substance misuse needs assessment 2012€¦ · this needs assessment has focused on equality to try...

Merton Drugs and Alcohol Action Team

Substance Misuse Needs Assessment 2012

April 2012

Compiled by Ottaway Strategic Management Ltd

Merton SMNA Report 2012 2 2/26/2016

Table of Contents

1 Executive Summary 3 2 Introduction and context 4 3 Needs Assessment NDTMS Data sets 8 4 Alternative Data sets 22 5 Service User and Stakeholder Engagement 23 6 Provider review and perfromance 24 7 Treatment Planning Implications 30 8 Recommendations 31

Appendices 33 9 one 33 10 two 33


1 Executive Summary 1.1 . 1.2 .


2 Introduction and context 2.1 The role of a Substance Misuse Needs Assessment is essentially part of the treatment

planning and commissioning cycle. In effect a needs assessment reviews the baseline demand for services in a local area, compares this were relevant to regional and national baselines and assesses performance of the local partnership over a given period. Data provided by NTDMS is critical to this process however this data is retrospective data and by its nature it reviews what has happened in the recent past rather than estimating what is going to happen in the future. Nonetheless specific trends can be reviewed which are strong indicators of the demand for treatment services and as such will inform the priorities the local partnership should address going forward.

Table 1: Commissioning Cycle (Commissioning for Recovery NTA 2010)

2.2 The commissioning of substance misuse treatment provision is co-ordinated by Merton PCT

on behalf of the Merton DAAT. It is based on an analysis of local substance misuse needs with a focus on what is required locally. In part, the Merton Adult Treatment Plan 2011-12 was built on a ‘needs assessment’ carried out in 2010/11 but has also been influenced by local knowledge of the issues and the needs of service users.

2.3 In 2011-12 the treatment budget was £xxm. This included Merton’s substance misuse pooled treatment budget (£xxm), Drugs Intervention Programme grant (DIP £xxm), Primary Care Trust mainstream budget (£xxm) and social services (£xxm) and Supporting People (£xxm).

2.4 Budget uplift based on mid-year performance was.

2.5 Recovery Agenda, National Drugs Strategy, commissioning priorities


Each service has a responsibility to deliver drug treatment within the context of the National Drug Treatment Strategy as contained in the Merton Adult Drug Treatment Plan 2011/12; to enable an:

Increase in those reducing their drug and alcohol misuse and those achieving

abstinence

Increase in those reducing their offending include repeat offenders

Increase in those improving health and well being

Increase in those reintegrating with education, training and employment, housing & other services

2.6 Substance Misuse treatment provision in Merton 2011-12 is delivery through a range of tier 2 and 3 providers set out below and is based on commissioning intentions:

Merton Community Drug Team. (South West London and St Georges MH Trust). Wilson Hospital, Cranmer Road, Mitcham CR4 4TP, 0208 6874666. Services Provided:

General health cancelling and screening

Pharmacological interventions including, opiate substitution, Alcohol Detox

Blood borne virus testing and referral

Immunisation for Hepatitis B and C

Relapse prevention

Continuing care

Shared care with GP practices

Group Therapy

Motivational Work

Employment specialist services

Counselling services

Care Management

Merton Adult Crack Service (MACS): 269A Kingston Road, Raynes Park, SW20 8LX, 0208 417 1960, Services Provided:

Structured Counselling

Needle Exchange

Hepatitis C testing

Crisis intervention

Day Programme

Family Support, women’s group and crèche

Information and workshops and SM awareness raising

Alternative Therapies

Stimulant Service

Community Drugs Service For South London (CDSSL) 20 Woodcote Road, Wallington SM6 0NN, 0208 773 9393 Services Provided:

Needle Exchange

Alternative Therapies, inc . Auricular Acupuncture

Structured Counselling

Needle Exchange

Hepatitis C testing

Crisis intervention

Information and Workshops


Kaleidoscope, 40 – 46 Cromwell Road. Kingston, KT2 6RN, 0208 549 2681. Services provided:

