Raising quality

Key reading:

Guidance on standards for the establishment and operation of drug consumption rooms in the UK.

Hunt N., JRF, 2008.
This report provides essential guidance for local multi-agency partnerships that are contemplating establishing and operating a drug consumption room (DCR) in the UK. A number of local partnerships across England, Wales and Scotland are currently discussing whether or how DCRs might help address their local drug problems. At present there are no DCRs in the UK, however, evidence elsewhere suggests that they can be valuable for engaging marginalised drug users, reducing overdose deaths and can have a beneficial impact on community safety in areas where public drug use is widespread.

This guidance:

• helps meet a need to define minimum operational standards, identified within the original Report of the Independent Working Group on Drug Consumption Rooms (JRF 2006);
• addresses international and domestic legal issues, including duty of care;
• examines the commissioning process, operational policies and procedures and monitoring and evaluation.

Download: Full report (PDF 180KB)

Good practice in harm reduction

NTA, 2008.
The NTA publication, Good Practice in Harm Reduction (October 2008) helps service providers and commissioners improve harm reduction services for drug users. The guide is the result of interviews with a number of partnership areas who scored highly on the recent Healthcare Commission/NTA joint improvement review of harm reduction services. It seeks to identify what works well on the front-line and therefore what drug partnerships could do to improve their harm reduction services. It highlights how the top ten per cent best performing partnerships approach the planning and delivery of services which enabled them to score well in the improvement review. Not all these approaches will be relevant for every area, but the guide does contain a number of useful case studies which show how gaps in service provision in a range of urban and rural areas have been addressed.
Download: Full report (PDF 387KB)

Supporting and involving carers: a guide for commissioners and providers

NTA, 2008.
This guide has been published to support the improvement in availability and quality of services for families and carers, as well as improving the involvement of families and carers in drug users’ treatment. The guide provides information for substance misuse commissioners and providers on the evidence base and good practice in commissioning and providing services for families and carers, as well as for involving them in drug users’ treatment. In addition to the main guidance, Appendix 1 (NTA, 2008) gives details of the evidence base for family and carer services and Appendix 2 (NTA, 2008) provides further information for specific groups.
Download: Full report (PDF 844KB)

Improving the quality and provision of Tier 4 interventions as part of client treatment journeys: A best practice guide

NTA, 2008.
This guidance summarises key challenges that currently face the Tier 4 sector. It links the roles that each stakeholder group can play in jointly finding solutions and improvements. This document can be read in tandem with Models of Residential Rehabilitation for Drug and Alcohol Misusers (NTA, 2006), Drug Misuse and Dependence: UK Guidelines on Clinical Management, and Commissioning Tier 4 Drug Treatment (NTA, 2006). Reference should also be made to the World Class Commissioning Programme launched by the Department of Health in December 2007 (Department of Health, 2007). World Class Commissioning will deliver a more strategic and long term approach to commissioning services with a clear focus on delivering improved health outcomes. Many of the principles highlighted in this NTA best practice guidance, notably thorough needs assessments, partnership working and user involvement are reflected in the World Class Commissioning vision.
Download: Full report (PDF 395KB)

NHS Healthcare Commission, NTA, 2008.
Using ten criteria around commissioning and systems management and harm reduction provision the authors assessed a number of services to see how they performed. Their results and recommendations are presented in this report.
Download: http://www.healthcarecommission.org.uk/_db/_documents/
Improving_services_for_substance_misuse_May_2008.pdf (PDF)

Essential care: a report on the approach required to maximise opportunity for recovery from problem substance use in Scotland

Scottish Advisory Council on the Misuse of Drugs, 2008.
The majority of the Essential Care report is concerned with support that is needed to address problems in areas of drug service users’ lives other than addiction, such as general health, mental health and social skills and relationships. It lists all the areas which may need attention, together with evidence of their benefits. However the main conclusion is that there needs to be a major change in the philosophy of care for problem substance use in Scotland – focused on the recovery of each individual.
Download: Full report (PDF 300KB)

