Open Event Reconfiguration of Substance Misuse Services in ... Event Presentation - Internet...Open...
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Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
Introduction
Objectives
To Excite and Inspire
To Inform
To network with other providers
To answer your questions
Outcomes
Gain and Understanding of:
Westminster and its substance misuse issues
The basic rationale behind the change
The new treatment model
Outcome based commissioning
Areas of focus and the challenges ahead
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
Westminster
“A City within a City”
One of the busiest Cities in the world
500’000 people – nightlife
3400 licensed premises
Busier at 3am than 3pm
Home to Parliament Media Attention
A Unique Opportunity
Whole scale redesign of services
Integrating Drug and Alcohol Services
Comprehensive Service User Consultation
An Unique Opportunity In a Unique City
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
Index of Multiple Deprivation 2007, national deprivation quintile
Most affluent wards in the country found next to some of the most deprived
Hazardous and harmful levels of drinking
amongst higher socio economic
Queens Park, Westbourne, Church Street –
Top 20% of most deprived wards in the country
A City of Contrasts
NHS Westminster Public Health Data 2008
Westminster City Council Ward Profile Data
8th Most deprived Local Authority in England
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
Figures have been taken from Neighbourhood Statistics Mid Year Estimate for Jun 2007 Westminster Joint Strategic Needs Assessment Aug 2008
Westminster Public Health Annual Report 2007/08
Estimated 1’000’000 frequent the city on a daily basis
Population of approx 230’000 residents
50.1% Male49.9% Female
Demographics
29% of the Population BME 52% of the Population Born outside of the UK
1/3 of Westminster’s population will leave 1/3 replace in any given year
73.9% of working age20’000 Claiming some kind of
worklessness benefit
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
Chinese3% Asian
11%
Black8%
Other7%
White71%
Chinese2%
Asian19%
Black14%
Other12%
White53%
Proportion of Westminster Population in each ethnic group
Proportion of Westminster children and young people in each ethnic group
Source: GLA 2007 round population projections (PLP low)
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
Figures have been taken from Westminster LARP Data a, Glasgow Estimate and Alcohol Needs Assessment Research Project 2005
Prevalence of Substance
Misuse
Alcohol UseHazardous 6,257Harmful 12,659Binge Drinking 31,552 Dependent 8210 (ANARP)
Problem Drug Users 3,627Opiate and Crack users –
Smoothed estimate Opiate Misusers 2,801 Crack cocaine Misusers 2179
Capacity of Treatment System70% PDU Penetration = 2,476Minimum 10% of dependent drinkers = 821 (ANARP)
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
Westminster’s Treatment
Population
Just over half of clients accessing structured treatment receive either specialist or GP
prescribing
Approx 60% of new presentations are either NFA or present with
a housing problem
Women remain under represented in the treatment population
84% of PDUs
accessing structured treatment in 2008 were there for
12 weeks.
Around two thirds arefrom a white background
85% of the treatment population misuse either opiates or crack cocaine
Approximately 60% of the treatment population are aged 35 or older
Westminster Performance Management Data/ NTDMS 2007/08
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
National Service Framework for Children, Young People and Maternity ServicesDepartment of Health (2004).
http://www.nwph.net/alcohol/lape/index.htm
Nationally, 50% of child protection cases reference parental alcohol misuse
Alcohol
2,752 alcohol related hospital admissions for Westminster residents
Approx 230 people in structured treatment at any given time
in 45% of all violent incidents, victims believed offenders to be under the
influence of alcohol (Home Office Stats)
37% of domestic violence cases involve alcohol (Home Office Stats)
Parental alcohol misuse –around 2,447 children in Westminster impacted by parental drinking
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
Approximately 600 Westminsterresidents prescribed in a primary
care setting
Primary Care
12 GP Practices participating in Shared Care 12 pharmacies offering needle
exchange services
74% Male, 26% Female(Comparable to overall treatment
population)
Delivery of brief interventions for alcohol misusers
Approximately 51% using substances on top of their
script
13% of clients employedOlder population
Provisional findings from Westminster DAAT GP Shared Care Audit 2009
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
HM Government NO ONE LEFT OUT Communities ending rough sleepingWestminster City Council Rough Sleeping Strategy 2007–2010
Homeless Population
41% of rough sleepers have a problem with drugs
40% of rough sleepers have a mental health problem
49% of rough sleepers have a problem with alcohol
Approx 15 hostel providers accommodating approx
1200 individuals
Nearly one quarter of all rough sleepers nationally are in
Westminster
Understanding the differences 57% new to the streets9% will be returners
34% entrenched ongoing
1,820 individuals were verified rough sleepers in
Westminster in 06/07
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
Drug Intervention
ProgrammeArrests
550 ‐650 drug tests per month32% Testing Positive76% Out of borough
Drug Rehabilitation
Requirements;
100 New Orders in 08/09 with a 49% success rate
Approx 50% on caseload are NFA
319 DIP Care Plans agreed in 2008
150 DIP referrals to specialist treatment
In 2008 Over 600 ROB Assessments at court with approx 150 receiving ROB
43 % of Dip caseload engaged in structured treatment in
2008
Home Office Dashboard/ Performance Indicators 2008
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
User Focused Treatment SystemDeveloped in collaboration with key partnersSignificant input from Drug and Alcohol usersImproving the experience and outcomes of service usersIntegration of drug and alcohol treatment into broader work of NHS Westminster, Community Protection, Police and Probation Service
The Future Of Drug and Alcohol Treatment Provision In Westminster
July 2009
Positive Outcomes: Health and Well Being, Reduction in Criminal Behaviour
Increase range, quality and accessibility of alcohol treatment
Increase number of women and BME communities accessing treatment
Improved care pathways – the right treatment at a time they need and want it
Focus on social reintegration‐ accommodation, training, education
Emphasis of meeting needs of children and families of substance misusers
Service users at the centre‐ developing service user advocacy and support
Treatment rooted in local community, need to engage to ensure meeting their needs
8 Key Features of the Westminster’s Vision For Substance Misuse Services are:
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
The Model
Hub and Spoke Design
2 mini treatment systems North and South
Range of services on offer as detailed in specification
Delivered from 3 key settings:
Neighbourhood Centres Direct access service offering Tier 2 and 3 interventions
Structured Intervention Centres
offering appointment based tier 3 interventions
West End Referral Centre Offering harm reduction interventions and referral on
In reach services at a range of community based settings
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
What are the results we are buying?What Performance targets will you set yourself?
