Review of Drug & Alcohol Services In Derby

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1 Review of Drug & Alcohol Services In Derby Take part from 9 June until 20 July 2014 To take part: Please read the background information contained within this document. If you have any questions about this review please contact Jo Seekings on or Please return your completed questionnaire by 20 July 2014 using the Freepost envelope provided, you don t need a stamp or you can return it using your own envelope addressed to: Public Health Directorate Derby City Council FREEPOST MID24259 Derby DE1 2BR You can also complete this review online at: and select the Review of Drug & Alcohol Services Background Information Social Value Questions New Model Questions Additional Comments Criminal Justice Questions About You Payment by Results Questions Next Steps Public Health Directorate Derby City Council The Council House Corporation Street Derby DE1 2FS

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3 Section One Introduction What are you reviewing? Public Health, as part of Derby City Council, are reviewing the existing specialist drug and alcohol treatment services. Since being awarded contracts, the local services have contributed to: increasing the number of individuals accessing drug and alcohol treatment reducing the number of unplanned hospital admissions for alcohol increasing the number of Derby residents successfully leaving drug or alcohol treatment reducing the number of drug and alcohol related crimes in Derby. The current model of services in Derby is described on page 3. Why are you reviewing services? The existing drug and alcohol service contracts will finish on 31 March European Union regulations mean we have to review services and offer any interested organisations the opportunity to bid to provide services in Derby. This gives us the opportunity to review and improve the current services offered so that new contracts can begin on 1 April Derby City Council, like other local authorities across the country faces ongoing financial challenges. This means that we have to be creative and think of different approaches to provide the highest quality services at the best price. Who is involved? We want to hear anyone s views. This includes: - people working in services - people who use services - any professional who has an interest in drugs and alcohol - people who have been effected by someone else s drug and alcohol use. How can I get involved? We welcome your comments on the current and future services. You can complete as much or as little of this review as you wish. We have had some ideas over what the future services could look like and would welcome your views on our vision and your comments as to what else we should consider. The review is also available to complete online at if you prefer to access an online version. 1

4 Substance Misuse Pregnancy Service Parent & Carer Support Service Introduction Section One Current Model of Treatment The current model of drug and alcohol treatment is shown below: Safeguarding & Family Support Service Alcohol Services Single Point of Contact Criminal Justice Single Point of Contact Drug Services Single Point of Contact Referral Into Community Alcohol Treatment Service Alcohol Taskforce & Addictions to Medicines Service Community Drugs Intervention Programme Custody Suite & Court Liaison Workers Harm Reduction & Specialist Prescribing Service Non Prescribed Illicit Substance Support Service Optional Referral Into Specialist Detoxification Provided by local inpatient and national residential facilities. Recovery Support Service Providing support to individuals stable in treatment and those successfully exiting treatment services Case Management Groups (Street Drinkers, Complex Cases, A&E Hospital Admissions) The current model of treatment has helped more people than at any other time in Derby s history. The current services cost Derby around 5 million per year but this level of funding is likely to reduce. Public Health are committed to providing high quality drug and alcohol services but need to explore different ways to do this building upon the successes of the last 3 years. 2

5 Substance Misuse Pregnancy Service Section One Introduction Future Model To remove barriers to access and also to enable the workforce to be more flexible in the future we predict the need to integrate services. The future model is shown below: Safeguarding & Family Support Services Integrated Single Point of Contact Covering all alcohol, drug and criminal justice needs in unison. Integrated Drug & Alcohol Service Single service providing support for any drug or alcohol problem. Non prescribed support and harmful/hazardous drinking to be provided from community sites. Specialist Detoxification Referral Into Complex Cases, Custody Suite & Courts Service Optional Referral Into Primary Care Support Services Including the alcohol taskforce and addictions to medicines services Recovery Support Service Greater evidencing of contributions made to Public Health Outcomes Framework Substance Misuse Pregnancy Service Provided by local inpatient and national residential facilities. Providing support to individuals stable in treatment and those successfully exiting treatment services Definitions: Safeguarding & Family Support Services Integrated Drug & Alcohol Service The integrated drug and alcohol service will provide all drug and alcohol support to anyone living in Derby requiring help and support. Complex Cases, Custody Suite & Courts Service This service will work with people with more complex needs and offer extra support. Family Support Services The safeguarding and family support services will provide support to people known to the drug and alcohol services. The service will also help staff working within the services to use best practice in working with families. 3

