NTA Residential Rehabilitation Event

1. NTA Residential Rehabilitation Event Welcome Baroness Massey of Darwen

2. NTA Residential Rehabilitation Event Rosanna O’ Connor NTA Director of Delivery

3. 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

4. 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

5. 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

6. 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

7. 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

8. Key themes for Commissioners & Providers March 2011 Mark Gillyon Head of Delivery - North

10. 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.

11. 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.

12. The sector is changing... • Different models of delivery • ‘Traditional’ • Locally commissioned and locally provided • ‘Quasi-residential’

13. 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

14. 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

15. Data support • NDTMS Regional Teams • Data collection, support, training, analysis • Rehab Online • Marketing • Testimonials • Vacancies • Evidencing outcomes and value

17. Future developments Colin Bradbury Residential Rehabilitation Event March 2011

18. Contents • Payment by Results • Case Mix Adjustment • Residential Rehabilitation Outcomes

19. Payment by Results 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)

20. 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

21. Case Mix 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...

22. Rehabilitation Outcomes 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

23. In summary... • How might we further incentivise recovery, moving beyond the existing evidence base? • Payment by Results • How can we ensure accurate tariffs are set and there is a level playing field? • Case Mix Adjustment • How could we ensure people get the right treatment at the right time? • Patient Placement Criteria • What role can residential rehabilitation play in this? • Outcomes Study