Guidelines for the evaluation of treatment in the field of problem drug use

EMCDDA, 2007.
The main objective of the guidelines is to provide a European audience with basic information on the options, elements and procedures of drug-related treatment evaluation. The target readership includes professionals working in treatment services for substance use and dependence, administrators and officials in social and health authorities, researchers dealing with treatment of substance dependence, and those who professionally or politically may have an interest in evidence from treatment evaluation.
Download: Full report (PDF 544KB)

Non-medical prescribing, patient group directions and minor ailment schemes in the treatment of drug misusers

National Treatment Agency for Substance Misuse, 2007.
Non-medical prescribing (particularly nurse and pharmacist prescribing), patient group directions (PGDs) and minor ailment schemes (MAS) are all part of a range of NHS reforms designed to improve patients’ access to medicines, develop workforce capability, utilise skills more effectively and ensure provision of more accessible and effective patient care. Successful implementation requires robust clinical governance mechanisms and teamworking, as well as access to specialist pharmaceutical support. Commissioners, managers and practitioners can now explore the potential of all these different mechanisms as ways of improving access to medicines for drug misusers.
Download: Full report (PDF 253KB)

The International Treatment Effectiveness Project - Implementing psychosocial interventions for adult drug misusers

National Treatment Agency for Substance Misuse, 2007.
The International Treatment Effectiveness Project (ITEP) is part of the National Treatment Agency’s Treatment Effectiveness strategy, which identified areas for enhancing the quality of treatment interventions. The project was a collaboration between the NTA, the Institute of Behavioural Research (IBR) in Texas and several service providers in the north-west England and London. ITEP utilised a care planning approach (referred to as “mapping”) in the form of a manual, which was used by trained keyworkers with their clients. Previous research had shown that these psychosocial interventions had a number of positive outcomes in terms of clients’ treatment experiences and reductions in illicit drug use.
Download: Full report (PDF 421KB)

Nothing about us, without us. English users representative report

IHRA, 2007.
In May 2007, the National Treatment Agency for Substance Misuse (NTA) sponsored eleven service user representatives from across England, to attend the International Harm Reduction Association’s (IHRA) 18th International Conference on the Reduction of Drug Related Harm, hosted in Warsaw. Their intention was to collect information on new evidence-based initiatives on reducing drug-related harm and communicate these messages to the wider service user community. The overall aim was to identify examples of international good practice that could inform and improve harm reduction services in England. This report covers the team’s five key areas of learning from conference - blood borne virues, harm reduction, prisons, service user involvement and drug users involved in sex work.
Download: Full report (PDF 180KB)

The status of social care – a review 2007

Platt D., UK. Department of Health. 2007.
Report of a review by Dame Denise Platt on how the status of social care might be raised, as commissioned by the Secretary of State for Health, in her speech to the national Social Services Conference in October 2006. The terms of reference for the review were: To review the current arrangements for promoting the contribution social care makes to the promotion of people’s independence, inclusion, health and well being. To consider whether any action is required to improve the status of social care services and the social care workforce. To propose recommendations and timetable on any next steps which will be required.
Web: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/
PublicationsPolicyAndGuidance/DH_074217

Good practice in care planning

NTA, 2007.
During 2005/06, the first joint Healthcare Commission and NTA substance misuse themed Improvement Review took place. The Healthcare Commission’s Improvement Reviews look at whether healthcare organisations are striving to improve the care and treatment they provide to patients. The reviews focus on aspects of health and healthcare where there are substantial opportunities for improvement, and help organisations to identify where and how they can perform better.
Web: http://www.nta.nhs.uk/publications/documents/
nta_good_practice_in_care_planning_gpcp1.pdf (PDF 323KB)

The impact of violence and abuse on engagement and retention rates for women in substance use treatment

NTA, 2007
This document describes the available evidence and includes professional opinion from key informants on the impact of domestic violence and abuse on women’s capacity to access, engage and benefit from drug treatment
Download: Full report (PDF 535KB)

