Introduction to Core Data Set H Young People

1. Introduction to Core Data Set H Young People Simon Morgan simon.morgan@nta-nhs.org.uk Julie Marshall julie.marshall@nta-nhs.org.uk londonndtms@nta-nhs.org.uk March 2011

2. Objectives • To gain an understanding of all of the information required by NDTMS • Clarify requirements and definitions of Core Data Set H (CDS H) • Reiterate that CDS H effective from 1 April 2011 • Discuss avoidable Data Quality issues

3. Introduction to the NTA • The National Treatment Agency for Substance Misuse (NTA) is a special health authority within the NHS, established by Government in 2001 to improve the availability, capacity and effectiveness of treatment for drug misuse in England • NDTMS relates to the process of collecting, collating and analysing information from and for those involved in the drug treatment sector • NDTMS evidences your work and the impact of your work • Numbers in effective treatment • Public Health Outcomes Framework • NDTMS is used to determine funding allocations

4. Introduction to NDTMS • NDTMS was initially developed to collect data on adult substance misusers receiving specialist drug treatment services. The new ten year Drug Strategy (Drugs: Protecting Families and Communities) has highlighted the importance of creating a data set that is young person specific • Core Data Set H for young people has been developed for all young people’s services and should be completed for all people accessing young people’s treatment services irrespective of age

5. Core Data Set H – why is it needed? • Information reported to the NDTMS Young People’s data set is used to ensure that effective specialist substance misuse treatment services are available for all young people who require them • Data is used to inform local needs analysis and commissioning; inform NTA regional teams in supporting the continued development of treatment services locally • At national, regional and local levels it will also provide the opportunity to collect and measure outcomes and outputs

6. What is specialist substance misuse treatment – YP? • ‘Young People’s specialist substance misuse treatment is a care planned, medical, psychological or specialist harm reduction intervention aimed at alleviating current harm caused by a young person’s substance misuse’ • Interim Commissioning Guidance on young people’s specialist substance misuse services NTA 2008

7. Core Data Set H • http://www.nta.nhs.uk/core-data-set.aspx

8. Core Data Set H • NDTMS core data set - reference data - Reference data is defined as (relatively) static data. Generally it is employed as a means of validating data entry and will typically be used to control the contents of drop-down lists etc. • NDTMS core data set – business definitions for young people's treatment providers - Guidance for agencies on the core data set. • NDTMS core data set – guidance for young persons' treatment providers - Details the latest changes and explains which services should report to NDTMS; provides relevant definitions, as well as confidentiality and consent issues and answers to frequently asked questions.

9. Core Data Set H • NDTMS core data set - reference data • NDTMS core data set – Business Definitions for YP

10. Core Data Set H • The Core Data Set is made up of four data entities: • Client information • Episode (including regional fields) • Interventions • Treatment Outcome Profile (TOP)

11. Client Information • Finitial (key field) - the first initial of the client’s first name • Sinitial (key field) - the first initial of the client’s surname • DOB (key field)-the day, month and year that the client was born • SEX (key field)- the sex that the client was at birth. • Ethnicity - If a client declines to answer then ‘not stated’ should be used. If a client is not asked, then the field should be left blank. • Nationality - Country of nationality at birth (all case management systems / DET will have a drop down list box) ‘Not stated’ added • NB - If you put the full name in your case management system, only the initials will be submitted to NDTMS

12. Episode • An episode of treatment is a set of interventions with a specific care plan. A client may attend one or more unique interventions of treatment during the same episode of treatment. CLIENT AGENCY 1 AGENCY 2 EPISODE EPISODE Referral Date Discharge Date Referral Date Discharge Date Modality 1 YP Harm Reduction Service Modality 1 YP Psychosocial - Counselling Modality 2 YP Psychosocial – Relapse Prevention Modality Start Date Modality End Date Modality Start Date Modality End Date Modality Start Date Modality End Date Client Treatment Journey

13. Episode • Referral date (key field) - The date that the client was referred to the agency for this episode of treatment – for example it would be the date a referral letter was received, the date a referral phone call or fax was received or the date the client self referred • Agency code (key field)-A unique identifier for the treatment provider that is defined by the regional NDTMS centres • Client Reference - a unique number or ID allocated by the treatment provider to a client - this must not hold or be composed of attributers which might identify the individual. NB - The client reference is an effective way of identifying any exceptions

14. Episode – Consent for NDTMS • Clients must give explicit informed (typically written, but can be oral) consent to share their information with NDTMS • Clients should be informed about how their information is handled by the NDTMS • The NDTMS Confidentiality Toolkit is found under ‘Confidentiality Toolkit’ on http://www.nta.nhs.uk/agency-daat-information.aspx • Consent should be reviewed at the care plan review stage • Values are now No person not consented; Yes person has consented • Only clients who have consented to information being submitted to • NDTMS will be included in numbers in treatment

15. Episode • Previously treated - Has the client ever received structured drug treatment at this or any other treatment provider • Post code - The postcode of the client’s place of residence. Only the truncated postcode is submitted to NDTMS (E5 9) • If a client states that they are of NFA, then this field is to be left blank

16. Episode – Accommodation Need YP • The accommodation need refers to the current situation (28 days prior to treatment start) of the client with respect to housing need.

