NDTMS Core Dataset ‘F’ Training

1. NDTMS Core Dataset ‘F’ Training Regina Lally, Kellie Peters and Michael Wallington Drug Treatment Monitoring Unit

2. Ground Rules • Please respect those around you by not holding individual conversations whilst the sessions are in progress • Please put mobiles on silent/vibrate • Please take any calls outside of the meeting

3. Aims • Clarify requirements and definitions of Core Data Set F (CDS-F) • Clarify DAAT care co-ordination pathways and practicalities surrounding TOP data submission to NDTMS • Provide updated information around data quality, reporting and monitoring

4. New for Core Dataset F • Main additions to YP dataset • Adult dataset changes are: • 1 new field • Reference data changes

5. TOP Care Co-ordination • Options: Yes / No • To be used from 1st April 2009 • To support the monitoring of TOPs completion • Agency is care co-ordinator who has current responsibility for completing TOP

6. Parental Status • Reference Data changing from 1st April 2009: • All the children live with the client • Some of the children live with the client • None of the children live with client • Not a parent • Client declined to answer

7. Successful Completions Treatment completed - drug free Treatment completed - occasional user (not opiates or crack) Drug Discharge Reasons

8. Drug Discharge Reasons Transfers • Transferred – not in custody • Transferred – in custody

9. Drug Discharge Reasons Incomplete • Incomplete – Dropped Out • Incomplete – Treatment withdrawn by provider • Incomplete – Retained in Custody • Incomplete – Treatment Commencement Declined by Client • Incomplete – Client Died

10. Successful Completions Treatment completed - alcohol free Treatment completed - occasional user Alcohol Discharge Reasons

11. Alcohol Discharge Reasons Transfers • Transferred – not in custody • Transferred – in custody

12. Alcohol Discharge Reasons Incomplete • Incomplete – Dropped Out • Incomplete – Treatment withdrawn by provider • Incomplete – Retained in Custody • Incomplete – Treatment Commencement Declined by Client • Incomplete – Client Died

13. Tier 4 ALC - Inpatient Treatment ALC - Residential Rehabilitation Adult Alcohol Modalities • Tier 3 • ALC - Community Prescribing • ALC - Structured Psychosocial Intervention • ALC - Structured Day Programme • ALC - Other Structured Treatment • Tier 2 (New) • ALC – Brief Interventions • Will NOT count towards numbers in Treatment.

14. Consent Clients should give written consent to share information about their care plan. This consent should specifically state which agencies the client consents to have information received about them and which they do not. A form recording the client’s consent should be kept in the notes. Consent should be reviewed at the time of reviewing the care plan.

15. Confidentiality • Agencies should have clear policies about how assessment information and care plans are shared. • Good information sharing protocols help the care planning process to be smoother and prevent the hold-ups and misunderstandings that might arise if all the relevant information for the client was not available to practitioners and keyworkers in different agencies. (Good practice in care planning, July 2007 NTA)

16. NTA Confidentiality Toolkit • Confidentiality policy should be clearly explained to client (verbally and written form), before assessment for treatment. • Should cover: • What information will be collected by the agency • When and what information will be shared with other services and organisations • Who information will go to and why (NDTMS) • When the confidentiality may be breached (NTA Confidentiality Toolkit, pending 2009 NTA)

17. Questions • Anything NDTMS related!

18. NTA Quarterly Reports • Available on NDTMS.net • Providers no longer being given access to restricted section • DAAT should circulate relevant report to providers

19. TOP Care Co-ordination • Discuss the care pathways and map out the client journey. Look at • Where do they enter Structured Treatment • Which agencies are they likely to be engaged with • Who should be providing TOPs in each situation • Think about a variety of scenarios

20. TOP Feedback

21. Client Information

22. Referral Date Definition • Referral date • (referral to agency date) date agency becomes aware that the client is waiting. • Date of receipt of phone-call, letter, client walks through door asking to be seen etc.

23. Care Planning “As soon as possible, the allocated keyworker will ensure that the client undergoes a comprehensive assessment of needs. Following this a comprehensive care plan is drawn up”. (Care Planning Practice Guide, August 2007, NTA) “…service user involvement [is] an integral part of the development of care plans, with the users as the central focus of care planning, review and ongoing treatment.” (Good Practice in Care Planning, July 2007, NTA)

24. Care Planning Domains If “Drinking Days” completed, “Units of Alcohol” MUST be completed as well “Units of Alcohol” is typical number of units consumed on a drinking day

25. Care Planning Domains

26. Care Planning Domains

27. Parental Status • Reference Data changing from 1st April 2009: • All the children live with the client • Some of the children live with the client • None of the children live with client • Not a parent • Client declined to answer

28. Tier 4 ALC - Inpatient Treatment ALC - Residential Rehabilitation Adult Alcohol Modalities • Tier 3 • ALC - Community Prescribing • ALC - Structured Psychosocial Intervention • ALC - Structured Day Programme • ALC - Other Structured Treatment • Tier 2 (New) • ALC – Brief Interventions • Will NOT count towards numbers in Treatment.

