Meeting title: Joint Commissioning Group

Meeting date:26thSeptember2011

Report title:Performance Report

Report of:Data Analyst

1.Purpose

The purpose of this report is to provide members of the Joint Commissioning Groupwith an overview of performance measures relating to substance misuse. Concentrating this month on: Drug treatment successful completions, Treatment exits, Treatment outcome profiles (TOP), and Harm reduction measures:Hepatitis B vaccinations and C Tests.

2.Drug Treatment Successful Completions

2.1 All Drugs Successful Completions:

From the baseline number calculated at 200 in March 2011, Sunderland’s consecutive 1 year rolling monthlyperformance figures for Q1 for all drugs were (NB – these are based on a number, rather than a rate):

  • April:189-6% below baseline
  • May:191-5% below baseline
  • June:179-11% below baseline

2.2Opiates Successful Completions

From the baseline number calculated at 71 in March 2011, Sunderland’s 1 year consecutive rollingmonthly performance figures for Q1 for opiates were (NB – these are based on a number, rather than a rate):

  • April: 65-09% below baseline
  • May:64-10% below baseline
  • June:51-18% below baseline

It is worth mentioning however thatoverall the percentage of successful completions as a ‘proportion of all those in treatment’ (as opposed to using the baseline figures) for all drugs is 13% and compares well with the national average at 14%.

3Treatment Exits by Reason

The treatment exits trend for Sunderland is quite similar to the national trend for the 1st quarter of 2011-12, although ‘Treatment completed drug free’is a little lower at 29% compared to nationally at 34%.

‘Treatment completed’ shows the biggest difference with Sunderland at 21% compared to nationally at 13%, this may indicate that Sunderland has a higher proportion of occasional drug users compared to nationally.

Improvement Measures for Successful Completions and Treatment Exits

  • A workshop has been convened on 14 October to work through exception reporting mechanisms with providers to better inform future reporting.
  • There is a need to ensure key workers are making every effort to contact clients who DNA appointments and
  • That they are liaising with other agencies involved in the client’s care to see if they have continued to engage elsewhere when transferred
  • Where possible ascertain the reason(s) why a client has dropped out of treatment
  • Contact the current 3 top ‘Successful completions’ areas to identify any good practice methods they are using and which they are willing to share which could be beneficial to Sunderland.These are: Merton, Knowsley, and Redbridge all with a 30% successful completion rate as a proportion of all in treatment.

4Treatment Outcome Profiles (TOP)

During Q1 20011-12 Sunderland performed well above the 80% threshold target for TOPs, ensuring full access to the reports was available; overall all the outcomes were around or above the national averages.

One exception was 91% zero response rate for treatment starts relating to the questions on crime,(Shop Lifting, Other Theft, Drug Selling, and Assault) Nationally this percentage tends to be high and for June was measured at 85%,although Sunderland was only 6% above the national average there is still quite clearly some improvements which should be made in this area.

Improvement Measures for TOP

The importance of asking allthe TOP questions will be emphasised to each of the key workers completing the TOP forms, and awareness will be made relating to the current partnership response rate for the crime questions and the need for improvement, it also needs to be determined if the low response rate is due to a reluctance of the keyworkers to ask the crime questions, or if it is a data recording issue.

TOP awareness is an integral part of the new Single Shared Assessment (SSA) tool and this should ensure a more consistent and directed approach to TOP.

5Harm Reduction

5.1Hepatitis B Vaccinations

During Q1, there were 106 new treatment journeys, of these: 31 clients were offered and accepted a Hep B vaccination, of these:

  • 3 have started a course
  • 5 have finished a course

This take up rate of 8clients (26%) is below the national average at 32%

There were more clients (33) who were offered and refused a test during Q1 than those who were offered and accepted (31)

37 clients were immunised already

4 were assessed as not appropriate to offer

1 had acquired immunity

5.2Hepatitis C Tests

Hep C tests for clients in treatment who were previously or currently injecting,stands at 64%, this is above the national average currently at 60%.

However the national good practice guideline is 90% for both B vaccinations and C tests therefore there is room for improvementin both these areas.

Improvement Measures for Harm Reduction

  • There is a need to ensure Hep B vaccinations are promoted to all clients explaining the benefits – this is also being taken up via the Single Shared Assessment work stream
  • Encourage the uptake of Hep C testing and follow up re-results

1

Stephen G Potts

Data Analyst

Sunderland Partnership