17. Location of CLA

18. Episode - Parental Status • Young people who are under the age of 18 years can also have parental status and should be asked about parental status

19. Episode • DAT of residence -The DAT in which the client normally resides. If NFA then for tier 3 treatment providers, the DAT of the treatment provider should be used as a proxy; and for tier 4 treatment providers, the referring DAT should be used as a proxy • PCT of residence - The PCT in which the client resides. If NFA the PCT of the treatment provider should be used as a proxy • Local Authority- The local authority in which the client currently resides. Due to Partnerships and local authorities not being coterminous in all cases, when the client is NFA the local authority of the treatment agency should not be used as a proxy.

20. Episode • Problem substance no. 1 -The substance that brought the client into treatment at the point of triage • Age of first use of problem substance 1 • Route of administration of problem substance 1 - Inject, Sniff, Smoke, Oral or Other • Drug 2 & Drug 3 - Additional substance that brought the client into treatment at the point of triage / initial assessment. No Second Drug and No Third Drug are introduced for data completeness. New drug Methylone and Mephedrone are introduced • NB - ‘Poly drug’ should no longer be used

21. Episode • Referral source - Detailed list in the reference data but new YP codes are: Secure Children’s Home; Secure Training Centre; Youth Offender Institute; and YP Housing • Triage date - The date that the client made the first face to face presentation to the treatment provider • Care plan date - Date that the care plan was created and agreed with the client for this episode • Injecting status - Is the client currently injecting; previously injected; never injected or client declined to answer? • TOP Care Co-ordination - Does the treatment provider currently have care co-ordination responsibility for the client in regards to completing the TOP?

22. Episode • Children - How many children live with the client at least part of the time? A child is a person who is under the age of 18. Young people who are under the age of 18 years can also have parental status and should be asked about parental status

23. Episode • Pregnant - All sexually active woman should be asked about pregnancy • Drinking days – No. of days in the 28 days prior to initial assessment the client consumed alcohol • Units of alcohol - Typical number of units consumed on a drinking day in the 28 days prior to initial assessment

24. Episode • Hep C Tested – (Yes/No/Not Asked) If Yes, then complete test date. • Hep C latest test date - Date that the client was last tested for Hepatitis C. This test may be within the current treatment episode or previously to the episode. This test may be in the current treatment episode or previous to the episode If the date is not known; the 1st of the month If the month is not known; the 1st January of the known year

25. Episode • Hep B vaccination count - No. of Hep B vaccinations given to the client within the current episode of treatment • Hep B intervention status - Within the current treatment episode, whether the client was assessed and offered a vaccination for Hep B

26. Episode • Hep C intervention status codes - Within the current treatment episode, whether a client was assessed and offered a test for Hep C? • Drug Treatment Health Care Assessment Date - The date that the initial healthcare assessment was completed.

27. Episode – status questions at treatment start and exit • These items focus on the status of the YP coming into and exiting treatment and are an acknowledgement that young people sometimes present with complex needs and vulnerabilities that may impact on their substance misuse and that, as a consequence, they may also be engaged with a range of other targeted and specialist services.

28. Episode – treatment entry status • YP in contact with Mental Health Services at treatment start - Is the YP currently in contact with inpatient or outpatient mental Health Services? • YP in contact with YOT at treatment start - in contact with the Youth Offending Team as a result of receiving a reprimand or final warning, acceptable behaviour contract, anti social behaviour order or community sentence • YP involved in self harm at treatment start - This refers to the YP’s current involvement or suspected involvement in activities such as cutting, burning, banging, hair pulling or poisoning. This includes accidental or non-accidental overdose • YP involved in offending at treatment start - This refers to a YP’s current or suspected involvement in activities which may or may not have come to the attention of the police, YOT or LA

29. Episode – treatment entry status • YP involved in sexual exploitation at treatment start - This refers to a young person’s current involvement, or suspected involvement in activities such as prostitution, production of pornography or age inappropriate relationships with adults • YP involved in unsafe drug use at treatment start - This refers to a YP’s current involvement or suspected involvement in unsafe drug and alcohol related activities. • YP Lead Professional at treatment start - This refers to the professional, who as part of the CAF process has been appointed to act as a single point of contact and coordinate provision for a child and their family. • YP has a CAF at treatment start - This refers to a YP who has been identified as requiring additional needs and assessed using the Common Assessment Framework

30. Episode – treatment entry status • YP Frequency of use of drug 1 at Treatment Start – number of days use of drug 1 in the last 28 days • YP registered with a GP at treatment start - Has the YP registered with a GP at the point of treatment entry • YP a Looked After Child

31. Episode – treatment entry status (new) • YP in contact with disability services at treatment start - At the start of the current treatment episode, is the client in contact with services, which assist in the support or management of their physical or mental disability? • YP engaged in unsafe sex at treatment start- This refers to a YP’s current or suspected involvement in unsafe sexual activities such as unprotected vaginal, anal or oral sex

