Recent consultations:
DrugScope is preparing its response to the National Treatment Agency consultation Improving the value of drug treatment services - draft assumptions. We invited members and stakeholders to feed into this process.
What the consultation is about and why it matters
The consultation document is available on the NTA website at: http://www.nta.nhs.uk/areas/value_improvement/default.aspx
The NTA is producing a model intended to help ensure value for money in the commissioning of drug services. The proposal is that commissioners would divide up local drug using populations into the following groups:
- people who use opiates or crack in the community;
- people who use opiates and crack in the community;
- people who use opiates or crack and who are in prison;
- people who use opiates and crack and who are in prison;
- young users of any drug other than opiates and crack;
- adult users of any drug other than opiates or crack.
The model identifies 144 'draft assumptions' that would be applied to these drug using populations, covering what interventions should be available, how long they take to deliver, etc.
The NTA emphasises that the model will 'support and assist' local partnerships and not be a rigid element of performance management. It will be an important benchmarking tool, however.
If you would like further information please contact our Membership Development Officer, Carlita Mcknight on 0207 520 7558 or carlitam@drugscope.org.uk
In December 2007, the Secretary of State for Justice, Jack Straw, announced a review of diversion of offenders away from prison. Lord Keith Bradley, former Home Office Minister, was appointed to Chair the review.
The Bradley Review terms of reference are:
“To examine the extent to which offenders with mental health problems or learning disabilities could, in appropriate cases:
- be diverted from prison to other services; and
- the barriers to such diversion."
Bradley plans to report in December 2008
We have been concerned that this landmark review recognises that 'dual diagnosis' is the norm and not the exception among prisoners with mental health problems. A key barrier to diversion is a lack of capacity for and commitment to working with offenders who have both mental health and substance misuse problems. For example, there is evidence that people with drug problems can be turned down for Drug Rehabilitation Requirements (a community sentence which offers an alternative to prison for suitable offenders) if they have mental health problems. Conversely, few court diversion and mental health liaison services are set up to deal with offenders who also have drug and alcohol problems.
On 15 October, a group of DrugScope members and other key stakeholders met with Lord Keith Bradley to discuss better ways of working with problem drug users who end up in the criminal justice system.
Downloads:
Click here for a copy of the Bradley Review letter (PDF 39KB)
Click here for DrugScope's Criminal Justice briefing paper (PDF 51KB)
Click here for DrugScope's Dual Diagnosis briefing paper (PDF 43KB)
Click here for a copy of the key points made at the expert reference group (PDF 45KB)
If you have any comments on the response and the issues raised please get in touch. Contact Marcus Roberts, Director of Policy at marcusr@drugscope.org.uk or Carlita McKnight, Membership Development Officer, at carlitam@drugscope.org.uk
DrugScope responded to the Department of Health's recent consultation on the future of tobacco control. To inform our response we consulted with DrugScope members and stakeholders.
Our central message is that there is strong support for the UK Government's focus on reducing smoking related health inequalities by targeting the most socially excluded and marginalised groups. Smoking and smoking-related harm are exceptionally high among users of drug treatment services - it is estimated that between 70 to 90 per cent of people in drug treatment are tobacco smokers. In our response we conclude that the Government should give close consideration to the potential role of the drug treatment sector in reducing smoking related harm.
Currently, monitoring and performance management systems do little to incentivise or support drug treatment services to support smoking cessation. We recognise that there are genuine issues about the capacity of treatment services to address smoking cessation in view of the demands on their limited resources and the complexity of the needs of many of their clients. As a first step, the National Treatment Agency should raise the profile of smoking cessation, engage with treatment providers to discuss their concerns, and work with the sector to develop a more effective and consistent response to service users who smoke.
We would like to thank all those who worked with us in informing DrugScope's response.
DrugScope will be discussing the issues raised by the consultation with the NTA and the Department of Health.
DrugScope's response is available here:
If you have any comments on the response and the issues raised please get in touch. Contact Marcus Roberts, Director of Policy at marcusr@drugscope.org.uk or Carlita McKnight, Membership Development Officer, at carlitam@drugscope.org.uk
We are inviting DrugScope members and others to complete an online survey/questionnaire to inform our response to the Green Paper on Welfare Reform. The survey can be completed here. Any comments/responses we may use will be anonymous. The proposals in the Green Paper specific to problem drug users are summarised below.
The new drug strategy promises more personalised approaches to treatment services: 'We will examine how we can best support those leaving and planning to leave treatment with packages of support to access housing, education, training and employment.' The drug strategy commits the Government to 'explore the case for introducing a new regime for drug misusers which provides more tailored and personalised support...In return for benefit payments, claimants will have a responsibility to move successfully through treatment and into employment.'
The Welfare Reform Green Paper - No one written off: reforming welfare to reward responsibility - was published in July 2008. The Green Paper proposes far reaching changes to the benefit system for people of working age and will affect people claiming income support, jobseekers allowance and incapacity benefit/employment and support allowance. There are proposals specific to problem drug users in chapter 2 (pages 46 - 51).
The key proposals relating to problem drug users are:
Identification of problem drug users:
- All benefit claimants to declare whether they are addicted to heroin/and or crack cocaine.
- Information to be shared between the DWP/Jobcentre Plus and the criminal justice system (e.g., the police, probation service, prisons).
- Sanctions such as recovery of benefit overpayment or fraud investigation if it is found that problem drug use was not declared. ('If we are to take this forward, then those investigations could include information sharing with the police and, in a small number of cases, contracted-out drug testing.')
Requirement to engage in drug treatment:
- Problem drug users not in drug treatment required to talk to a treatment agency.
- Where appropriate, problem drug users required to see a specialist employment adviser and agree a 'rehabilitation plan'. Specialist support (building on the Progress2Work programme) to address barriers - e.g., health problems, basic skills needs, housing, debt.
- Benefit sanctions for not taking up treatment or employment support without good cause.
- Introduction of a new 'treatment allowance' specifically for problem drug users to replace normal benefit payments.
Employers:
- Working closely with employers' to help move people into the labour market'. ('Employers will have a key role to play...')
The proposals will be piloted and evaluated prior to any full roll-out.
Initial focus will be on problem heroin and crack cocaine users, 'over time we will consider the case for extending this approach to others - for example, those dependent on cannabis, powder cocaine or dependent on alcohol.'
Responses to the Green paper should be submitted by 22nd October.
The Green Paper is available on the DWP website here -
http://www.dwp.gov.uk/welfarereform/noonewrittenoff/
