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Purpose of today

A proposed new model for an Adult Community Substance Misuse Treatment and Recovery System in Nottinghamshire County Dr Chris Kenny DPH Nottinghamshire County and Nottingham City 26 September 2013. Purpose of today. To describe: Importance of substance misuse The proposed model

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Purpose of today

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  1. A proposed new model for an AdultCommunity Substance Misuse Treatment and Recovery System inNottinghamshire CountyDr Chris KennyDPH Nottinghamshire Countyand Nottingham City26 September 2013

  2. Purpose of today To describe: • Importance of substance misuse • The proposed model • The proposed outcome measures

  3. Importance of substance misuse • Health and wellbeing • Crime and disorder • Housing • Employment • Social functioning

  4. Why ? • Strategic shift in focus – Recovery emphasis, treatment is part of that journey, not the ultimate destination • Whole system never formally tendered* or subject to market exercise to test value for money *NHS Bassetlaw did undertake a formal tender process for part of the system in 2011

  5. The current system

  6. “If recovery is a train journey from Nottingham to London ……. treatment is the taxi that gets you to the station”Simon Jenkins12 Step Recovery

  7. What are we consulting on? Our vision to have an Adult Community Substance Misuse Treatment and Recovery System, which will enable individuals easy access to stigma free, high quality cost effective treatment and recovery services across Nottinghamshire, regardless of where they live or the substances used

  8. Proposed Model Principles • A model with the Recovery at its core – everyone entering substance misuse services has the potential to recover • A consistent and responsive approach to treatment and recovery service provision and delivery across all seven districts of Nottinghamshire • A consistent approach to outcome monitoring • Equity of treatment and recovery provision regardless of whether an alcohol or drug user • A consistent approach to commissioning • Clarity regarding financial efficiency and value for money

  9. Possible outcome measures • Recovery – what does this mean? • Health and wellbeing • Reduced crime • Employment • Housing • Support for others

  10. COMPLEX As ENHANCED plus: In-patient/unplanned withdrawal or detoxification Pregnancy shared care ACCESS POINT Self Primary Care Hospital Criminal Justice System EXIT Planned Drop out Prison Free of all substances ENHANCED As STANDARD Plus: Comprehensive assessment Opioid Substitution/other prescribing Structured psychological interventions Harm reduction (BBV&TB testing, NSP) Planned community withdrawal/detoxification Assessment physical & mental health needs Consider residential/community rehabilitation STANDARD ALL CLIENTS (including family member and carers) Triage and initial assessment Keyworker allocated Family member/carer assessment Low intensity psychological interventions/extended brief interventions Proactive/facilitated referral to housing, education, employment, personal finance, healthcare support and Mutual Aid (self-help) Based upon: National Treatment Agency (2012) Medications in recovery: Re-orientating drug dependence treatment

  11. Discussion points • Relative importance of substance misuse • Public and patient engagement in the process • Impact on providers • Use of resources in the context of overall LA financial plans

  12. A proposed new model for an AdultCommunity Substance Misuse Treatment and Recovery System inNottinghamshire CountyDr Chris KennyDPH Nottinghamshire Countyand Nottingham City26 September 2013

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