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National Treatment Agency for Substance Misuse - page 5 / 52

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Contents

Introduction .......................................................................6 Policy and context ............................................................7

2.1

Good-quality drug treatment is effective ....................7

2.2

Significant improvement in access to and capacity in drug treatment since 2001.......................7

2.3 2.4 2.5 2.6

Drug treatment population trends ..............................7 Harm reduction ..........................................................8 Drug treatment and the criminal justice system.........8

Variation in the quality and effectiveness of drug treatment..................................9

2.7

Improvements required in treatment effectiveness ..............................................9

1 2

2.8

Changes to commissioning .....................................10

Commissioning substance misuse services ................12

3.1

A revised framework for drug treatment services ....12

3.2

Key differences between Models of Care 2002 and Models of Care: Update 2006 ..........................12

3

4

    • 3.3

      The Drug Interventions Programme (DIP) ................14

    • 3.4

      Drug treatment based in prisons..............................14

    • 3.5

      Primary care.............................................................15

    • 3.6

      Inpatient treatment and residential rehabilitation: The need for expansion .....................17

    • 3.7

      Greater emphasis on aftercare.................................18

    • 3.8

      The four tiers reiterated ............................................19

    • 3.9

      Treatment effectiveness: Improving clients’ journeys........................................................19

Substance misuse assessment.....................................26

    • 4.1

      Screening assessment.............................................26

    • 4.2

      Triage assessment ...................................................26

    • 4.3

      Initial care plan .........................................................26

    • 4.4

      Comprehensive assessment....................................26

    • 4.5

      Risk assessment ......................................................27

    • 4.6

      Competences required to

conduct assessments..............................................27

5

Care planning ..................................................................28

5.1

The need for good-quality care planning and co-ordination of care ..........................28

5

Models of care for treatment of adult drug misusers: Update 2006

5.2 5.3

Care planning in Models of Care: Update 2006 ......28 Care planning...........................................................28

Integrated care pathways ..............................................33 6.1 Commissioning integrated care pathways ...............33 6.2 Elements of integrated care pathways.....................33 6.3 ICPs and the treatment journey ...............................33 Quality criteria and improvement reviews ....................34

7.1

The Department of Health’s Standards for Better Health .....................................34

7.2

NTA and Healthcare Commission Improvement Reviews..............................................34

7.3

National standards for professionals working in drug services ..........................................35

7.4

Quality requirements for drug treatment ..................36

Performance monitoring and management .................38

8.1 8.2

Monitoring drug treatment .......................................38 Performance management of drug treatment..........38

Drug treatment interventions.........................................40

9.1

Drug treatment interventions as part of a local treatment system ..............................40

9.2

Substance misuse related advice and information.............................................40

6

7

8

9

10

    • 9.3

      Harm reduction interventions ...................................40

    • 9.4

      Community prescribing interventions:

GP prescribing and specialist prescribing................41

    • 9.5

      Structured day programmes....................................43

    • 9.6

      Structured psychosocial interventions......................43

    • 9.7

      “Other structured treatment”....................................44

    • 9.8

      Inpatient drug treatment...........................................45

    • 9.9

      Residential rehabilitation...........................................46

    • 9.10

      Aftercare...................................................................46

References.......................................................................48

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