Needle Exchange

Prescribing

Healthcare checks Ethnic Minority Centre The Vestry Hall, London Rd, Mitcham, CR4 3UD, 0208 648 0084 Services Provided:

Advice/Information (especially for EMC)

Education

Referral into Specialist Treatment Crime Reduction Initiative (CRI) 2 Ilex House, 94 Holly Rd, Twickenham, TW1 4HF, 020 8891 0161 Services provided:

Referral into Specialist Services

Criminal Justice Interventions for those in Custody/Court/Prison

Support and advice

Rapid access to substitute prescribing

Housing advice support and referral

Structured day services, harm reduction

Benefits advice and access to education and training

Community Alcohol Service (CAT) White Lodge, Springfield University Hospital, Glenburnie Rd SW17 7DJ, 0208 6826931 Services provided:

Advice/Information

Alcohol Counseling

Referral into Detox

Health Screening

Group Therapy

Catch 22 Young Peoples service (up to the age of 24) The Inter-Generational Centre, Mitcham, Catch22 Merton Substance Misuse (MSM) Service, 020 8408 1607 Services Provided:

Transitional Services 18-24

Onward referral

Access to education and training

2.7 Priorities for the Merton Needs Assessment 2012

.

2.8 Transitory process of commissioning in Merton 2.9 .


3 Needs Assessment NDTMS Data sets

3.1 In context of Needs Assessment data, NTDMS review data for 2010-11 3.2 The National Treatment Agency (NTA) requires each local partnership to undertake an

assessment of need every year. A clear aim of the assessment is to distinguish between met and unmet need. There are many reasons why need can be unmet. Merton is a diverse area so this needs assessment has focused on equality to try and isolate areas where there is under-representation of provision or barriers to services.

3.3 According to the NTA, the needs assessment should identify the following:

What works in open access and structured drug treatment services and what unmet needs are there across the system

Where the system is failing to engage and retain people

Hidden populations and their risk profiles

Enablers and blocks to treatment pathways

Relationships between treatment agencies and harm profiles

3.4 Ideally, the needs assessment should be used by the Joint Commissioning Group to:

Inform the annual treatment plan

Make evidence-based commissioning decisions

Inform and develop JCG strategy

3.5 By developing these areas, the partnerships should develop a shared understanding of

evidence-based need in relation to drug treatment services, which should help commissioning, treatment planning and the allocation of resources. The needs assessment is a systematic and strategic process which informs the Adult Treatment Plan, a document which sets out the partnership’s strategy for service provision in the coming year.

3.6 This substance misuse needs assessment has been developed in accordance with the

National Treatment Agency (NTA) guidance for partnership needs assessments. In particular, information has been used which has come from the National Drug Treatment Monitoring System (NDTMS) data sets as provided by the NTA. These show who is in treatment, respective prevalence rates and participation in the treatment process. This data was used for the treatment bull's-eye process and the treatment journey assessments. If was felt that, where practical, Merton DAAT has assessed other local data to draw together the full needs assessment.

Treatment bull's-eyes

3.7 The NTA has provided all DAATs with a methodology for estimating the size of their unmet need. It is called the bull's-eye technique and is similar to a Venn diagram. The bull's-eye has four circles, each of which represents drug treatment populations between 2007/08 and 2010/11.

3.8 The process for calculating the treatment bull's-eyes has been taken from the database provided by NDTMS. The details of this information are set out in accompanying tables of data.


3.9 The information provided by the NTA sets out the data recorded by treatment providers operating within Merton, but only includes clients living in Merton. If a service provider is treating clients that live outside the borough boundary, it is likely they are not included in the data. In short, these figures are solely for clients that have come to a service provider in Merton and that live in the borough.

What do the bull's-eyes show us?

