Date Published: 29 January 2009
Local drug treatment networks score top ratings in national review
Healthcare watchdogs today (Thursday) rated 87% of the local networks for drug treatment services as "excellent" or "good" in a national review.
A report released today by the Healthcare Commission and the National Treatment Agency (NTA) shows how well local areas are meeting the needs of diverse communities and people who require inpatient or residential drug treatment.
The review covered each of the 149 local drug partnerships in England, where drug treatment is commissioned and managed by representatives from primary care trusts, local authorities, the police and the probation service.
Findings reveal widespread good practice with 15% of local drug partnerships rated as "excellent" and 72% "good" overall. Thirteen percent were rated "fair" and no partnerships had an overall score of "weak".
The review showed the majority of partnerships understood the diverse needs of their local community: 99% carried out needs assessments which addressed diversity issues, 99% met statutory obligations regarding diversity and 91% of services had access to a range of interpretation services. However more work is needed to make sure partnerships maintain this focus on diversity when developing plans for drug treatment, and to consult more broadly with groups not currently accessing treatment.
The NTA estimates that every year about 16,000 people access NHS inpatient detoxification and publicly-funded residential rehabilitation services. The review found that the vast majority of these services provide treatment in safe environments staffed by competent practitioners, with 59% of providers scoring "good" and 34% "excellent" in this area.
Nevertheless the review revealed most partnerships still had scope for improvement, some in key areas:
* There is a significant risk of overdose if a patient returns to drug use after detoxification due to decreased tolerance levels. The review found many partnerships need to do more to minimise these risks: 68% of partnerships did not monitor rates of overdose post-discharge, and around a third (34%) did not ask community-based services to carry out risk assessments for patients who have left detoxification services unexpectedly.
* Twenty eight percent of inpatient services and 41% of residential services were either not reporting data or were reporting incomplete data to the National Drug Treatment Monitoring System (NDTMS). It is a national priority to address this, as local and national strategic planning depends on this information. Without this information it is difficult to know if current provision is adequate, how long people will wait to access services, and rates of completion of treatment programmes.
* There is a commissioning shortfall regarding residential rehabilitation services. Only 44% of local drug partnerships had increased their funding above the rate of inflation for these services over the last five years, despite a significant national increase in budget for drug treatment generally. This area of treatment has not seen the same level of growth, and some partnerships need to address shortfalls in their treatment planning to ensure there is appropriate access to this type of treatment for those who need it.
Anna Walker, the Healthcare Commission's chief executive, said:
"It is excellent to see drug treatment providers are serving their diverse local communities well, and that the quality of treatment is of such a high standard. It is particularly impressive that not one partnership scored ‘weak' in this review, for the second year running.
Having said that, it is important to note that partnerships still need to ensure the risk of overdose after discharge is assessed and minimised for every patient, and to make sure that residential rehabilitation treatment is available to all who would benefit from it.
This is the last in a series of reviews assessing the performance of drug treatment in this country. From the evidence we have collected over three years, it is clear that substance misuse services are performing extremely well. This country is providing top quality treatment to more people with drug problems than ever before, and I hope to see this progress continue."
Paul Hayes, the NTA's chief executive, said:
"The review's verdict that this country is providing top quality drug treatment is very encouraging.
As access to drug treatment services has increased over the last few years, the NTA's priority is to further improve quality. We issued new guidance to partnerships in September 2008 aimed at helping them plan for effective inpatient and residential services, and new government funding was announced in November to boost residential and supported housing placements. It is important that there is a balance of options available so that people can get the treatment most likely to help them overcome their addiction.
The findings of this report will continue to inform the ongoing improvement of drug treatment services to meet the needs of individuals and the communities they are part of."
Local drug partnerships were asked 40 questions across 11 categories. Each area was then scored on a scale; "weak", "fair", "good" and "excellent". In addition, individual detoxification and rehabilitation services were given their own score.
The watchdogs have made recommendations to partnerships to tackle key deficits highlighted by the review. The NTA is working intensively with the lowest performers, but all partnerships have developed action plans to improve performance. Good progress has already been made.
This is the last of a series of three reviews on substance misuse produced over the last three years. The previous two looked at community prescribing and care planning and commissioning and harm reduction.
Source: The Healthcare Commission (England, UK).