Kirklees DAAT 2006/07 Progress Report 2007/08 Draft Priorities

1. Kirklees DAAT2006/07 Progress Report2007/08 Draft Priorities Kirklees PCT Board 29 August 2007 Tony Cooke Senior Commissioning & Partnership Manager DAAT Strategy Lead

2. Operating Environment August 2007 • Review of national drug strategy, though treatment agenda unlikely to radically change • Focus on CYP issues and U25 prevention via NICE guidance • Improving evidence base, quality agenda and better understanding of outcomes/impact • Reducing budgets and ongoing unit costing exercises • Annual needs assessments (2006/07 revealed 900 people outside treatment, with 200 known to 5+ agencies) • Stretch targets tightly managed by National Treatment Agency • Joint NTA/Healthcare Commission inspections • Renewed focus on alcohol interventions • Majority of Kirklees offenders still have drug/alcohol problems

3. Strategic Priorities 2006/07 • Increasing numbers in treatment and increasing access from all sections of the community • Improving retention in treatment and successful completion of treatment whilst further reducing waiting times, particularly for offenders • Introducing outcome monitoring system (Treatment Outcome Profile) • Improving harm reduction and BBV services • Improving aftercare support and access to housing and employment/training • Further developing user and carer involvement and advocacy where necessary

4. 2006/07 NTA Performance Review • 5 ‘core’ NTA targets, 4 green/1 amber • Numbers in treatment up from 1816 (2005/06) to 1917 (07/08 target: 2,000) • Retention at 12 weeks up from 68% to 76% (80%) • Successful discharge up from 34% to 44% (52%) • Number on care plan up from 79% to 90% (95%) • Average wait just over one week (impact of nurse prescribers and open access services) • Ongoing performance improvements via case file audit, improved clinical governance and effective performance management

5. Healthcare Commission Inspections • 2005/06 Inspection: Prescribing and Care Planning: 3 (top quartile) • 2006/07 Inspection: Commissioning and Harm Reduction: 4 (top 5 nationally) • Commissioning: Particular strengths - performance management, contracting, value for money, awareness of local needs and overall ‘systems management’ • Harm reduction: Strengths - pharmacy services, strategic management, drug related deaths • Improvements needed: Response to Hepatitis C, approach to Tier 4

6. Draft Priorities 2007/08 • Maintenance of broad strategic priorities • Engineer shift towards primary care based provision with specialist services reserved for most needy • Dual diagnosis - joint developments PCT/SWYMHT • Strengthen offender management systems with Police/Probation whilst not detracting from health improvement agenda • Improvements to CYP commissioning as advised by NICE • SM commissioning strategy/embed agenda within CSD directorate of PCT • Refocus within DAAT to enable broader focus on ‘safer/stronger’ issues in partnership with KMC/Police/Probation • Continue strong links to LPSBs/LAA

7. Summary • Overall picture healthy but with fresh challenges emerging • Many of strengths due to PCT role e.g. clinical governance support/commissioning infrastructure • Challenging targets stretched further and rate of improvement may mean some targets not hit • Risks created by reducing budgets - no fat left to trim • Provider dissatisfaction at apparent ‘boom and bust’ - requesting consolidation • Still need for more integrated commissioning across adults, criminal justice and young people’s provision