The innermost circle were in treatment on March 31, 2011

The second circle were in treatment in 2010-11 but not in contact on March 31, 2011

The third circle represents those that accessed treatment in 2009-10 but not in 2010-11

Finally, the outer circle represents the drug users who did not access treatment in any year. These are called "treatment naïve". Treatment naïve figures are derived by adding all the individuals in treatment during the past two years and subtracting this figure from the Glasgow PDU estimate

Table 2: All treatment clients by gender 2010-11

3.10 Bull's-eye 1 - All treatment clients by gender (Table 2)

3.10.1 In broad terms, this bull's-eye shows the number of clients in treatment by gender, in contact and those no longer in contact with services. It also sets out the Drugs Intervention Programme clients by gender. The data is also compared with the 2009-10 and 2010-11.

3.10.2 It is clear that the number in treatment has grown from 579 in 2009-10 to 675 in 2010-11.

In contrast DIP client numbers whilst having grown in 2009-10 (379) have reduced significantly in 2010-11 (143). The figure for those in contact during the past 12 months has grown as has the figure for those ‘no longer in contact’. This would suggest that Merton DAAT is seeing more clients and taking more clients through effective treatment programmes.


Table 3: Opiate and crack PDUs NDTMS 2008-09

Bull's-eye 2 - Gender in crack and/or opiate using OCUs (Table 3)

3.10.3 This shows that for opiate and crack users the gender split remains fairly constant at 65-6% compared to 33-35%. This is broadly consistent although anecdotally agencies suggest more women are coming into services. This bull's-eye has used data from Glasgow University which estimates that 1029 crack and opiate users in the borough leaving a treatment naive population of 439 people.

Merton SMNA Report 2012Merton SMNA Report 2012 11 26-Feb-16

Table 4: All treatment clients NDTMS 2008-09 by drug type

Bull's-eye 3 - All drugs (Table 4)

3.10.4 This bulls eye shows the main drugs that Merton clients presented to services in 2010-11 (figures for benzodiazepines, amphetamines and other drugs can be seen in tables below).

In total, 675 individuals were in treatment on March 31, 2011.

In 2010-11, 221, 33% presented with crack and/or opiate as their main drug of choice

197 (29%) presented with opiate as their main drug of choice

164 (39%) presented with crack cocaine as their main drug of choice

Powder cocaine users remain broadly constant at 10% compared to previous years whereas cannabis user has increased 24%

These patterns remain consistent across the bull's-eye except for DIP figures which show a decrease in clients since last year.


Table 5: Opiate and crack PDUs by ethnicity NDTMS 2008-09

Bull's-eye 4 - Ethnic breakdown of crack and/or opiate using OCUs (Table 5)

3.10.5 The ethnic composition seems to have changed in the last four years. Indeed of those OCU’s in treatment there seems to be a growth in the White population from 80% in 09/10 to 83% in 10/11. The Black population has reduced from 13% in 09/10 to 9% in 10/11. In contrast to the DIP client base which although reduced in numbers still presents a higher Black profile with 26% in 09/10 growing to 35% in 10/11. The DIP’s Asian and other profiles have also increased and correspondingly the whiter profile has decreased from 66% in 09/10 to 45% in 10/11. This suggests more ethnicity in coming in to services through DIP and less through mainstream treatment providers.


University of Glasgow Prevalence Estimates and Methodology

3.10.6 The Home Office commissioned a research study to produce prevalence estimates of problematic drug users (PDU) at both local and national levels. It should be noted that the term PDU refers to users of opiates and/or crack, including those who inject either of these drugs. The figures do not include people who inject other drugs or use powder cocaine, amphetamine, ecstasy or cannabis. The term PDU has now replaced by the term OCU.

3.10.7 It is expected that all partnerships will use these Home Office estimates as part of their needs assessment process each year. This needs assessment is using 2009/10 OCU estimates.

How these estimates were produced

3.10.8 The Capture Recapture (CRC) process was used to provide the majority of local DAAT estimates. Essentially, this method estimates the "hidden" or "unknown" drug populations by assessing the overlap between known problematic drug users who appear in data sets (such as treatment data and CJS data) and using the information to estimate the number who do not appear in any of the data sources. Once the hidden population is estimated, it is added to the total "known" population to provide an estimate of the whole population of problem drug users.

