NDTMS – Core Dataset ‘F’

1. NDTMS – Core Dataset ‘F’ NDTMS Adult Drug & Alcohol Services Core Dataset ‘F’ February 2009 Jill Smith NEPHO – NDTMS Team

2. NDTMS – Core Dataset ‘F’ • National Drug (and Alcohol) Treatment Monitoring System • Began collecting performance data on treatment of • adult problem drug users, • then YP drug & alcohol misusers, • then adult alcohol • Client details • Episode details • Treatment modality/intervention details • Treatment outcome Profiles (TOP) details • Local Regional fields

3. NDTMS – Core Dataset ‘F’ • National Drug (and Alcohol) Treatment Monitoring System • Number of fields has expanded and changed • Reference options within fields have expanded and changed • Additional services completing NDTMS • Additional Government Departments involvement • Now on Core Dataset F • Where to begin?

4. NDTMS – Core Dataset ‘F’ Basics: Data Completion • All fields should be completed • Some fields should be reviewed • Some fields should be completed at discharge • Some fields can be completed after discharge • Garbage in ~ Garbage out • Analysis and information jeopardised • when fields left blank

5. NDTMS – Core Dataset ‘F’ Basics: Understand the Questions The NTA Business Definition and Reference Data Documentation is important and changes as understanding of usage and meaning develops

6. NDTMS – Core Dataset ‘F’ Basics: Get hold of the documentation • NTA WEBSITE FOR DOCUMENTATION:- • http://www.nta.nhs.uk/areas/ndtms/core_data_set_page.aspx • NB: Awaiting revised guidance for: • Young persons' treatment providers and • Adult alcohol treatment providers

7. NDTMS – Core Dataset ‘F’ • Core Dataset F Changes • Young People Service dataset – new fields • Treatment Outcomes Profile (TOP) Care Coordination flag • Reference items added/removed/changed • Fields Removed

8. a) Treatment Start and Treatment End YP has lead professional? YP in contact with mental health services? YP in contact with YOT? YP Involved in Sexual Exploitation? YP Involved in Unsafe drug use? YP Involved in Offending? YP Self-harming? NDTMS – Core Dataset ‘F’ 1. New Fields

9. Treatment Start only YP Education Status (=<16)? YP Involved in unsafe Sex? YP Parent in SM Treatment? YP Parent in MH Treatment? NDTMS – Core Dataset ‘F’ 1. New Fields…….

10. NDTMS – Core Dataset ‘F’ 1. New Fields……. • Treatment Exit only • YP has a CAF? • YP safer sex? • YP sexual health interventions? • YP registered with GP • YP met goals on Care Plan

11. NDTMS – Core Dataset ‘F’ 2. TOP / Care Coordination flag Does the treatment provider currently have care coordination responsibility for the client in regards to completing the TOP information when appropriate during the client’s time in structured treatment? One service to manage TOP process (agreed at a local Treatment System level) One set of TOPs for one episode of care Consent for sharing TOP process data

12. NDTMS – Core Dataset ‘F’ 2. TOP / Care Coordination flag Recent enquiry received by NDTMS team: Re top coordination surely ALL providers are required to fill in a care plan for their organization and if they do who decides who is the overall care coordinator? Care Planning is not the same as Care Coordination Decisions about Care Coordination have to be made at a local level and even then there must be ongoing communication between services to ensure all the clients’ needs are being met

13. NDTMS – Core Dataset ‘F’ • 3. Reference data changes • a) Adult Drug & Alcohol Interventions • Now expanded to include Community Prescribing for Drug clients. • Community prescribing involves the provision of care-planned specialised drug treatment, which includes the prescribing of drugs to treat drug misuse. The range of community prescribing interventions can include the following: • Stabilisation on substitute opioids, including dose titration • • Prescribing for a sustained period to substitute illicit drugs such as methadone and buprenorphine (maintenance prescribing) • • Prescribing for withdrawal from opioids with opioid or non-opioid medications such as buprenorphine or lofexidine (community detoxification) • • Prescribing to prevent relapse • • Stabilisation and withdrawal from sedatives, such as benzodiazepines • • Prescribing for assisted withdrawal from alcohol where appropriate • • Treatment for stimulant users, which may include symptomatic prescribing • • Non-medical prescribing (by nurses or pharmacists).

