Meeting documents

1 THE ISSUE

1.1 A brief summary of the way drug misuse services are commissioned and delivered.

1.2 Recent changes to the structure of services.

1.3 An overview of the Drug Action Team's Treatment Plan for 2005-2005 highlighting the issues which have a particular bearing on partnership working between the PCT, the Council and the Voluntary Sector.

2 RECOMMENDATION

2.1 The council Executive notes the recent changes to the structure of services and welcomes the improvement in performance that has resulted.

2.2 The Council Executive endorses the Annual Treatment Plan for 2004 - 2005.

3

FINANCIAL IMPLICATIONS

3.1 The Council manages a pooled budget on behalf of the Drug Action Team (DAT) of £1.58 million, with funds coming from the Council, the Primary Care Trust (PCT), the Home Office, the National Treatment Agency and Probation.

4 THE REPORT

4.1 The Drug Action Team (DAT) is a statutory partnership chaired by the Local Authority's Director of Social & Housing Services, comprising representatives from the Primary Care Trust, Police, Probation and the Local Authority. It is required to plan, commission, deliver and monitor services that help to combat drug misuse and its consequences, from policing to treatment and rehabilitation services.

4.2 The National Treatment Agency (NTA), a Special Health Authority, is responsible for the implementation of the Government's 10 year substance misuse strategy via a national service framework called "Models of Care". Drug Action Teams (DAT), deliver this strategy at a local level and are measured on their success against Key Performance Indicators (KPI) across a range of four areas: Young People; Treatment; Supply and Communities.

4.3 The NTA requires a treatment plan to be written which outlines the delivery of these KPIs against a local strategy of substance misuse treatment and intervention. The KPIs are an increase upon the 1998 baseline of total numbers in treatment; the proportion of problem drug users retained in or successfully completing treatment; the average waiting times for accessing various aspects of care against national targets and year-on-year growth in the drug treatment workforce.

4.4 Tier 1 refers to `front line' staff in a wide range of agencies - the NHS, the Criminal Justice System, Education - who come into contact with people who may have a drug problem. Action involves training being offered to a wide range of workers.

4.5 Tier 2 work is focused around a single agency - Bath Area Drug Advisory Services (BADAS) - delivering open access interventions and treatment, primarily about harm minimisation and preparing clients for more structured treatment in Tier 3. All referrals for drug treatment will come via this agency allowing a greater emphasis on an integrated service. This agency, with the DAT, will also work closely with Pharmacies on needle exchange provision and with GPs on shared care prescribing.

4.6 Tier 3 work is divided between two agencies, one in the voluntary sector (the Drugs and Homeless Initiative, DHI) and the other itself a statutory agency partnership (between the Avon & Wiltshire Partnership Mental Health trust - AWP) and the Primary Care Trust (PCT). Between them these services deliver the treatment that is measured by the waiting time KPI. Since the start of the year when the DAT required these agencies to work in new ways to deliver their services, there has already been a significant improvement in waiting times. Treatment within Tier 3 is structured and requires a reasonable level of client motivation, working closely with clients to achieve their care planned goals. There is intended to be a significant increase in the level of work with GPs and Registered Social Landlords.

4.7 In-Volve Young People's Drug Service: In-Volve, a national organisation, have been commissioned until 2007 to provide a `young people friendly' drug service for under 19's. A comprehensive treatment service will be offered from the Southgate Street centre for approximately 100 young people, whilst the rural outreach and primary school project will allow for early interventions and harm minimisation work with another 700-800 young people per year.

4.8 During 2003/04, Bath & North East Somerset Drug Action Team (DAT) re-commissioned all its drug and alcohol treatment services to met the requirements of Models of Care and is the first DAT in the region to do so. As a result there are fewer separate agencies providing care - essentially BADAS, AWP and DHI - and they work in a structured, integrated way across the client pathway. In addition, as described above, a single agency, Involve, has been commissioned to deliver and co-ordinate young people's services.

4.9 This process has at times been difficult for providers to deal with but with more certainty about the future has come more stable delivery.

4.10 Average waiting times were initially poor but showed progressive improvement throughout the year until only two of the six areas were below the national target (see Appendix 1).

4.11 The current Local Delivery Plan (LDP) target is for 1,100 people to access services and this is based on a complicated model calculated by the Department of Health, which depends on accurate starting figures. A national mini-census of treatment services for 2003/04 has just been completed and may form a new baseline for future reporting.

4.12 This plan (available on request) is drawn up by the DAT to a format required by the NTA in a way which is intended to cover all tiers and modalities or prevention and care. The pooled budget, which amounts to over £1.3 million, consists of earmarked money from several funding streams, including the Department of Health, the Local authority, the Home Office and the Office of the Deputy Prime Minister. There are reasons to be optimistic about services in the future.

4.13 There are also risks to the aspirations of the DAT and service providers alike.

5 RISK MANAGEMENT

5.1 A risk assessment related to the issue and recommendations has been undertaken, in compliance with the Council's decision making risk management guidance.

6 RATIONALE

6.1 Service changes were required if new targets were to be met within existing resources.

7 OTHER OPTIONS CONSIDERED: NONE

8 CONSULTATION

8.1 The Services described above were subject to a formal tendering process.