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Alcohol and drugs


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Alcohol and drugs

  1. 1. Alcohol and Drugs Alcohol consumption has a direct impact on NHS services. It has been found that drink- driving casualties are rising, with young male heavy or problem drinkers six times more likely to be involved in an accident than moderate drinkers.1 Alcohol related ambulance use in Barnet The Ambulance Service in Barnet has shown that there has been an increase in alcohol related calls. See Table in , which indicates that there has been a 33% increase in alcohol related calls. This has a direct impact on NHS costs. The rising trend in alcohol related incidents is further supported by Police CAD data: Drugs The Drug and Alcohol Action Team published their needs assessment report in January 2009.2 Their key findings were: Barnet’s Drug and Alcohol Team’s (DAT) key findings3 were: There has been a marked improvement in harm reduction services. Partnership plan  has been achieved for new presentations offered Hepatitis B vaccination and also those with known hepatitis C intervention status. The current penetration rate is 41% which compared favourably with .  There was a 75% (136 in 2006-07 and 34 in 2007-08) decrease in number of clients  known to DIP services but not to treatment. Retention rate of clients over 12 weeks was higher in Barnet (82%) compared to  London (77%) and nationally (78%). Current service provision not meeting the needs of under 25s  10% of BME groups were found to be in treatment but audit in BDAS found that about  a quarter of their clients were Iranians. Drug Treatment A diagram illustrating what drug treatments are available in Barnet is in . Access to drug treatment services in Barnet 2007/08 can be found in . Barriers and Gaps to Treatment 1 Prime Minister’s Strategy Unit (2004) Alcohol Harm Reduction Strategy for England. Cabinet Office 2 Barnet Adult Drug and Alcohol Team Needs assessment for Barnet Adult drug and alcohol treatment services January 2009 3 Drug and Alcohol Team Needs assessment for Barnet Adult Drug and Alcohol Treatment Services. Jan. 2009
  2. 2. A users’ survey highlighted areas where there were gaps and barriers in service provision. Indeed, users were also able to suggest how future services could be improved. Drug Services – Users Perception4 Barriers to treatment and engagement Children are not allowed at two of the treatment services and this makes it difficult for  parents to engage and keep appointments. These parents therefore do not get the most they can get from being in treatment. Accessibility at The Crossing poses some concern because it is based on 3 floors.  Gaps in service provision About 41% (26) either did not have a Care Plan or did not know what it was. The  survey also showed that clients were less aware of Treatment Outcome Profile/forms. Also highlighted in the needs assessment for Adult Drug and Alcohol services was the  need for more support for people that have both mental health and substance use issues. There is no clear referral/treatment pathway, the clients move from service to service. Also strain is placed on drug and alcohol practitioners who are not trained to deal with mental health issues. Issues around services not answering their phones and passing on messages.  Service users suggestions on how to improve existing services. Family support  Child Care for those that need it  Being able to pick up script from The Crossing  A weekend Drop-in  Support for kids and families under pressure from social services  More aftercare for those finishing orders, groups and key working  Expansion of BSUG area to include games, coffee area & drop in area when The  Grove is closed Further gap analysis is discussed in . As a result of the needs analysis key priorities for 2009/10 were identified. 4 Drug and Alcohol Team Needs assessment for Barnet Adult Drug and Alcohol Treatment Services. Jan. 2009
  3. 3. Key priority areas for Drug and Alcohol Team Key priorities for 2009/10. The Partnership has agreed the following priorities for 2009/10: 1. To establish a clear clinical governance infrastructure across the treatment system that is fit for the future, where the DAAT retains clear accountabilities for overall performance monitoring and management, commissioning decisions and reporting into appropriate strategic forums. This will be supported by a review of DAAT team roles and functions that will finalise a structure that will enable the Partnership to deliver on all elements of the Treatment plan. 2. To establish and implement a clear framework for regular service reviews, particularly clinical audits in line with all relevant clinical guidance, including an emphasis on workforce competence. 3. To progress carer involvement within DAAT structures and, consequently, further develop carer services/involvement with treatment. 4. To implement Community Peer Education plan, focussing on five identified communities that have proven hard to engage; drawing them into the planning structures and evolving service delivery as necessary. 5. To implement changes within Tier 2 service provision in light of the current planned review; this will focus on accessing new PDUs into the treatment system and the further development of the service specification for the outreach service. 6. To review Models of Care processes and ensure that care co-ordination and re- engagement policies are effectively monitored through regular service reviews and clinical audits. This will include a focus on both improving successful treatment exit rates and improving compliance with TOP reporting. 7. To continue to review DIP service model to ensure that more referrals are accessed into and engaged with treatment following arrest, release from prison or subject to ROB/Conditional cautioning. 8. To review and implement necessary changes to reduce the barriers to access and engagement for substance using parents including the further development of child care facilities and re-configuring of family focussed services. 9. To monitor and adapt, as necessary, transitional policy for young people in treatment who require adult services and improve retention/effective engagement rates for under 25s. 10. To establish effective planning and strategic development mechanisms are in place to ensure a wider range of accommodation options are available for service users and that last years housing needs assessment is better reflected in local strategies. 11. To undertake a full service model review to inform future developments (with a strong focus on Tier 2 provision), as two out of the three key service sites’ leases are due to expire at the end of March 2010. 12. To establish clear pathways for accessing service users into employment, education and training opportunities initially through the nascent Aftercare service; to provide support to those PDUs in receipt of benefits but not involved with treatment in partnership with JC+. 13. To further develop performance management frameworks that ensure timely and appropriate information and analysis are available at all partnership meetings.
  4. 4. This will include the establishment of Data management forum that will ensure consistency across the treatment system, compliance with NDTMS, TOPs and DIRWeb and enable a more coherent approach to the use of current data systems.