Here is a simple example showing how this might translate into estimating populations: In "A Town" 1,000 OCUs are in prison, 1,500 are in treatment and 100 are in both. We can then calculate the total OCU population by inversing the ratio of overlapping OCUs in prison – 10/1 and multiplying the known number of treatment users by this ratio (1500 x 10/1 = 15,000).

3.10.9 To supplement this calculation four other data sources were factored in:

NDTMS (Tier 3 and 4) only

National offender management service offender assessment system (OASys)

Drug users cautioned and convicted under the Misuse Of Drugs Act (1971) for offences involving possession (or possession with intent to supply) heroin, methadone, and or/crack cocaine from the Police National Computer (PNC)

Counselling, assessment, referral, advice and through care (CARAT) teams working with drug users in prison

3.10.10 The opiate and or crack user (OCU) estimate for Merton provided by the University of Glasgow for 2009/10 shows there are 1,029 problematic crack and/or opiate users in the borough.

Local estimates of crack and/or opiate OCUs accessing treatment calculated from bull's-eye data 2010/11 (this has been calculated using the 2009/10 University of Glasgow UCU estimates) o Combined numbers in treatment 221 o Estimated crack and/or opiate PDUs 1,029 o Estimated treatment naïve 808 o Treatment penetration rate for crack and/

or opiate users in Merton (704/1,495) 21%


3.10.11 It can be seen from the calculations above that Merton is just below the London average and significantly below the national average for its treatment penetration rates with crack and/or opiate using OCUs. However, it is interesting that the number of treatment naïve has reduced during this period, suggesting that, proportionately, more are coming into treatment services.

Local estimates of opiate users accessing treatment calculated from bull's-eye data 2010-11 (calculations using 2009/10 OCU estimates, because new ones are not available)

Number in treatment 197

Estimated number of opiate users 720

Estimated treatment naïve 523 or 73% of total

Treatment penetration rate for opiate users in Merton (560/1,284) 27%

Local estimates of crack users accessing treatment calculated from bull's-eye data (calculations using 2009/10 OCU estimates)

Numbers in treatment 164

Estimated number of crack OCUs 712

Estimated treatment naïve 548 or 76% of total

Treatment penetration rate for crack users in Merton (551/1,780) 24%

3.10.12 The table below shows London-wide figures for this calculation. It suggests for Merton 1,029 problematic drugs users with a penetration rate into services of 21%, which is a decrease of 3% on the penetration rate for the previous year. This is well below the London average penetration rate of 35%, and the national penetration rate of 42%.

Table 6: Merton, London, National comparison table showing 2009/10 and 2010/11

treatment penetration rates for crack and/or opiates

Partnership Merton London National

2009/10 Estimated OCU Population (University of Glasgow) 1,029 51,445 306,150

2008/09 Estimated OCU Population (University of Glasgow) 1,007 62,769 321,229

2009/10 OCU Population compared to 2010/11 22 -11,323 -15,080

Numbers in Treatment 2009/10 579 40,011 254,549

Numbers of Crack and/or Opiate Users in treatment 2009/10 250 18,667 131,264

OCUs as a % of Tx population 2009/10 43% 47% 52%

Penetration Rate 2009/10 25% 30% 41%

Numbers in Treatment 2010/11 675 46,698 304,892

Numbers of Crack and/or Opiate Users in treatment 2010/11 221 17,948 128,982

OCUs as a % of Tx population 2010/11 33% 38% 42%

Penetration Rate 2010/11 21% 35% 42%

2010/11 Penetration rate variation on 2009/10 -3% 5% 1%


3.11 Treatment Journey Map (NDTMS 20-12 Needs Assessment Data)


3.11.1 The table above maps out the treatment journeys, focusing on the main sources of

referral, those in treatment by main service providers and the transfer between service providers of these clients and of those leaving the system. The data has been provided by NDTMS 2010/11 as part of the treatment mapping tool kit. In summary, the map simply refers to those clients who have moved into and through the treatment system in Merton over this period.

