assessment Date: First face-to-face appointment between keyworker and client Date Referred to Modality: Date it was mutually agreed that the client required this treatment intervention. For the first intervention in an episode this should be the date that the client was contacted and agreed to a referral into the treatment system for a specialist substance misuse treatment intervention. This is not the date a referral letter was received.

6. Delivering independent intelligence for health and wellbeing NDTMS Data Fields 5Parental Status: Includes any parenting where a client has full or partial parental responsibilities: biological, step-, foster, adoptive, guardians and is living with that child(ren) for a minimum of one month – see separate Appendix K in business definitions. Child now defined as <18. Ask at treatment start only. All new references: All the children live with the client Some of the children live with client None of the children live with client Not a parent Client declined to answer

7. Delivering independent intelligence for health and wellbeing NDTMS Data Fields 6 Children living with: Refers to Hidden Harm agenda. Child can be sibling, relative, friend’s child, landlord’s child, own child. May have different addresses – count all children (<18) at all addresses. ***collect at presentation only. 7 Pregnant: Ask! Record N for males ***collect at presentation only. 8 Referral Source: Long list – check for most appropriate and try not to use Other. If you need to, then tell us! 9 Injecting Status & BBV: It is expected that all adult clients will have their injecting status recorded, their Hep B & C status recorded, all who accept Hep B vaccination offer to take it up (during the current episode), all previous or currently injecting to have received a Hep C test. “Assessed as not appropriate to offer” answer available but not expected from Adult services.

8. Delivering independent intelligence for health and wellbeing NDTMS Data Fields 10Dual Diagnosis: Is client currently receiving care from any mental health service for reasons other than SM? Do not leave blank (please!) Not required for YP services 11 Treatment Interventions: Tier 2, 3 & 4 covered by separate options for Alcohol and Drugs. Keep Tier 2 separate from Tier 3/4 with clear distinction between episodes. 12 Health Care Assessment Date: Adult clients are expected to have a date recorded. (May take a few weeks to contact all appropriate referrals). Different services will have a different model of what a HCA is, but all structured treatment should include one. YP services should only report a date when a YP receives an assessment from a health clinician such as a Nurse, Doctor or Psychiatrist AND when the assessment relates specifically to their substance misuse. 13 Retention: Adult services are expected to retain clients in drug treatment for >12 weeks for that treatment to have any ongoing benefit. (Not necessary for alcohol clients)

9. Delivering independent intelligence for health and wellbeing NDTMS Data Fields 14 Discharge Reason: Drugs - Most important that Treatment Complete - Occasional User cannot be option for client with any use, whatsoever, of Opiates or Crack. In that case, must use Unplanned – Dropped Out. Also note availability of Incomplete – treatment commencement declined by client. Similar for Alcohol. 15 Intervention Exit Status: May not be the same as the discharge reason but final modality exit is expected to reflect discharge reason 16 TOP Care Coordinator field: Does the treatment provider currently have care coordination responsibility for the client in regards to completing the TOP information when appropriate during the client’s time in structured treatment? Check – don’t just say No. This field should reflect changes in responsibility.

10. Delivering independent intelligence for health and wellbeing NDTMS Data Fields YP Specific Questions at Presentation and Discharge These questions are intended to capture complexity of client need and (hopefully) the addressing of those needs during treatment. They represent the only outcome information (other than proxy measures) for young people aged under 16. See Appendix G in Business Definitions for details behind each of the questions http://www.nta.nhs.uk/core-data-set.aspx

11. Delivering independent intelligence for health and wellbeing NDTMS - Quiz 1.Should the 3 problematic drug fields change as client treatment takes effect? 2.What are the 5 main referral source groups for YP services?