32. Episode – treatment entry status • YP education status at treatment start

33. Episode – treatment exit status • YP Lead Professional at treatment exit - This refers to the professional, who as part of the CAF process has been appointed to act as a single point of contact and coordinate provision for a child and their family • YP Frequency of use of drug 1 at Treatment Exit – number of days use of drug 1 in the last 28 days

34. Episode – treatment exit status • YP in contact with YOT at treatment exit - in contact with the YOT as a result of receiving a reprimand or final warning, acceptable behaviour contract, anti social behaviour order or community sentence • YP in Contact with Mental Health Services at Treatment exit - Is the YP currently in contact with inpatient or outpatient mental Health Services? • YP involved in self harm at treatment exit - This refers to the YP’s current involvement or suspected involvement in activities such as cutting, burning, banging, hair pulling or poisoning at point of discharge • YP in contact with disability services at treatment exit - At the point of discharge, is the client in contact with services, which assist in the support or management of their physical or mental disability

35. Episode – treatment exit status • YPinvolved in sexual exploitation at treatment exit - This refers to a young person’s current involvement, or suspected involvement in activities such as prostitution, production of pornography or age inappropriate relationships with adults • YP involved in unsafe drug use at treatment exit - This refers to a YP’s current involvement or suspected involvement in unsafe drug and alcohol related activities. • YP has a CAF at treatment exit - This refers to a YP who has been identified as requiring additional needs and assessed using the Common Assessment Framework

36. Episode – treatment exit status • YP involved in offending at treatment exit - This refers to a YP’s current or suspected involvement in activities which may or may not have come to the attention of the police, YOT or LA • YP registered with a GP at treatment exit - Has the YP registered with a GP since the point of treatment exit • YP engaged in unsafe sex at treatment exit- This refers to a YP’s current or suspected involvement in unsafe sexual activities such as unprotected vaginal, anal or oral sex

37. Episode – treatment exit status • YP sexual health interventions at treatment exit - At the point of discharge, has the YP had a sexual health intervention? • YP met goals agreed on care plan at treatment exit - Has the YP met the main goals of their care plan at treatment exit

38. Episode – Discharge • Discharge Date - The date that the client was discharged ending the current structured (Tier 3/Tier 4) treatment episode • If a client has had a planned discharge then the date agreed within this plan should be used • If a client’s discharge was unplanned then the date of last face to face contact with the treatment provider should be used • If a client has had no contact with the treatment provider for two months then for NDTMS purposes it is assumed that the client has exited treatment and a discharge date should be returned at this point using the date of the last face to face contact with the client

39. Episode – Discharge Codes

40. Episode – Discharge codes

42. Episode – Discharge destinations Discharge destination - The lead agency that the treatment provider has referred a young person back or onto once the treatment episode has been completed

43. Episode – Discharge destinations (cont)

44. Episode – Discharge destinations (cont)

45. Intervention • A client may have more than one treatment intervention running sequentially or concurrently within an episode • Only tier 3 and 4 interventions are submitted to NDTMS and are counted towards numbers in effective treatment

46. Intervention • Treatment Intervention (key field) -The treatment intervention a client has been referred for or has commenced within this treatment episode

47. Intervention • Date referred to intervention (key field)- The date that it was mutually agreed that the client required this treatment intervention. For the first intervention in an episode this should be the date that the client was contacted and agreed to a referral into the treatment system for a specialist substance misuse treatment intervention. The date a referral letter or fax was received should not be recorded as the date that the client was referred to the intervention. • For subsequent interventions it should be the date that both the client and the key worker agreed that the client is ready for this intervention.

48. Intervention • Date of First Appointment Offered for Intervention - The date of the first appointment offered to commence this intervention. This should be mutually agreed to be appropriate for the client • Intervention Start Date - The date that the stated treatment intervention commenced i.e. the client attended for the first appointment • Intervention End Date - The date that the stated treatment intervention ended. If the intervention has had a planned end then the date agreed within the plan should be used. If it was unplanned then the date of last face to face contact date within the intervention should be used

49. Intervention • YP treatment being delivered in a specific residential placement • Intervention exit status - Whether the exit from the treatment intervention was planned or unplanned

50. Treatment Outcome Profile - TOPs • The implementation of the Treatment Outcomes Profile (TOP) in routine clinical practice began from 1 October 2007; its completion and submission via the National Drug Treatment Monitoring System (NDTMS) is requested for all clients (16 and over) accessing tier 3, and 4 structured drug treatment • The TOP consists of a short set of simple questions that focus on the four key areas (substance use, injecting behaviour, criminal activity, health and social functioning) that are used to judge improvement during and after treatment. Outcomes from treatment are evidenced by looking at changes in the behaviours recorded over time • It is requested that the TOP be completed with all clients at the start of their first treatment modality (Treatment Start TOP) and then around every 26 weeks throughout the treatment journey as part of the care plan review process (Review TOP) and at treatment exit (Treatment Exit TOP)