open event reconfiguration of substance misuse services in ... event presentation - internet...open...

July 2009

Open Event : Reconfiguration of Substance Misuse Services in

Westminster

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


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


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


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


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)


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)


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


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


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


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


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


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:


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


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


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


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


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


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


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


Question and Answer Session

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