Models of care: update 2006

NTA, 2006.
This update is intended to build on the framework and concepts in Models of Care 2002 rather than replace them. It requires drug treatment commissioners and providers to have implemented the key tenets previously described in Models of Care 2002.
Download: http://www.nta.nhs.uk/publications/documents/
nta_modelsofcare_update_2006_moc3.pdf (PDF)

Drug intervention programme and prolific and other priority offenders programme: emerging practice and lessons

UK Home Office Drug Strategy Directorate, Home Office, 2006.
This paper provides examples of emerging practice and lessons learned in relation to the working partnerships between CJITs and PPO teams in effectively case managing drug misusing PPOs.
Download: Full report (PDF316KB)

Improvement review into substance misuse services

NTA/Healthcare Commission, 2006.
The NTA and the Healthcare Commission have agreed to work in partnership to review substance misuse services to bring about improvements in drug treatment services. The first of a series of these national reviews focussed on two key aspects of drug treatment for 2005/2006, whether drug treatment services are prescribing drugs safely and appropriately and whether there is good treatment planning and coordination of services. The national review covered 149 drug action teams (DATs). Drug action teams are partnerships responsible for drug treatment services in England and are made up of representatives from NHS trusts, social services, the police, the probation service and the voluntary sector. Fifty six mental health trusts and 303 primary care trusts (PCTs) within those drug action teams have also been given a rating.
Web: http://www.healthcarecommission.org.uk/serviceproviderinformation/
reviewsandinspections/improvementreviews/substancemisuse.cfm

Diversity manual

Home Office, 2006.
The Diversity Manual is intended for use by regional government, local partnerships and delivery partners across the areas of crime and drugs. The Manual sets out the legislative framework requiring partnerships and service providers to commission and provide services appropriate to local needs. It identifies responsibilities relating to diversity, provides case studies of good practice and contains useful information and links and resources to support the delivery of services for local populations which are compliant with legislation.
Download: Full report (PDF494KB)

Responses to drug misuse: treatment

RSA Drugs Commission, RSA, 2006.
This paper overviews treatment as a response to drug misuse.
Download: Full report (PDF 707KB)

Alcohol and drugs in London: improving the options for women, July 2005

Greater London Alcohol and Drug Alliance., Stella Project., London Drug and Alcohol Network, GLA, 2005.
This is the report of a conference whose aims were to identify: key barriers to service provision for women with alcohol and drug problems in London; practical solutions that will close gaps in service provision and ensure services become accessible to all women affected by drugs and alcohol in London; examples of good practice; and a series of recommendations informed by the delegates and speakers experiences.
Download: http://www.london.gov.uk/mayor/health/docs/womens_report.pdf (PDF 694KB)

Roles and responsibilities of doctors in the provision of treatment for drug and alcohol misusers

NTA, 2005.
All organisations employing doctors need a robust clinical governance structure that addresses issues of education and supervision. This report recommends that appraisal must be carried out by a trained appraiser with experience of the clinical area. Supervision could be carried across different employing and specialty areas, so for example a consultant addiction psychiatrist could supervise a GP with special clinical interest working in their geographical area.
Web: http://www.nta.nhs.uk/publications/
documents/nta_doctors_roles_and_responsibilities_sept_2005.pdf

Treatment outcomes: what we know and what we need to know

Gossop M. UK. National Health Service. National Treatment Agency for Substance Misuse, 2005.
(Treatment effectiveness 2). This paper reviews what has been learned from the following major national drug treatment outcome studies: NTORS (National Treatment Outcome Research Study); DARP (the Drag Abuse Reporting Programme); TOPS (Treatment Outcome Prospective Study) and DATOS (Drug Abuse Treatment Outcome Study).
Download: Full report (PDF 283KB)

QuADS: organisational standards for alcohol and drug treatment services

Alcohol Concern/SCODA, 1999.
The QuADS manual sets out measurable standards which describe minimum and good practice levels of drug and alcohol service provision. The standards cover core management standards, service user standards, core care standards, and standards for specific service types and target groups. The standards can be used by drug and alcohol services to measure and evaluate their own service provision. DrugScope is currently working with drug services and DATs to help with the implementation of QuADS.
Price: £23.50
Download: QuADS guidance (PDF 352KB)