Health Wellbeing & Substance Misuse Co-commissioning

North West ‘Through the Gate’ Substance Misuse Services ProjectCaroline Bonds, Senior co-commissioning ManagerSubstance misuse

November 2014

Overview…

• Transforming Rehabilitation (TR)– Through The Gate (TTG) / Gateways

• Virtual Campus (VC)– Digital Inclusion platform in prisons

• Breaking Free Online (BFO)

Strategic Context – TR

• The Secretaries of State for Health and Justice agree that new funding would be made available from the Department of Health

• Funding aimed at improving access for people with drug and or alcohol dependency in custody and ‘through the prison gate’ to existing substance misuse treatment and associated health services in the community

• Announced as part of Transforming Rehabilitation Strategy

May 2013

North West ‘Through The Gate’ Pathfinder

Cumbria & Lancashire

CRC

Greater Manchester &

Cheshire CRC

• DH funded initiative with NOMS, NHS England and Public Health England

• Announced as part of Transforming Rehabilitation Strategy May 2013

1. Test new pathway approaches to tackling substance misuse and building sustainable recovery through the gate in particular for those serving <12 months

2. Encourage, incentivise and engage Service Users to engage and take responsibility for managing their recovery and rehabilitation

3. Improve alignment between commissioners along the offender journey

• Range of new products including: Drug testing, alcohol brief interventions, prison TOP, Recovery Housing, Computer Assisted TherapyComputer Assisted Therapy

• Roll out through tri-partite governance

The Project - continued

• Improve the alignment between commissioners along the offender journey

• Up to 5,000 offenders a year in the NW would receive additional support in custody and on release

• Not a pilot – but a test for up to a two year period to develop existing provision and enhance delivery

• Learning from this approach used to inform wider roll out in the new system in line with the projected timescales of Transforming Rehabilitation Programme (TR)

List of NW prisons in NW TTG SMS Project

Contract Package Area Prison

Women HMP Styal

CPA 2 – Cumbria & Lancashire (Male)

SODEXO & NACRO

HMP Preston

HMP Kirkham

HMP Haverigg

HMP Lancaster Farm

CPA 6 – Cheshire & Manchester (Male)

PURPLE FUTURES:

Interserve led with 3SC, Addaction, P3 & Shelter

HMP Manchester

HMP Altcourse

HMP Forest Bank

HMP Risley

HMP Thorn Cross

Why the North West?

• Selection criteria:

– High levels of current discharge from prisons within proposed TR contract package areas

– Concentrations of existing Drug Recovery Wing and Drug Free environments

– Strong peer support networks

– Levels of stability around re-tending of integrated substance misuse and wider health services

– The range of current substance misuse services which were operating an in-reach/out-reach model in and out of prisons

– Possibility of testing early adoption of the reconfiguration of the prison population

What's new – products/services/interventions developed

• An increase in the frequency and range of drug testing

• Enhanced Supply Reduction activities

• Improved pathways and case management through multi-agency plans from day 1 in custody and through the gate

• Improved processes for Standard Plus applications

• Determine the most appropriate screening and brief interventions approaches and points in the offender pathway for these to be delivered

• Improved well-being, mental health and dual diagnosis care programme approach pathways in custody and through the gate

What’s new? - continued

• Abstinence in prison and abstinent in communities linking to Public Reform Agendas

• Asset Based Community Development - ABCD• Introduction of Prison Treatment Outcome Profile (TOP)• Take home Naloxone• Improved Peer Support• Abstinence based recovery housing• Meet & Greet at the gate (Friends, homes & jobs)• Improved family interventions• NW Innovation fund to allow engagement with smaller voluntary

organisations• Computer Assisted TherapyComputer Assisted Therapy

– Using technology to enhance recoveryUsing technology to enhance recovery– Promoting Digital InclusionPromoting Digital Inclusion

Welcome to the Virtual Campus

What is the Virtual Campus?

• A secure way for you to use web based technology for learning, information, advice and guidance

• Recording your progress so that you are not as likely to have to repeat any learning if you are transferred

• The Virtual Campus also lets you– complete an exam online

– access some carefully chosen content securely from the web

Logging On…

You can message your advisor

..

Find information, advice and guidance from any Virtual Campus PC

The Virtual Campus

Future Developments

• Mentoring

• Virtual Classroom – Remote Delivery of classes

• Continued content development to meet local and national needs

• Phase 3 deployment

• Phase 4 expansion programme

• New Hybrid TS Solution

• In Cell Trial over next 12 months

• Health & Wellbeing Interventions

Breaking Free Online (H&J) & NOMS

• BFO Health & Justice BFO Health & Justice developed through extensive consultation with NOMS

• NOMS confirmed it meets all quality assurance, information assurance and security requirements & receives MoJ ‘White Label’ of approval

• Hosted in a ‘sterile’ environment – Service Users cannot access any other website from the dedicated URL: noms.breakingfreeoneline.com

• Access via the Virtual Campus computers or authorised laptops

• Accessible in all prisons and following release via UK Online Centres & other community internet resources

Other implementation activities

• BFO BFO training extended to ‘through the gate’ mentor services

• Partnership with Emerging Horizons around delivery of Pillars of Recovery training

• Incorporated Naloxone patient information

• NOMS approved as PSO 4350 Effective Regime Intervention

• Developing Oxford, Cambridge & RSA accreditation

• Secured ethical approval from MoJ to undertake research evaluation

Breaking Free Online at HMP Haverigg

• Preliminary usage data on 22 offenders using BFO

• Mean number of treatment episodes = 11.57 (range = 1 - 41)

• Mean total time spent on BFO = 5.87 hours (range = 24.35 mins - 19.81 hours)

• Analysis of literacy and computer literacy:

• To date, 3 offenders have transferred to HMP Kirkham and requested access to BFO

Literacy level Equivalence n (%)

Level 2 GCSE A-C 8 (36)

Level 1 GCSE D-G 9 (41)

Entry level 3 Age 9-11 4 (18)

Entry level 2 Age 7-9 1 (5)

Feedback…

“I was pleasantly surprised that our learners did not need more than basic IT skills to interact with Breaking Free

Online, and more computer literate users did not get bored with the system. I would go so far as to say that there has

been little or no education-related barriers to its use.”

Ian McNaughtonLearning Support OperativeVirtual Campus

BFO Delivery…

Health, Wellbeing & Substance Misuse Co-CommissioningCommissioning GroupDirectorate of Commissioning and Commercial

National Offender Management Service3.07 Clive House70 Petty FranceLondon, SW1H 9HD

www.justice.gov.uk/about/noms/working-with-partners/health-and-justiceEmail - health.co-commissioning@noms.gsi.gov.ukEmail - Substance-misuse.co-commissioning@noms.gsi.gov.uk