14. NDTMS – Core Dataset ‘F’ 3. Reference data changes a) Adult Drug & Alcohol Interventions … Now expanded to include Community Prescribing for Drug clients. NB: Substitute prescribing alone does not constitute drug treatment (NTA expert prescribing group, 2002). A community prescribing intervention should be provided within a care-planned package of care with an identified keyworker. It should be aimed at addressing the range of identified needs. The care plan should address drug and alcohol misuse, health needs, offending behaviour and social functioning.

15. NDTMS – Core Dataset ‘F’ 3. Reference data changes a) Adult Drug & Alcohol Interventions … Reminder: Specialist Prescribing for Drugs NB: Specialist prescribing is community prescribing for drug misuse in a specialist drug service setting, which normally comprises a multidisciplinary substance misuse team. Specialist prescribing interventions normally include comprehensive assessments of drug treatment need and the provision of a full range of prescribing treatments in the context of care-planned drug treatment. The specialist team should also provide, or provide access to, a range of other care-planned healthcare interventions including psychosocial interventions, a wide range of harm reduction interventions, BBV prevention and vaccination, and abstinence-oriented interventions.

16. NDTMS – Core Dataset ‘F’ • 3. Reference data changes • a) Adult Drug & Alcohol Interventions … • New: Brief Interventions for alcohol services • When combining Tier 2 & Tier 3 interventions, be • sure that the Tier 3 record is clearly differentiated • within NDTMS • Use of combined Tier 2 and Tier 3 interventions can lead to performance measurement errors with serious consequences

17. NDTMS – Core Dataset ‘F’ • 3. Reference data changes • b) Parental Status? • Now expanded beyond biological, step-, foster, adoptive, guardians to include any parenting where a client has full or partial parental responsibilities and is living with that child(ren) for a minimum of one month – see separate Appendix K in business definitions • All new references: • All the children live with the client • Some of the children live with client • None of the children live with client • Not a parent • Client declined to answer

18. NDTMS – Core Dataset ‘F’ • 3. Reference data changes….. • b) Children Living With? • Age of ‘child’ raised to under 18 – and now collected at presentation only • No children living with client • 1 child living with client • 2 children living with client • n children living with client • Client declined to answer • c) Hep B & Hep C Status? • New: Assessed as not appropriate to offer

19. NDTMS – Core Dataset ‘F’ 3. Reference data changes….. d) Discharge Reason (Separated from Discharge Destination) Please note that different definitions will apply to the above codes depending on the setting of treatment i.e. in YP providers or if the client is being treated primarily for Alcohol. Adult Drug Discharge Reason? – Planned

20. NDTMS – Core Dataset ‘F’ 3. Reference data changes….. d) Discharge Reason Adult Drug Discharge Reason? - Neutral

21. NDTMS – Core Dataset ‘F’ 3. Reference data changes….. d) Discharge Reason Adult Drug Discharge Reason? - Unplanned

22. NDTMS – Core Dataset ‘F’ 3. Reference data changes….. d) Discharge Reason (Separated from Discharge Destination) Adult Alcohol Discharge Reason? – Planned

23. NDTMS – Core Dataset ‘F’ 3. Reference data changes….. d) Discharge Reason Adult Alcohol Discharge Reason? - Neutral

24. NDTMS – Core Dataset ‘F’ 3. Reference data changes….. d) Discharge Reason Adult Alcohol Discharge Reason? - Unplanned

25. NDTMS – Core Dataset ‘F’ Cross reference with Appendix I of YP Business Definitions 3. Reference data changes….. j) Employment Status? Removed: Not in Education or Training or employment Attending PRU/Special Schooling arrangements

26. NDTMS – Core Dataset ‘F’ 4. Fields Removed from YP Dataset a) Dual Diagnosis b) Sex Worker c) Sexuality (Picked up through new fields or not appropriate for YP) But still being collected in Adult Drug & Alcohol services

27. Alcohol and the North East THANK YOU!