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published and include guidance on treatment for both drug and alcohol misuse. An Alcohol Education and Prevention in Further and Higher Education Organisations module is currently being developed and will be published in spring 2010. - 20 -
Commissioning alcohol interventions & treatment The current position Community alcohol treatment is almost exclusively funded by NHS Primary Care Trusts (PCTs) in England. These Trusts act either as a single funding entity or less commonly as the member of a partnership such as a Drug (and Alcohol) Action Team (D(A)AT) joint commissioning group (JCG). In Wales, because of the joint alcohol and drugs strategy, responsibility is shared between NHS Local Health Boards (LHBs), Substance Misuse Action Teams (SMATs) and Criminal Justice Agencies (although see later sub-section for information about changes to the arrangements for the planning and commissioning of substance misuse services in Wales from April 2010 with the introduction of Area Planning Boards). Some elements of residential alcohol rehabilitation programmes (i.e. ‘rehabs’) are funded by local authorities, following approval via a community care assessment. Probation is well-connected at a strategic level but delivery problems exist at the practical level e.g. in influencing PCT commissioning of alcohol treatment services and/or clear care pathways formulated between generic alcohol services and probation. This has led to some probation areas/trusts financing alcohol treatment requirement (ATR) assessments and treatment exclusively or predominately using probation funds. Whose responsibility? Models of care for alcohol misusers (MoCAM) makes clear that in England ‘as part of NHS provision, commissioning alcohol interventions and treatment is the responsibility of local Primary Care Trusts (PCTs).’ This includes provision for offenders under statutory supervision and is a particular issue for those subject to ATRs, who require access to specialist treatment. As part of their statutory duties, probation areas/trusts are responsible for meeting supervision and enforcement costs of a community sentence or licence but should not be funding mainstream health provision i.e. paying for interventions or treatment for offenders under their supervision no better than that which should be available to all residents of the locality. Areas/trusts may wish to consider making a contribution towards an enhanced level of interventions or treatment e.g. fast track access, longer or more intensive than that delivered on a non-statutory basis, regular reports (within the bounds of consent 20 ) from providers on issues like attendance, compliance and progress, 20 See Department of Health (2003) Confidentiality: NHS Code of Practice http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4069253 - 21 -
Page 1 and 2: NOMS Alcohol Interventions Guidance
Page 3 and 4: 122. Family issues 123. Safeguardin
Page 5 and 6: Glossary ATR Alcohol Treatment Requ
Page 7 and 8: NWPHO North West Public Health Obse
Page 9 and 10: The guidance was informed by: - •
Page 11 and 12: Models of care for alcohol misusers
Page 13 and 14: Drinking Categories Drinking Catego
Page 15 and 16: - Tier 3: Community-based, structur
Page 17 and 18: 3. CHANGE 4. CONTROL The primary pu
Page 19: • The Drink Impaired Drivers (DID
Page 23 and 24: • the contribution that can be ma
Page 25 and 26: • Alcoholics Anonymous (AA) appea
Page 27 and 28: interventions across the re-offendi
Page 29 and 30: Priorities highlighted by the JSNA
Page 31 and 32: set at Tier 3 within the above Oper
Page 33 and 34: Plotting a course through the commi
Page 35 and 36: to stand a better chance of success
Page 37 and 38: • Assessment of population needs
Page 39 and 40: Commissioning Framework for alcohol
Page 41 and 42: A suite of Key Performance Indicato
Page 43 and 44: Targeting This section of the guida
Page 45 and 46: Secondly, most offenders with alcoh
Page 47 and 48: small amounts of discretion to use
Page 49 and 50: have no other criminogenic need. DI
Page 51 and 52: Drinking Type Intervention MOCAM Ti
Page 53 and 54: or possibly dependant drinkers usin
Page 55 and 56: making risk of serious harm decisio
Page 57 and 58: The AUDIT score will generally be a
Page 59 and 60: Before engaging in structured treat
Page 61 and 62: Court proposals and the sentencing
Page 63 and 64: • arrangements have been or can b
Page 65 and 66: Supervision requirement Seriousness
Page 67 and 68: Alcohol Specified Activity Requirem
Page 69 and 70: oral report assessment or FDR pack.
Page 71 and 72:
Where high intensity orders are pro
Page 73 and 74:
Delivery of interventions The amoun
Page 75 and 76:
women reducing their drinking level
Page 77 and 78:
of brief interventions; the types o
Page 79 and 80:
• Look at the offender’s person
Page 81 and 82:
Providers are then better able to f
Page 83 and 84:
Independent research suggests that
Page 85 and 86:
• structured day and care planned
Page 87 and 88:
fortnight. Home detoxifications are
Page 89 and 90:
2d.10.2 The offender is instructed
Page 91 and 92:
Information sharing protocols Areas
Page 93 and 94:
The first meeting with the offender
Page 95 and 96:
which consists simply of the first
Page 97 and 98:
DID should only run alongside an AT
Page 99 and 100:
has developed a nationally approved
Page 101 and 102:
Managing the sentence Alcohol misus
Page 103 and 104:
or 2. Set weekly sessions for 12 we
Page 105 and 106:
esponse to such an application, the
Page 107 and 108:
• Anyone who has received treatme
Page 109 and 110:
Areas/trusts should have in place a
Page 111 and 112:
Women may be more reluctant to admi
Page 113 and 114:
Sanctions are greater for women wit
Page 115 and 116:
Information Pack for Offenders 125
Page 117 and 118:
• Young people have an experiment
Page 119 and 120:
There is some research evidence tha
Page 121 and 122:
and dual diagnosis. Guidance for pr
Page 123 and 124:
in Reduction 161 , for prisons in 2
Page 125 and 126:
lead to changes in substance use an
Page 127 and 128:
inter-agency training day where pro
Page 129 and 130:
Guidelines Council (SGC) advice tha
Page 131 and 132:
Testing Legal position Unlike the d
Page 133 and 134:
where alcohol is a known disinhibit
Page 135 and 136:
Also - National Standards for Offen
Page 137 and 138:
Improving continuity of care The im
Page 139 and 140:
2. Sentences of 12 months or more:
Page 141 and 142:
to compel offenders to submit to dr
Page 143 and 144:
Post-release provision Areas/trusts
Page 145 and 146:
during the development of local str
Page 147 and 148:
substitute arrangements might be pu
Page 149 and 150:
Working in partnership Effective lo
Page 151 and 152:
� Clear lead agency on each case
Page 153 and 154:
Training and development Offender M
Page 155 and 156:
Social Care and Community Justice.
Page 157 and 158:
Performance management Why do we co
Page 159 and 160:
A successful completion of an ATR i
Page 161 and 162:
Specialist alcohol staff should be
Page 163 and 164:
References Addaction (2009) Closing
Page 165 and 166:
Department of Health/NHS Finance Pe
Page 167 and 168:
McSweeney, T., Webster, R., Turnbul
Page 169 and 170:
Raistrick, D., Heather, N., and God
Page 171 and 172:
PC 57/2005 Effective management of
Page 173 and 174:
ASSESSMENT OF NEED Very harmful/Dep
Page 175 and 176:
North East Region To commission an
Page 177 and 178:
Gloucester shire Leicestershire & R
Page 179 and 180:
2009-10 Probation Area/Trust Glouce
Page 181:
West Yorkshire To ensure that probl
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