Treatment Plan 2003/4 Summary

We identify Models of Care (MoC) implementation as our key priority for the coming year, building upon the work achieved already, learning from the Enhanced Treatment Outcome (ETO) pilot in Fenland and local enthusiasm to ensure effective services. We are also aware of the challenges of a demanding timetable of implementation and the need to achieve this from within existing resources in our area.

We are clear that although all treatment modalities are available to residents of Cambridgeshire and Peterborough, the degree of availability varies and this will be addressed through MoC.

We are awaiting announcements on the future of central funding for Arrest Referral Schemes. We have estimated increases in public sector funding in advance of final decisions being made with regard to inflation.

Planned spend 2003/04
We are advised that there will be no additional funds available to Cambridgeshire or Peterborough in 2004/5 and an increase of 5% in 2005/6. As a result, the Joint Commissioning Group advises that the Pooled Treatment Budget increases can only reasonably be seen as funding inflation over the next three years, and therefore service developments will have to be met from within existing resources.

Tier One - Non-drug treatment specific services
Specialist agencies offer training and support to workers in generic health and social care settings. Protocols and clinical governance guidelines have been developed through the Shared Care Monitoring Group (SCMG) for GPs working with substance misuse patients. South Peterborough has a Personal Medical Service (PMS) pilot and an increasing number of GPs from all PCT areas are engaged in early screening programmes and shared care arrangements. Specialist housing workers have been offered training, particularly in the light of the "Winter Comfort Case" and they continue to be supported by specialist agencies. Plans are in place to appoint dedicated staff, (through Supporting People funding), for programmes such as supported tenancies and floating support. Progress2Work is in the early stages of development and will build on existing programmes that are aimed towards substance misusers who could benefit from training and employment opportunities.

Objectives for 2003/04
Development of training for Tier One workers

JCG to publish agreed referral, screening and assessment system; directory of services (including eligibility criteria and priority groups); standardised referral process; information sharing policy; monitoring and review system. Advised by MoC Planning and Implementation Group (MoCPiG).

Tier Two - Open access drug treatment services

Objectives for 2003/04
Appoint Needle Exchange Co-ordinator

Evaluate impact of Peterborough CAD in relation to improving access for B & EM drug users

Support DPAS-led process of understanding Travellers needs and proposals for service developments

Tier three - Structured community based drug treatment services

Objectives for 2003/04
Through MoC implementation process, develop proposals for structured programmes that take account of opportunities with partner organisations.

Ensure funding for adequate medical cover in Cambridgeshire (especially Huntingdon and Fenland) and Peterborough - highlighted as priority area for 2003/04 pooled budget investment.

Tier Four - Residential drug treatment specific services

Objectives for 2003/04
Review of Residential Rehab providers.

County Wide seminar to be held to explore residential rehab programmes and intensive community support options.

Countywide protocols and eligibility criteria to be published and adopted by Peterborough and Cambs Local Authorities and the two DAATs.

Residential Rehab highlighted as priority area for 2003/04 pooled budget investment.

Workforce Activities Objectives for 2003/04
Conduct training needs analysis.

Promote Bespoke programmes on leadership, development and human resources management.

Promote regional recruitment initiatives based upon findings from training needs analysis.

Work with partners to enhance the competency and capacity of the medical profession in drug treatment.

Implementation of DANOS in accordance with NTA guidance.

Underserved groups

Objectives for 2003/04
Develop local services in light of national alcohol strategy.

Develop local services in light of CAD evaluation.

Develop services in Peterborough within framework of NTA diversity pilot programme.

Develop services against MoC and best practice guidance, introducing appropriate care pathways for stimulant users by 2004.

Implement systems for persistent offenders that are still in planning stages and ensure integration with other treatment systems and services e.g. Arrest Referral and DTTO's.

Review existing services against MoC and best practice.

Introduce appropriate care pathways for stimulant users.

User pathways published by MoC implementation group.

Review local services in light of national alcohol harm reduction strategy.

Review services in light of NTA Diversity Pilot framework.

'Systems' Investments

Objectives for 2003/04
To provide sufficient capacity and support for the Joint Commissioning Process.

To develop common information systems that can be used to inform the commissioning process.

Ensure appropriate IT systems in place.

User or Carer involvements

Objectives for 2003/04
To establish a baseline of current user forums and involvement.

Investigate the feasibility of establishing a local forum based up methadone alliance model of best practice.

Establish and agree a common framework for user involvement, consultation and participation.

Investigate the feasibility of establishing a local forum based up methadone alliance model of best practice.

Models of Care implementation
To establish the local implementation group, map current services against the Four Tiers and identify priorities for service developments within the DAATs' Treatment Plans.

To complete an assessment of whether the assessment and referral mechanisms (and treatment providers) in the area are operating according to the evidence-based patient placement criteria and treatment protocols outlined in the Models of care document. The joint commissioning group will be expected to use this assessment as the basis for adjustments to providers' service specifications for 2004/5.

To agree and publish a local referral, screening and triage system supported by an information sharing policy. This should make clear to all interested parties how the referral points into the drug treatment system work, who is responsible for conducting the various levels of assessment, how referrals are made into the main modalities of treatment, the protocols for information sharing and exchange, and the assessment forms and instruments that will be used.

To agree and publish locally defined care pathways, and a local system of care co-ordination. It should allocate clear roles and responsibilities, ensure the incorporation of existing care management roles (e.g. community care assessors, probation officers) into a comprehensive system, and agree a single set of care planning documentation.