6 Our Vision Section One Public Health is committed to providing high quality services that are value for money for all residents. Our vision for services are below: Quality services that are value for money. In the future services need to continue to deliver high quality care and support in a way that is good value for money. In the past drug and alcohol services have been designed to make access to the right treatment and support easy for everyone so that people can get to the services they need. The new model will keep this by having a single route into all services and will make sure that people get the support they need in one service instead of having different workers in different services. Rewarding results. In 2012 a local payment by results system was introduced that rewarded services when they met a number of key targets. In 2015 we want to change this model so that we reward the delivery of good quality care across a person s whole treatment journey. We ve explained this more on page 8. Supporting the workforce. In Derby there is a high skilled and committed workforce. The new model will need people who are able to change to new ways of working and we want to support them to do this. We want to ensure that everybody s voice is heard together including people who use the services, keyworkers and clinicians. To achieve this we want to introduce organisational targets that measure the outcomes for people who use the service and also how organisations support all of their staff to deliver the best support to people in Derby. Gradual change Because the new model is different from the old one the change that needs to take place won t happen all in one go. To help the new service provider to move towards the new model being fully operational we will offer contracts that reflect a gradual move towards delivery of the new model. Meeting more local needs As part of the Social Value Act 2012, we want to offer you the opportunity to tell us anything that is important to you about drugs or alcohol in your local area. You can do this on page 9. 4

7 Section Two Questions on the new model Please answer the next few questions about the new model shown on page 3. Your views are important to help us to shape the final design. Please complete the questions below that you are comfortable answering. All of the information you give will be treated in confidence. Q1: Should the future drug and alcohol services be integrated? Q2: Will the new model make it easier for people in Derby to access services and get the support they need? Q3: Where do you think people should be treated? In one central treatment centre In separate community settings Other location Don t Know Prefer not to answer Q4: The future model proposes greater joint working with General Practitioners. Should treatment workers be required to attend regular meetings with GPs? Q5: Should the main way to access inpatient detoxification and residential rehabilitation be through the new service? Q6: Should care for pregnant women who have drug or alcohol problems be provided by the new service maintaining close working relationships with maternity services? 5

8 Questions on the new model Section Two Q7: Should the new service have to show how it supports Public Health improvements and general health needs? Q8: Should the safeguarding and family support services continue to operate separately from the main service? Q9: Should the organisation(s) providing the new service have to show how it manages staff performance to the Council? Q10: Please use the space below for any other comments you have about the new model. 6

9 Section Three Questions on criminal justice Please answer the next few questions about the new model shown on page 3. Your views are important to help us to shape the final design. Please complete the questions below that you are comfortable answering. All of the information you give will be treated in confidence. Q11: In the future, should the service provide a dedicated drug and alcohol worker to the police custody suite covering all peak times? Q12: Should a worker support the magistrates court to promote drug and alcohol treatment related court orders? Q13: Case management is currently provided for street drinkers, complex cases and repeat alcohol A&E attendees. Do you think that these groups cover all people in need of extra support? If no, please tell us your views within the additional comments space below. Q14: Should the new service show the Council how it working to reduce crime and the impact of drug and alcohol misuse on communities? Q15: Please use the space below for any other comments you have about criminal justice services. 7