Who are your customers and how many do you plan to serve? Does your service have a good understanding of Westminster’s substance misusing population? What are your strengths in serving this group?How would you go about socially reintegrating this group?
What are the chances of success?What is it about you that gives you the best chance of
success?
What is the organisations ethos, history and commitment to quality and diversity?Evidence proven track record of success, and examples of innovationWho are the key people delivering this service?How will you ensure quality?
Is this the best use of resources?Does this offer the DAAT Value for Money?
What are your Financial Projections?What does it cost to get a successful outcome? What added value do you offer?
Examples of Questions For Consideration When Working with and Outcomes Based Approach
An Outcomes Based Approach
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
Outcome Alignment Diagram
National Strategy
Local Outcomes
Objectives from Safer
Westminster Plan/ NHSW Business Plan
Programme Outcomes
Preventing harm to young people and families affected by drugs
Reduction in chronic acute ill health caused by alcohol
Public information campaign, communications
and community engagement
Protecting communities through robust
enforcement to tackle drug supply, substance misuse
crime and a.s.b.
Delivering new approached to substance misuse treatment and social
reintegration
Work in partnership with the Family
Recovery to:Breakdown BarriersEarly identification and intervention
Integration of servicesImprove economic
well being
Increase the number of brief
advice/interventions provided in a range of
settings. To increase the number of people accessing Alcohol
Treatment
Treatment is rooted in the local community ,
meeting the needs of all residents.
Public are aware of harm substances can cause and are able to
make informed decisions
To work in partn4ership with
Police and Probation to tackle drug and alcohol related offending and antic social behaviour.
Ensure treatment is personalised, outcome focused, making full
use of treatment approaches shown to
be effective.
How will your service work to safeguard
children and vulnerable adults and
meet the needs of substance misusing
parents and carers of substance misusers?
How will your service reduce the harm
caused by alcohol use on the individual and wider community?
How will your service engage with the local community and build
confidence in the work being done to
tackle substance misuse?
How will your service help to reduce the rate
of drug and alcohol related crime and anti-
social behaviour?Measured by National
Indicators NI 17- ,NI38, NI 120
What innovative approaches to
treatment and social reintegration will
your service adopt? PSA 25 and NI 141,
144,146,148,150
Commissioner verification
ProviderInformation
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
Major Challenge to the ProjectWestminster DAAT intends to secure all 5 sites during the tender processUnable to secure all 5may ask bidders for support10th August Property Needs set out in invitation to tenderSpatial plans available online Estimate of space required
Property
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
Property Requirements
Estimated Size Structured Intervention Centres 200 Square MetresNeighbourhood Centres 300 Square MetresWest End Referral Centre 100 Square Metres
LocationNorth North of Oxford Street/ Bayswater RoadSouth South of Green/ St James Park “Low Density Residential Area”Central (Referral Centre)Ideally Soho Area
Estimated Spatial Plans Available online
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
TUPE likely to apply for all current employeesOrganisations invited to tender will be provided with relevant information from current providers by the City Council
The Current Workforce
Open Event for interested parties regarding the reconfiguration of substance misuse services in WestminsterWestminster City Council
ACTIVTY TARGET
Deadline for receipt of PQQs 27th
July 2009
Evaluation of PQQS Wb. 27th July 2009Wb. 3rd August 2009
Shortlist of organisations agreed Wb 10th August 2009
Invitation to tender Wb 10th August 2009
Receipt of written questions 11th September 2009
Deadline for reply to written questions 18th September 2009
Deadline for receipt of bids 23rd October 2009
Evaluation of written tender bids Wb. 26th
October 2009Wb 2nd November 2009
Tender presentations / service user panel / site visits / Post tender clarification Wb 9th November 2009Wb. 16th
November 2009
Award of Contract December 2009
Lead in time for start of new contract January, February, March, April, May, June, July, August 2010
Contract Start date 1st
August / 1st September 2010
Tender Timetable