NTA Residential Rehabilitation Event

WelcomeBaroness Massey of Darwen

NTA Residential Rehabilitation Event

Rosanna O’ ConnorNTA Director of Delivery

Welcome to all...................

Key aims:

to support closer relationships between residential providers and commissioners

to provide an opportunity for networking

to facilitate the sharing of ideas and models of delivery

The new drug strategy

2010 drug strategy sets out a clear ambition to help people recover and to overcome their dependency Companion public health white paper makes clear reducing drug use, enabling people to overcome dependency and recover fully are a key priority

Improving successful completions are a component part of the success of any partnerships approach to recovery

Residential rehabilitation has a key part to play in providing abstinence-based treatment and enabling people to successfully complete treatment

There are also a range of residential models available, some of which we are highlighting today

 

NTA role in delivering the drug strategy

Mandated to work with others to support the transformation of treatment systems into recovery systems

Ensure integration of treatment into wider systems of recovery: Ensuring that the system links to housing, employment, education,

children services, families and Mutual Aid Ensure a holistic tailor-made response to the whole needs of an

individual’s recovery journey Assisting partnerships to develop recovery orientated systems in

prisons – bringing together the clinical and CARAT services

Transition year

Transitional year as some NTA functions transfer to Public Health England

New local accountability structures from April 2012 – e.g. Health & Wellbeing Boards

‘Building Recovery in Communities’ to replace Models of Care

Snapshot of the 2011/12 work plan

Implementation of BRiC Patient placement criteria – segmenting treatment population Support Payment by Results Secretariat to the National Skills Consortia Supporting recovery networks & champions and Mutual Aid groups

Key themes for Commissioners & ProvidersMarch 2011

Mark Gillyon

Head of Delivery - North

MoC 3 Building Recovery in Communities

2007 Clinical Guidelines

Integrated Drug Treatment System (IDTS)

Recovery Mutual Aid, successful completions, the supportive role of families,

the importance of housing and employment

Support through the system

User choice and responsibility

Families and safeguarding

Targeting the right interventions, to the right people, at the right time.

The new framework

The over arching aim of the new framework is to support local areas in developing their systems and services to become recovery focused,

highly ambitious and offer a real opportunity for sustainable recovery.

The sector is changing...

Different models of delivery

‘Traditional’

Locally commissioned and locally provided

‘Quasi-residential’

The commissioning environment is changing...

Funding in 2011/12

Funding in 2012/13

Funding from 2013 onwards

Outcome-based systems, Payment by Results, and the leadership of Directors of Public Health / Health & Wellbeing Boards

Other things will change...

Successful completions The number of people leaving drug treatment free of their drug(s) of

dependency

Payment by results Model / length focus vs. specific required outcomes

Data About 2/3 report to NDTMS New models / new data problems

The future of PTB Within Public Health ring-fence, for Health & Wellbeing Boards

Data support

NDTMS Regional Teams Data collection, support, training, analysisRehab Online Marketing Testimonials VacanciesEvidencing outcomes and value

Future developmentsColin Bradbury

Residential Rehabilitation Event

March 2011

Contents

1. Payment by Results

2. Case Mix Adjustment

3. Residential Rehabilitation Outcomes

Payment by Results - Background

A recovery programme, not a treatment programme – aiming to attract new providers

Around 6 pilot local authority areas

April – Sep 2011: co-design, running 2011-2013

Independent evaluation

4 outcomes (interim & final) identified: Leaving treatment free from drug(s) of dependency Re/Offending Employment Health & Wellbeing (interim only)

Payment by Results

Opportunities and challenges

Moving away from process/ front end targets

Giving providers freedom and flexibility to innovate and sub-contract what they need

Letting the market show “what works”

Encouraging new providers to enter the market

Developing a single point of contact model

A need to avoid perverse incentives

Delivering more outcomes with the same money

Ensuring small/ new providers are able to compete

Payment by Results

Case Mix

Using outcome and re-presentation data to predict risk for new treatment entrants

Push and pull factors for recovery

Allowing comparisons of outcomes in similar areas and services – segmenting on the basis of probability of recovery

Limited to the data we have

Says something about an individual’s chances, but nothing about how best to help them...

CaseMix

RR outcome research

a prospective outcome study of publicly funded providers of drug and alcohol residential rehabilitation

expert academic and provider advisory group

Peer reviewed academic journal

Consult on which sort of models should be included

Rehabilitation Outcomes

In summary...

How might we further incentivise recovery, moving beyond the existing evidence base?

Payment by ResultsHow can we ensure accurate tariffs are set and there is a level playing field? Case Mix AdjustmentHow could we ensure people get the right treatment at the right time? Patient Placement CriteriaWhat role can residential rehabilitation play in this? Outcomes Study