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The planning and commissioning of substance misuse services in Wales From 2010-11 Substance Misuse Area Planning Boards will be established in Wales, which will enable, where appropriate, the planning and performance management of substance misuse services to be undertaken across each of the areas covered by the new Local Health Boards (LHBs) established as a result of NHS reconfiguration. These arrangements will build on, and encompass the regional arrangements that are already operating for some substance misuse services, including the Drug Intervention Programme. A key role for the new Substance Misuse Area Planning Boards will be to take decisions on the allocation of the resources for substance misuse services that form part of the NHS funding. Initially funding which had formed part of the discretionary allocation to the 22 LHBs in Wales (known as the 0.4%) will be pooled at Area Planning Board level and the Boards will be responsible for taking decisions on how these resources are spent for 2010-11 onwards. In addition, the Home Office DIP resources and the Substance Misuse Action Fund capital budget will also be allocated to the new Area Planning Boards. Ultimately, the intention is for partners to move towards agreeing wider arrangements for the pooling of resources for tackling substance misuse at Substance Misuse Area Planning Board level, including Social Services Departments, other Welsh Assembly Government funding streams, the Home Office and criminal justice agencies. SMATs will be encouraged to also consider where they feel the need to contribute to cross authority and regional commissioning through the Area Planning Board framework. Following the establishment of these new arrangements, Welsh probation areas/trusts 52 will be operating in a very clear joint commissioning environment. Probation will be a key partner at Area Planning Board level and, as such, areas/trusts will need to be represented by individuals with the authority to make decisions and commit resources on behalf of their organisation. Where Welsh probation areas/trusts currently directly commission substance misuse services, including alcohol, outside of regional joint partnerships they will be encouraged to bring these into the Area Planning Board arrangements. A range of partners, including Public Health Wales are currently working with the Welsh Assembly Government on the development of guidance to support the new Area Planning Boards. The guidance will set out minimum standards for substance misuse services; models for integrated care pathways and also cover the arrangements for area-based planning in more detail. The guidance will be available in draft form in the Autumn in time to inform the Boards’ work later this year. 52 The four Welsh areas are currently in the middle of an application to establish a single All Wales Probation Trust, effective from March 2010 - 40 -
A suite of Key Performance Indicators covering substance misuse services are already in place against which the Welsh Assembly Government monitors the performance of CSPs in tackling this agenda. The budget holders within the new Area Planning Boards are all tied into the achievement of these KPIs via their organisation’s role within CSPs. However, the priority that the Welsh Assembly Government attaches to this agenda will be reinforced by the inclusion of relevant indicators within the new NHS performance framework, local authority performance frameworks and the priorities set for Public Health Wales. For non devolved bodies, these targets all support the delivery of PSA targets set by the Home Office and Ministry of Justice. Local Service Boards Local Service Boards (LSBs) are where the leaders of local public and third sector organisations come together to take collective action to ensure public services are effective and citizen focussed. LSBs: • Improve the quality of life and joined-up service delivery for citizens in their areas; • provide the leadership to ensure that difficult issues across public services are confidently managed not avoided or ignored; • stimulate integration, co-ordination and co-operation between local, regional and national public sector organisations; • set an example of innovative, citizen-focused leadership at the heart of the local partnership and delivery system; • ensure an effective whole system response to the needs of citizens by pooling resources; • ‘unblock blockages’ by removing bureaucracy or other obstacles Each Local Service Board (LSB) has selected a number of collaborative projects to drive forward. These projects have been selected on the basis of local needs assessments and engagement with citizens. They are drawn from the Community Strategy and other existing local plans and strategies. The purpose of the Local Delivery Agreement (LDA) is to describe the problem being solved, demonstrate the citizen benefits and to set out clearly the direction of travel, key project milestones and how success will be measured. Local Delivery Agreements: • should be a rolling programme of work based on the community strategy action plan that require the commitment of organisations to integrate their delivery and pool their resources to do so - 41 -
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 and 20: • The Drink Impaired Drivers (DID
Page 21 and 22: Commissioning alcohol interventions
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: Commissioning Framework for alcohol
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
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has developed a nationally approved
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Managing the sentence Alcohol misus
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or 2. Set weekly sessions for 12 we
Page 105 and 106:
esponse to such an application, the
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• Anyone who has received treatme
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Areas/trusts should have in place a
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Women may be more reluctant to admi
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Sanctions are greater for women wit
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Information Pack for Offenders 125
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• Young people have an experiment
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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
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inter-agency training day where pro
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Guidelines Council (SGC) advice tha
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Testing Legal position Unlike the d
Page 133 and 134:
where alcohol is a known disinhibit
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Also - National Standards for Offen
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Improving continuity of care The im
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2. Sentences of 12 months or more:
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to compel offenders to submit to dr
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Post-release provision Areas/trusts
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during the development of local str
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substitute arrangements might be pu
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Working in partnership Effective lo
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� Clear lead agency on each case
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Training and development Offender M
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Social Care and Community Justice.
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Performance management Why do we co
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A successful completion of an ATR i
Page 161 and 162:
Specialist alcohol staff should be
Page 163 and 164:
References Addaction (2009) Closing
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Department of Health/NHS Finance Pe
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McSweeney, T., Webster, R., Turnbul
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Raistrick, D., Heather, N., and God
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PC 57/2005 Effective management of
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ASSESSMENT OF NEED Very harmful/Dep
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North East Region To commission an
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Gloucester shire Leicestershire & R
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2009-10 Probation Area/Trust Glouce
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West Yorkshire To ensure that probl
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