In this latest post from one of our pilot sites, Stockport tell us more about their single assessment and referral service and how it is working.
An introduction to the START
Stockport Treatment – Access to Recovery Team (START) was introduced on 2nd April 2012 as an integral part of the new Payment by Results model. It is an independent assessment and referral service which is the first point of access into all treatment/recovery services in Stockport. It also sets a tariff for clients, and this determines the amount of the payments to providers as the service user achieves the various outcomes.
How the team was formed
The START team was modelled on and drawn from the criminal justice and substance misuse assessment and referral team, which supported criminal justice and Drug Intervention Programme functions. New members were recruited to support the extended remit of the team. The START now does assessments for all new clients aged 18+ regardless of referral source (self, GP, criminal justice etc.) and for all substances (drugs and alcohol).
Alison Leigh, Drug Action Team Strategic Manager elaborates,
“the basic idea of expanding our independent criminal justice team made sense from an operational and economical perspective…we already had the building blocks in place to introduce an independent assessment function and it is something that commissioners had been considering previously. However, that’s not to say it was easy. Things such as job re-evaluations, consulting with staff and trade unions and undertaking recruitment exercises, at a time of other significant changes within the local authority, caused some headaches but we managed to get the team in place for the April go live date.”
What does it do?
The main functions of the START are to be the single point of access into all treatment services, provide basic harm reduction advice, set tariffs for clients and support clients into the most appropriate service. It was also decided that the START would:
- Work with non-engagers who require extra work around motivation to attend specialist services
- Do advocacy work on behalf of the client
- Support the client’s entry into residential rehabilitation as required
- Deliver tailored criminal justice assessments/interventions at the point of arrest (work in custody suite), at point of sentence (assessing suitability for community orders) and at point of release (assessing prior to release and ensuring continuity of care)
- Support outreach work in the community
- Deliver alcohol awareness raising sessions
Location of assessments
The START provides advice, information and assessments in a number of locations, including the local authority contact centre, community settings in Priority 1 and 2 areas, criminal justice settings and specialist treatment providers as required.
Tori Dante, START team leader explains,
“We wanted to make the START as accessible as possible, so are delivering this service in a number of different settings. We also offer a selection of appointment times or people can call into one of the drop-in sessions. This is the first time assessments have been provided in community settings so we weren’t sure how this would go, but these drop-in sessions seem to be working, people are turning up and we are getting some really positive feedback from the people who live in these areas.”
So it’s so far… so good
The START went live on 2nd April 2012 for drug clients aged 18+ and for alcohol clients aged 18-25. The remit was extended for alcohol clients aged 26+ on 2nd July 2012.
Monthly data in terms of contacts, assessments, onward referrals, waiting times etc. is being collected and this is being closely monitored to identify areas for improvement or any trends.
A final point by Alison Leigh,
“The introduction of the START was a significant change to our treatment system. We had to ensure that treatment providers and service users understood the new processes and did a lot of communication work and publicity around this initially. There have been teething issues, as expected questions and issues did crop up which we hadn’t anticipated, but generally the introduction of the new assessment model has worked well. Where issues have been raised, they have been dealt with quickly by all parties (commissioners, START, service providers and service user representatives). Perhaps most importantly service users are turning up for assessments and service user representatives are giving us positive feedback.”