Table 7: Treatment referral pathways (NDTMS 2010/11)

3.11.2 The pie chart above shows clearly a strong volume of self-referrals (25%) to substance

misuse providers with 26%, with the Arrest referral/DIP being 26% of total referrals. The high volume of self-referrals gives a sense that whilst there may be people in the community that are treatment naive the self-referral route is still a strong route of referral suggesting that those that do come to treatment via the self-referrals route do so because they want to. This is broken down in more detail below.


3.12 Referral Pathways compared nationally and regionally

Table 8: Referral pathways (NDTMS 2010/11), Merton Compared to London and England.

Merton London National

GP N. 23 867 5049

% 9% 6% 7%

Self N. 68 6038 28927

% 25% 40% 38%

Drug Service N. 35 2071 11195

% 13% 14% 15%

Arrest Referral DIP N. 69 2205 7953

% 26% 15% 10%

Probation N. 6 539 4057

% 2% 4% 5%

CARAT N. 0 573 6880

% 0% 4% 9%

CJS Other N. 4 969 4856

% 1% 6% 6%

Other N. 64 1880 7463

% 24% 12% 10%

Total N. 718 15142 76380

% 100% 100% 100%

In 2010-11 self-referrals represented 25% of all forms of referral

29% came through the Criminal Justice System (DIP, Probation, CARAT and other CJS).

13% came through Drugs Services, 24% came through other sources compared and 9% who came via GP


3.12.1 The numbers and profile of referrals to treatment by provider is set out below. The highest volume of referrals was to MACS Project 105 (39%). The next highest provider to receive referrals in 2010-11 was SWLStG CDT Merton with 64, 13% of referrals.

Table 9: Clients Referrals to key providers (NDTMS 2010/11)

Provider Total Referrals

n %

MACS Project 105 39%

SWLStG - CDT Merton 64 24% SWLStG - Primary Care Liaison Services (Merton CDT)

37 14%

CDSSL-Merton Clients 39 14%

Total 269 100%

London 15142

National 76380

3.13 In Treatment

3.13.1 From the NDTMS data for individual treatment providers 20010-11 there were 1831 people in treatment across all Merton providers, 134 had been in treatment from between 2 and 4 years and 71 had been in treatment for more than 4 years. The highest volume providers were via SWLStG CDT Merton 28% of clients, and SWLStG Primary Care Liaison (Merton CDT) with 8%.

Table 10: Clients in Treatment (NDTMS 2010/11), Client in treatment 2-4 years and

more than 4 years.

Merton Clients In treatment by main provider

In treatment 2010/11

In treatment

2-4 years

In treatment 4 years +

% of clients in treatment for

more than 2 years

2010-11 n n OCU n OCU

MACS Project 249 12 83% 0 0 5%

SWLStG - CDT Merton 181 33 100% 17 100% 28% SWLStG - Primary Care Liaison Services (Merton CDT) 63 5 60% 0 0 8%

CDSSL-Merton Clients 96 4 75% 0 0% 4%

Total 589 54 80% 17 100% 12%


3.13.2 What is clearly evident is that those with clients for the longest periods are essentially prescribing services (SWLStG Merton CDT 28%, and SWLStG Primary Care Liaison Services (Merton CDT) 8%). This suggests that there is greater difficult in fulfilling the recovery agenda with clients at these services. Closer examination confirms that in the majority of cases a high percentage of those in treatment for longer than 2 years are Opiate and or Crack users (OCU). It is suggest that these clients with these providers are simply taking receipt of their methadone scripts and not really benefiting from any of the other services on offer to assist in their recovery. This will need to be further examined in discussion with providers and in examining specific care plans.

3.13.3 Movement within the system also seems strong in Merton as exemplified in the

Treatment map. This suggests that there is a good inter provider partnership and that clients are moving across providers to secure the best approach to meet their care planning requirements. This positive approach needs to continue to maintain the effectiveness of the recovery agenda in the borough.

3.13.4 The range of substances used by clients in the treatment system in Merton in 2010-11 is

set out in the table below.