10 Questions on payment by results Section Four Payment by Results (PbR) is a system where services are paid for the results they deliver. This is not usually seen by the public but helps to ensure the service is providing the best possible care. Most hospital and General Practice care works on a similar basis to this. PbR is made up of a tariff system, where each service provided attracts a fee paid to the provider. PbR Framework For example, the current tariff system for acute hospitals includes planned inpatient care, outpatient attendances, A&E and outpatient procedures. The future use of PbR in Derby is designed to refocus discussions between commissioners and providers of services away from costs and towards quality and innovation. The future service contract value will be weighted across the PbR Framework domains above. The weighting will change over the contract duration. We know changing takes time, so the contract will start with more payment given to the supporting service quality and innovation domain. Q16: Do the PbR Framework domains reflect the areas where services should support people? If no, please tell us your views within the additional comments space on page 10. Q17: Should the new model make payments that cover everything the services does and not just outcomes? For example, should a payment be made for signposting to sexual health services? Q18: Should the payment weighting change over the length of the contract as described above? Q19: Should the amount of PbR payment increase from 50% Year 1; 75% Year 2 and 100% Year 3? 8

11 Section Five Questions on social values If you live in Derby, we would like you to tell us in this section what you feel is important to you in your local area. Please keep your comments related to drugs and alcohol. For example, this could be providing drug education to community groups in Derby free of charge as part of the contract. Q20: Please write the area of Derby that you live in below. Q21: Please write in the space below anything you feel is important in your local area, this may be training needs, tackling health problems, employment/training or anything you feel is important. 9

12 Additional comments Section Six Q22: Please use the space below for any other comments you wish to make about drug and alcohol treatment services in Derby. 10

13 Section Seven About you The next few questions will help us to make sure that we hear everyone s views, whatever your age or background. This will help us to understand how representative the response we receive is of people living in Derby as well as the views of different groups of people. Q23: Are you Please tick all that apply. a Derby resident? a resident from outside of Derby? a service user or carer? a commissioner of services? from a clinical network? a technical expert? other? Please say: a provider of services? a member of a public network? a representative of voluntary or community organisation? a representative of a public sector organisation? a representative of a private sector organisation? a healthcare professional? Please complete questions 24 to 28 if you are a service user or resident. Q24: Are you Please select one option. male? female? transgendered? Prefer not to answer Q25: What was your age on your last birthday? Please tell us your age in years. Q26: Do you consider yourself to be a disabled person? Please select one option. Yes No Prefer not to answer Q27: To which group do you consider you belong? Please select one option. Asian or Asian British - Indian Dual Heritage White and Black African Asian or Asian British - Pakistani Dual Heritage White and Asian Asian or Asian British - Bangladeshi Any other Dual Heritage background Asian or Asian British - Chinese White English / Welsh / Scottish / Northern Irish / British Any other Asian background White Irish Black or Black British - African White Gypsy or Irish Traveller Black or Black British - Caribbean Any other White background Any other Black background Other ethnic group - Arab Dual Heritage White and Black Caribbean Any other ethnic group Prefer not to answer Other? Please say: Q28: What is your religion? Please select one option. Christian (including Church of England, Roman Catholic, Protestant and all other Christian denominations) Muslim Buddhist Sikh Any other religion Hindu None Jewish Prefer not to answer All information provided will be treated in accordance with the Data Protection Act We will use the results to review and improve the drug and alcohol services we provide. 11

14 Next Steps Section Eight June 2014 Review of services launched July 2014 Review period closes on 20 July 2014 Feedback events held with interested parties August 2014 Substance Misuse team formalise the specifications of the future services delivery and work with existing and potential providers to generate the greatest amount of interest from potential providers. September 2014 The formal tender process will be launched, lead by Derby City Council Procurement to identify the providers of services from April January 2015 In early 2015, the successful providers will be identified and work will commence to transition services from the existing treatment model to the new model in preparation for the April 2015 start date. April 2015 New Integrated Services Commence Operation 12

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16 13 Thank you for completing this review. Please return your completed questionnaire using the Freepost envelope provided, you don t need a stamp or you can return it using your own envelope addressed to: Public Health Directorate Derby City Council FREEPOST MID24259 Derby DE1 2BR For more information or if you would like to discuss our vision for drug and alcohol services in Derby further, please contact: Dr Richard Martin Assistant Director of Public Health Jo Seekings Substance Misuse Commissioner Angela Clift Substance Misuse Commissioner Nicola Jordan Substance Misuse Commissioner

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