Welcome to the WISMS ICO Workforce Planning Event

1. Welcome to the WISMS ICOWorkforce Planning Event Dr Linda Harris

2. Today we have a great opportunity • To establish a roadmap for workforce development across the partnership ( 2009 – 2012) • We are a DH ICO – we need to maximise the “power of the brand” • We have a Balanced Scorecard which demonstrates our commitment to moving from a “national sickness service” to a Locally Accountable Health and Social Care System

3. Today I would like us all to think as great leaders • Knowing what’s right • Articulating what’s right with clarity • Doing what’s right with enthusiasm and passion • Taken from a response from Mr Chris Long, CEO Hull Teaching PCT • ”

4. Our understanding of our services and stakeholders Our understanding of the national and local policy context Our understanding of the evidence for good and effective bio-psychosocial care Our understanding of what could be delivered differently or better “Knowing what is right” and bringing this knowledge to the table

5. Commitment and collaboration • As ICO members we wish to reposition ourselves so that our services are dealing with causes as well as consequences • We wish to deal with the determinants of health - education , social capital, lifestyle • We are committed to measuring impact as the means of achieving our just rewards and demonstrating the return on our investment

6. “Articulating what is right” in a series of activities • Our Balanced Scorecard is focussed on identifying the degree to which the individual/community affected by substance misuse are : - • Healthy • Earning • Learning • Safe We are motivated because we know that those who don’t achieve in all areas have poorer outcomes

7. In our ICO…. • Everyone has a voice • The principle of subsidiarity applies • The workforce participates in integratedprogrammes rather than isolated interventions • Excellence as a service provider does not in itself constitute success

8. What do we want to achieve from today ? Part 1- The ‘Knowing’ bit • Establish the relationship between the balanced scorecard and workforce transformation • Identify what areas are ripe for transformational change ? • Explore impacts of outcome based accountability as an integrated workforce

9. Part 2 – The ‘Doing’ bit • Explore some specific areas of workforce transformation • Psychosocial interventions • Service User Empowerment • Safeguarding • Interventions for NEETs • IT

10. Part 3 – Action Planning

11. Today will have been a success if……. All the partners contribute We acknowledge but are not scared by the challenges ahead We are committed to investment in all four areas of the scorecard We bring staff, service users and communities with us We are bold and seek to innovate – sometimes new things don’t work

12. Transforming the service user journey of care Some ideas….

13. Recreational Use Problematic Use Harm Addiction Therapeutic Principles Behavioural Change Stages and Processes of Change Internal Resources Formal Treatment Loved Ones Support Groups Recovery Recovery Communities Society

14. Where in the journey can we transform services? • Engagement? • Assessment? • Programmes/interventions? • Monitoring? • Patient involvement? • Recording of case and success in treatment

15. Engagement Website access Online and telephone triage Social marketing Touch screen self assessments Where in the journey can we transform care?

16. Assessment Involve service users in screening Go paperless Introduce safeguarding pathway Introduce benchmark screening tests Cluster patients in accordance with a currency and pricing model?

17. Formal treatment Routes to recovery/ITEP Motivational enhancement and Cognitive behavioural therapies Contingency management Rapid Detoxification Cont…

18. Working SMARTER • Telehealth • Paperless record keeping • Decision support tools • Text/webcam/e mailing our clients • Streamlining working practices

19. Balanced scorecard Economic Benefit Service user experience Workforce Development Individual health and well being Communities

20. Wayne, 28 and Bev, 22 • Live apart, their 2 children live with Wayne’s Mum in Castleford • Bev, in and out of prison in the past for acquisitive crime (drug related). Just secured a job as a waitress and is worried about keeping it as needs her methadone and has pain from an infected leg ulcer from injecting • Wayne, unemployed, drinks heavily. He worries about Bev’s drug use, she has overdosed before • They are trying to clear their debts and raise a deposit for a flat • They both want the family back together

21. Case study • Wayne • Young male, father • Cannabis from age 12, binge drinking aged 13 with friends, daily drinking in excess of 50 units a week for past 2 years • No previous employment and left school without qualifications • Never thought of accessing treatment – doesn’t think he has a problem and when he did see his GP seeking some “sleeping tablets” he was advised that his GPs did not prescribe these • Suffered from panic attacks when a teenager and found out alcohol reduced his anxiety. Hasn’t told anyone about this

22. Case study • Bev • Young female • butane gas aged 12, ecstasy and amphetamine from 15, heroin from 16 including periods of crack binges • Suffered abusive childhood, self harmed and developed moderate eating disorder. Sentenced to juvenile unit aged 17 for credit card fraud • Pregnant aged 17 ( Joe aged 5) and again at 19 (sally aged 3) using crack and heroin throughout both pregnancies so children move in with grandmother through residency order • Suffered postnatal depression and started on fluoxetine – antidepressants have not changed for five years • Hasn’t stayed in substance misuse treatment for longer 3 weeks • Prior to prison was “running for a dealer and injecting over 1gm of heroin a day speedballing her crack • Continues to self harm and is underweight • Not on contraception • Inducted on methadone on a supervised dispensed script and within 5 days had missed pick ups at the chemist – states its shift patterns at work

23. Wayne, 30 and Bev, 27 • Wayne receives alcohol brief interventions at the practice and attends the evening AA group now once a week. His Progress 2 Work advisor is supporting him to access training • They visit the centre as a couple, with children (under 5) who are now all up to date with their vaccinations. • Bev has reduced her methadone, attends a self help group to manage her anxiety. She has had Chlamydia and cervical screening. She is training to be a peer advocate