29. Modality Data

30. Treatment Outcomes Profile • Short, validated outcome monitoring tool released by the NTA June 2007 • Intended for implementation in all Drug services that provide structured Tier 3 & Tier 4 treatments • Data to be reported to NDTMS from 1st October 2007 • Should be completed at: • Modality Start • Care Plan Review • Discharge • Post Discharge [Optional] • www.nta.nhs.uk/areas/outcomes_monitoring/

31. Treatment Outcomes Profile • Validated for clients with Alcohol as main problem substance. • No initial requirement by NTA to complete TOPs at Alcohol Only agencies. • Recommended/Encouraged completion of TOP forms.

32. TOP NDTMS Data • You should aim to ask and complete every question. • Do not leave any of the blue boxes blank • Enter “NA” if a client refuses to answer a question or cannot recall.

33. TOP NDTMS Data Modality Start Date: dd/mm/yyyy [Trigger for first TOP] TOP Date: dd/mm/yyyy TOP Treatment Stage: Treatment Start TOP Care Co-ordination: Yes When multiple agencies are providing treatment, it is envisaged that responsibility for reporting TOP data will lie with the agency responsible for care co-ordination. DAATs should have agreed care co-ordination pathways locally.

34. TOP NDTMS Data Section 1: Substance Use Alcohol Use: 15 Opiate Use: 0 Crack Use: 0 Cocaine Use: 15 Amphetamine Use: 4 Cannabis Use: 10 Other drug use: 0 • Information sought: • Number of days out of last 28 client has used each drug. • Permissible values: • Number in range “0-28” • “NA” if client is unable to or refuses to answer question

35. TOP NDTMS Data Section 2: Injecting Risk Behaviour IV Drug Use: 0 Sharing: N • Information sought: • Number of days out of last 28 client has injected non-prescribed drugs. • Permissible values: • Number in range “0-28” • “NA” if client is unable to or refuses to answer question • Information sought: • Has client shared needles or paraphernalia in last 28 days. • Permissible values: • Y or N • “NA” if client is unable to or refuses to answer question

36. TOP NDTMS Data Section 3: Crime • No details of specific crimes should be shared by client with keyworker. • General information about type of crimes funding drug or alcohol habit should be shared and recorded to address all client needs and evidence improvement in lifestyle. • The information shared with NDTMS is subject to the same confidentiality as all client information currently / previously received. • Data is used for performance / outcome monitoring only.

37. TOP NDTMS Data Section 3: Crime Shop Theft: 18 Drug Selling: 6 Other theft: Y Assault / Violence: N • Information sought: • Number of days out of last 28 client has been involved in each crime. • Permissible values: • Number in range “0-28” • “NA” if client is unable to or refuses to answer question • Information sought: • Has client been involved in each crime in last 28 days. • Permissible values: • Y or N • “NA” if client is unable to or refuses to answer question

38. TOP NDTMS Data Section 4: Health & Social Functioning Psychological Health Status: 9 Paid work: 3 Education: 1 • Information sought: • Self reported score from scale. • Permissible values: • Number in range “0-20” • “NA” if client is unable to or refuses to answer question • Information sought: • Number of days out of last 28 client has had paid work or been in education. • Permissible values: • Number in range “0-28” • “NA” if client is unable to or refuses to answer question

39. TOP NDTMS Data Section 4: Health & Social Functioning Physical Health Status: 5 Quality of Life: 4 Acute Housing Problem: N Housing Risk: Y • Information sought: • Self reported score from scales. • Permissible values: • Number in range “0-20” • “NA” if client is unable to or refuses to answer question • Information sought: • Client has been homeless / risk of eviction in last 28 days. • Permissible values: • “Y” or “N” • “NA” if client is unable to or refuses to answer question

40. Modality End / Discharge Data • Modality End Date • Modality Exit Status • Can be entered as modalities are completed, client episode remains open • MUST be entered for all modalities on discharge from agency • Discharge Date • Discharge Reason • If a Discharge Date is entered, then a Discharge Reason must be given and vice versa. • Discharge information must be reported accurately and in a timely fashion as it is used to monitor successful completions.

41. Discharge Data and TOP • Complete TOP at discharge from treatment system. • This should be done face-to-face between keyworker and client where possible • May be done over telephone where no other option available (i.e in unplanned discharges). • NOT acceptable to complete on clients’ behalf without client present.

42. LUNCH

43. Data Collection Purpose • Enables national, regional and local-level reporting on alcohol treatment. • Supports the National Alcohol Strategy and needs analysis • Facilitate policy formulation • Supports development of efficient commissioning systems at local level

44. Planned Performance Monitoring • Performance measures for Alcohol Services are being developed now that there is one year of baseline data. • Numbers in Treatment • Waiting Times • Successful completions of treatment

45. Reporting and Monitoring • Monthly • www.ndtms.net • Quarterly • Proposed “Purple Reports”

46. www.ndtms.net

47. www.ndtms.net

48. Quarterly “Purple Reports” • For Consultation

49. Potential Reports • What would Commissioners find useful? • What would Agency staff find useful? • Suggestions???

50. What should you expect from DTMU? • Agency Training and Support: Dedicated Liaison Officers and Database Administrator providing telephone and in-house training on CDS-F dataset. • Guidance Documentation: ‘A Rough Guide to the NATMS’ (in development) • Monthly Validation and Data Quality Reports: Reporting erroneous client records, requiring correction. • Newsletter • Access to DTMU documents online • www.dtmu.org.uk