Models of care for treatment of adult drug misusers: Update 2006
Performance management of drug treatment
NHS local delivery plans
Performance monitoring and management
Monitoring drug treatment
Structured drug treatment (apart from treatment in prisons) is monitored through the National Drug Treatment Monitoring System (NDTMS). This system involves the process of collecting, collating and analysing information from the drug treatment sector. There is an NDTMS centre to cover each region, with the majority being hosted by public health observatories. One regional centre is housed within a mental health trust, while two regions are hosted by the NTA. The purpose of the NDTMS centres is to obtain accurate, good-quality, timely information for reporting structured drug treatment activity
8.1.2 Numbers in treatment and retained in treatment
Through the NDTMS, the NTA monitors the performance of the structured drug treatment system at national and regional level. It reports on the numbers of people in contact with services providing structured drug treatment, and those retained for 12 weeks or more – this data is required so performance can be measured against the national target. A detailed breakdown of the data collected on clients in treatment is published in the form of an annual report on the NTA website at www.nta.nhs.uk.
Local delivery of National Health Service priorities is ensured via the local delivery plan process. The LDP contains all the Government’s PSA targets on health, including drug misuse, and is the key vehicle for the local PCT to set its priorities for improving health, developing services and involving local people and agencies in the planning and delivery of healthcare. PCT plans for increasing the numbers of drug misusers accessing and retained in structured treatment are aggregated with the plans of other PCTs within a strategic health authority (SHA) area to form their overall LDP for increasing the numbers in treatment and improving retention.
On top of the PSA targets, DAT partnerships and the NTA have agreed local “stretch targets”, which are intended to better reflect local situations and need. The PCT and the SHA have included these stretch targets in their planning.
The SHAs are performance managed by the Recovery and Support Unit (at the Department of Health) and, in turn, the SHAs performance manages PCTs to ensure they meet the targets set. The plans must ensure year-on-year increases in numbers of drug users entering treatment and drug users retained in treatment for 12 weeks or more.
Details of local numbers in treatment and retention targets are available from SHAs and PCTs. Contact details for these can be found at the NHS website www.nhs.uk
8.1.3 Waiting times
Until March 2006, quarterly reported waiting times figures have been based on DAT partnership self-reports. However, from April 2006 figures will be reported via NDTMS.
Since January 2006, the NTA has been publishing a range of monthly drug treatment performance data, including numbers in treatment and numbers retained in treatment for over 12 weeks. The NDTMS website will make available an increasing amount of regularly published performance data (including waiting times) throughout 2006/07. See www.ndtms.net for more details.
8.1.4 Minimising the data collection burden
As a matter of principle, commissioners should endeavour to use NDTMS (and other nationally collated data such as DIRWeb) wherever possible, in service level agreements and performance monitoring with providers. This is to minimise requirements on providers to collect and provide two different sets of data.
8.2.2 Healthcare Commission performance ratings
The Healthcare Commission provides an independent assessment of the extent to which primary care trusts and provider trusts perform against national targets as part of the annual health check. In 2006/07, the following assessments will be made:
PCTs: Performance against LDP of “in treatment” and “percentage retained in treatment” figures
Mental health trusts: The improvement over the previous year of the “percentage retained in treatment” figure
Acute trusts: A process indicator looking at screening, advice, information and referral.
More information on these indicators, including detail on the measurements and data required, is set out on the Healthcare Commission’s website at www.healthcarecommission.org.uk.
8.2.3 NTA performance management
Drug treatment monitoring data is used by NTA regional teams to performance manage and support local DAT partnerships in achieving the targets agreed in their annual adult drug treatment