REPORT TO ADULTS’

HEALTH AND WELLBEING COMMISSIONING GROUP

24thJanuary 2017

REPORT OF DIRECTOR OF PUBLIC HEALTH

Young Peoples’ Substance Misuse and Adult’s Alcohol Treatment Service Review Update and Commissioning Intentions 2017/2018

  1. PURPOSE OF REPORT
  2. To update the commissioning group on the service developments following a service reviewundertaken during January 2016 and the current contractual position of the Young People’s Substance Misuse & Adults Alcohol Treatment Service.
  1. BACKGROUND
  2. The Stockton on Tees Young People’s Substance Misuse & Adult’s Alcohol Treatment Service is delivered as an integrated Service contract. Lifeline Project Ltd was awarded the contract for the integrated service in January 2014. The contract was initially over 2.3 years, with the option to extend for 3x1year extensions. The annual contract value for the integrated Young People’s Drug and Alcohol Service and Adults Alcohol Treatment Service is £766,969.00 p.a.

2.2. In March 2016 a paper was presented to the commissioning group outlining the results of a service review, recommendations from the paper were:

2.3.To extend the Service contract for 12 months.

2.4.To progress on a number of areas identified in the Review, where development and improvement were identified during the review process:

  • Work on guidelines that identify how a carer/family members will be involved in client’s treatment. These guidelines to be shared with clients and family members at the start of treatment and should ensure that family members are fully updated on how they will be included in treatment plans/reviews.
  • Improve marketing and stakeholder knowledge of the service through increased promotion of marketing materials and development of Communication/Marketing Strategy.
  • Progress the follow up project which has been put in place within the service, to survey as many clients as possible, to identify why an ‘average’ rating has been given for the building (Skinner Street) and facilities and identify if these issues can be rectified or if they are within the constraints of the building.
  • Where interest has been expressed for new group work sessions to be made available, these new groups to be implemented and trialled as part of the ongoing service offer.
  • Continue the education and awareness programme that has been put in place to ensure that clients understand the health requirement for screening for hepatitis B, C, HIV and chlamydia and also to support clients with immunisations where required.
  • Progress the project that has been initiated to look at times of demand and service user requirements, for service opening hours, especially within the hospital in-reach service, where work is underway to identify times of highest footfall and busy periods within A&E and the wards.
  1. CURRENT POSITION

3.1 Following the Service Review the team have worked to make improvements across all service areas, including the areas identified during the review as requiring development:

3.7 A Parent/Carer Involvement Audit was completed across all case files to identify how many clients had given access and reasons for preventing involvement by family members. 68% of clients had agreed to have their family as part of their Care Plan. All staff were given further training in the value of 'listening’ to family members input and in how to ensure that all clients were fully aware of the value of family/Carer input to the ongoing recovery. Family involvement is revisited at all Care Plan Reviews. Lifeline staff now also have a weekly attendance time within the Bridges Family and Carer Service, in order to work more closely with the Carers and Family members. The team recently attended a ‘Carer’s Rights Day’ Event and engaged with a number of Carers.

3.8 In order to improve Stakeholder knowledge and marketing methods, some of the work completed has been liaison with Pharmacies and Dentists, with alcohol training offered and promotional literature. Presentations to GP’s and an Action Plan put in place for closer working with GP’s. Alcohol Roadshows in Billingham and Thornaby, an awareness/marketing stall in the Shambles in Stockton and awareness themed stands in the Hospital, resulting in a joint working project with the hospital Occupational Health Team. Presentations were also made to the Stockton Town Pastors, Crisis Support Steering Group, Community Welfare Trust and Job Centre Plus.

3.9Service Users were asked to feedback on their ‘average’ rating for the building. Clients identified that they thought that the building reception looked too clinical, resulting in the area being decorated with themed displays – eg Sexual Health Awareness stands. Clients were also under the impression that the lift was out of order, though this is not the case and with assistance from a staff member it can be accessed.

3.10 A new Activity/Group Timetable was developed with new groups requested by Service Users – including Choir, Health & Beauty, Art and Walking Group. Regular initiatives are in place to increase interest in the groups, with clients receiving points for all groups attended, resulting in activities/raffles for those who attend regularly. Clients and volunteers often lead the groups and develop them in-line with the group feedback. The Group/Activity Timetable is regularly updated and clients are regularly encouraged to consider attendance at groups and to get involved in regular activities as part of their treatment.

3.11Screening for hepatitis B, C, HIV and chlamydia is regularly targetted with all clients, with this work being led by the Clinical Nurse and at all clinical reviews. Awareness Campaigns and groups have been offered within the service, resulting in improved performance for engaging clients in discussions and testing programmes.

3.12Work has been ongoing across the year to identify working hours across the team and opening times for the service, which are in-line with Service User needs. Resulting in extended service hours – 8am to 6pm, late night Thursday and Saturday mornings. There has been a project within the hospital to identify the hours of the highest footfall and therefore, the times when staff can target the most patients within hospital areas. The team are working closely with the hospital management team to identify working hours and access to the hospital for increased staff members.

  1. NEXT STEPS

4.1 After considering the findings from the service reviewand with performance levels meeting targets – (the number of referrals into the Lifeline Service in October 2016 was 618 (year to date), which is similar to the previous year. At any given time approx. 285 people are on the caseload. Unplanned exits were 7.8% of people in treatment over the 12 month period, which is lower than the national average (14.6%) and less than 1% of clients who discharge from the service, represent to the service for support. 87% of clients show a reduction in alcohol units consumed from treatment start to discharge). Therefore, it was concluded that Stockton Borough Council take up the option of the second12 months available under the existing contract arrangements. This has been agreed in principle with the provider and the contract will be varied accordingly if the extension period is agreed.

  1. RECOMMENDATION
  2. That the commissioning group notethe contents of this report.
  3. That the commissioning group agree to a further 12 months’ extension.

REPORT ENDS

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