The Story So Far…
There were several main drivers to remodel and transform our drug and alcohol treatment system and take part in the Payment by Results Pilot:-
- To move towards a payment model for service contracts that would enable services to be financially incentivised to help individuals to move towards recovery;
- To ensure we were getting the best outcomes for service users;
- To ensure the best value for money for the tax payer;
- To put recovery at the centre of drug and alcohol treatment.
As explained in our last article the transition to the new community service provision and pathways started in February 2012. By the 2nd April all of the new community services had started and the first three months have been a period of transition and implementation.
Between February and June the new independent LASAR (Local Area Single Assessment and Referral) service had assessed the majority those service users currently in treatment, this equates to over 1600 assessments. This process involved reviewing their care and working with them to choose which pathway they would like to take to continue their treatment which for Oxfordshire is Harm Minimisation delivered by Oxford Health NHS Foundation Trust in partnership with OASIS or Recovery, delivered by Lifeline. Since the beginning of April both these respective services have been working to successfully transfer care and engage these service users into the services that they offer.
Oxfordshire now has 3 new adult community Drug and Alcohol Services and each one has been implementing their service over the last 3 months.
Following feedback, LASARS (Local Area Single Assessment and Referral Service) provided by Aquarius have started to work with the DAAT, service users and treatment providers to revise the LASAR assessment document. This will incorporate lessons learnt during implementation, enable it to meet with local need and become a document that really does provide an effective and robust single assessment for referral to drug and alcohol treatment.
Lifeline, Recovery Service
Recovery and abstinence is not a new concept in Oxfordshire but providing opportunities within community services for service users to successfully achieve and maintain this is. During the implementation phase the Recovery Service, provided by Lifeline have recognised this and are starting to promote the concept to service users. For example, Introduction to Recovery groups have started which can be accessed daily across the county; these are taster sessions and require no commitment from the service user.
The service continue to review their programme provision to ensure that it is meeting the needs of their diverse population and have taken into account the rural nature of Oxfordshire by sourcing locations throughout the county for service delivery.
We are beginning to see very positive outcomes from service users engaging with Lifeline’s Recovery Service and below are a couple of examples of feedback from service users across the county who have been accessing the service:-
‘It does what it says on the tin. It really is a lifeline; it’s got the right name. After many years of trying to give up drinking it was impossible without help. I couldn’t do it on my own. Great people, I feel I was not judged. I feel I have been given a great opportunity. It’s fantastic. I am going to cling on with both hands and succeed’.
‘Lifeline is exactly as it says – a lifeline. Having an addiction is something that creeps up on you, no warnings. It takes over your life and threatens your existence. To have a service like Lifeline is priceless, I even go as far as to say lifesaving. With the help and guidance of such dedicated staff I have begun and will continue to turn my life around for me and the benefits are now being felt by my friends and family’.
‘Engaging with Lifeline and doing Community Rehab has had a really positive effect on my life. Before joining community rehab I was in a pretty bad place and the change in me now is all thanks to the group. The structure of having somewhere to be 5 days a week has been brilliant and the supportive environment within the group has really kept me going. The step work has opened my eyes to the possibilities in front of me and made me much more aware of myself’.
Harm Minimisation Service
Those who do not choose to work towards recovery can engage with the Harm Minimisation service, where a consultant led medical team provide Opiate Substitution Therapy in a wide variety of setting including GP (shared care) practices. Service user care will be regularly reviewed to explore recovery (recovery for Oxfordshire’s Recovery Service being Abstinence). When service users feel ready they can move over to the Recovery Service seamlessly. The Harm Minimisation is now fully implemented and is being delivered across the county and the model of nurses and key working is evolving well. There are contractual financial incentives for the service to be ‘converting’ service users to recovery.