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The Stockton-On-Tees Solution: A model for the delivery of alcohol services in Primary Care

The Stockton-On-Tees Solution: A model for the delivery of alcohol services in Primary Care Jo Heaney – Modernisation Manager, Public Health (Lead Commissioner alcohol & Young Peoples Substance Misuse). Aims and Objectives. Background Alcohol Prevalence Primary Care delivery then

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The Stockton-On-Tees Solution: A model for the delivery of alcohol services in Primary Care

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  1. The Stockton-On-Tees Solution: A model for the delivery of alcohol services in Primary Care Jo Heaney – Modernisation Manager, Public Health (Lead Commissioner alcohol & Young Peoples Substance Misuse)

  2. Aims and Objectives • Background • Alcohol Prevalence • Primary Care delivery then • Service Model • Primary Care delivery and now • Outcomes to date • Challenges • Questions • Activity 2 2 10/25/2014

  3. Background • Unitary Authority • Population- 192,406 • Ethnicity- 97% White • Absolute deprivation versus absolute affluence • Alcohol and Drug services separate • 24 General Practices 3

  4. Alcohol Prevalence 2470 dependant drinkers 831 in treatment Jan-Dec 2013 8,678- High risk 26,300- Increasing risk 37,269- Binge drinkers 4

  5. Primary Care Model 2012 Local Enhanced Contract Level 1 Screening & B.I £ 50 £ 1000 Supporting detoxification 150 Level 2 £ Q.I.P.P Project Project reviewed Lessons learnt T.A.P Pilot 5 10/25/2014

  6. Recovery Support Recovery Community AFTERCARE/Mutual aid groups (ALCOHOL & TREATMENT FREE) Rehab Psycho-social Interventions Pharmacological Disengage Assessment of Need / Recovery Planning (within base or hub setting) Assertive Outreach (where needed) Criminal Justice Other E.g. Drug Services / Social Care Hospital Self General Practice

  7. Present Primary Care Model T e a m A r o u n d T h e P r a c t i c e Transfer to central site Enhanced Contract (20) All patients Screened prior To referral Treatment/ Interventions Complete recovery General Practice (24) P.S.I Recovery Pharmacotherapy M.O.U/Action Plan No Enhanced Contract (4) Can refer Without screening Transfer to Community hub 7 10/25/2014

  8. Outcomes • Referrals received from all practices into the T.A.P team • There are 20 practices with an enhanced contract • There are 15 clinics ran within general practice • Clinics available within area’s of deprivation and affluence and in practices that had previously been reluctant. • There have been 16,249 people screened, 3901 full AUDIT and BI and 236 referred into specialist services during 13/14 • Referrals into the T.A.P team continue to grow 8 10/25/2014

  9. Challenges • Commissioner • Effectively engaging all practices in meaningful use of the enhanced contract and T.A.P • Building trust and confidence with practices that the whole treatment system would be responsive to referrals. • Data collection from enhanced service activity. • Ensuring that it is general practice doing the screening and not the T.A.P. • T.A.P Team • Reluctance by some practices to have clinics within surgery • Communication between surgery staff • Physical space in practices and the increased for home visits • High D.N.A rates- more apparent in some practices. 9 10/25/2014

  10. Questions 10

  11. Workshop Activity: In groups of five for 5 minutes I want you to discuss and identify what you would need to do in your localities, to ensure an effective model for the delivery of alcohol services does NOT develop within primary care! 11 10/25/2014

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