Table 11: Clients in Treatment (NDTMS 2010/11) by Drugs use and by Gender

Clients in treatment 10/11 All Clients Male Female

N. % N. % `N. %

Opiate &/or Crack Users 221 33% 143 32% 78 34%

Opiate Users 197 29% 129 29% 68 30%

Crack Users 164 24% 110 25% 54 24%

Cocaine Users 70 10% 51 11% 19 8%

Amphetamine Users 18 3% 10 2% 8 4%

Cannabis Users 165 24% 109 24% 56 25%

Benzodiazepines Users 44 7% 31 7% 13 6%

Other Drug Users 17 3% 8 2% 9 4%

Total 675 100% 448 100% 227 100%

3.13.5 Opiate and or Crack users are the overwhelming majority of users in the Merton

treatment system. This makes up 33% of the total population, with opiate users on their own being 29% and Crack 24% and 24% of users in treatment were cannabis users.


3.14 Exits and completions 3.14.1 The table below sets out treatment exits in 2010-11 by provider and compares this with

London and England. The data represents those that exited services in this year. The highest volume of planned exits was the MACs Project with 57 exits which was 23% of those in treatment in that service. Next was CDSSL Merton Clients (54 which was 56% of those in treatment) SWLStG CDT Merton with 21 which was 12% of those in treatment) and SWLStG –Primary Care liaison service- CDT Merton with 1 representing 33% of those in treatment in this service.

3.14.2 The percentage rates are useful to identify comparison by provider although it must be

recognised that the client base is not the same in each service and that services vary between providers. From a partnership perspective Merton is doing well with 58% planned completions as compared to 42% and 43% for London and England. Referrals on in Merton are low (10%) compare to London (24%) and England (25%). Merton’s Dropped out rate of 28% is broadly consistent to that of London 27% and England 24%. This s a positive reflection of the way services are provided locally.

3.14.3 Individually the most success provider for planned exits is CDSSL Merton Clients 78%,

followed by MACs Project 54%, SWLStG Merton CDT 48% and SWLStG PCLS with 100% having only one client exiting the service this year.

Table 12: Treatment Exits (NDTMS 2010/11)

Planned Referred on Dropped out Unplanned

- prison Unplanned

- other Total

Provider n % n % n % n % n % n %

MACS Project 57 54% 6 6% 40 38% 2 2% 0 0% 105 100%

SWLStG - CDT Merton 21 48% 8 18% 12 27% 0% 0% 3 7% 44 100% SWLStG - Primary Care Liaison Services (Merton CDT)

1 100% 0 0% 0 0% 0 0% 0 0% 1

100%

CDSSL-Merton Clients 54 78% 2 3% 13 19% 0 0% 0% 0% 69 100%

All Merton Total 159 58% 28 10% 78 28% 2 1% 8 3% 275 100%

London 5947 42% 3362 24% 3752 27% 202 1% 765 5% 14028 100%

National 28966 43% 16912 25% 15938 24% 1096 2% 3948 6% 66860 100%


4 Alternative Data sets 4.1

4.2 Hospital admissions A&E data for Substance misuse 4.3 LAS –London Ambulance Service data 4.4 Merton Hospital admissions for alcohol related diagnosis 4.5 Criminal justice data DIP

Dash boards Trigger offences Drug Crime Drug markets Anti-Social behaviour

4.6 Probation Service Data e-OASys 4.7 Housing and Social Care Data 4.8 .

Table 13: .

4.9


5 Service User and Stakeholder Engagement (Not updated) 5.1 5.2


6 Provider review and performance 6.1 Performance in delivering substance misuse treatment is critical, especially in the current

times where public funding is limited. To this end one measure of achievement is the volume of successful completion, which meets the Government’s National Drugs Strategy commitment to ensure achievements against the recovery agenda. To review this we have taken ‘NDTMS Successful Completion Performance data’ (Partnership and Provider) and modelled a comparison between the averages of completions in 2010-11 for each provider and tracked 2011-12 performance using a month on month and year on year comparison.

6.2 The tables below review opiate and non-opiate completions (drug free). To assist this we have inserted the average of completion last year between the three main providers (Horizontal Green line). This is a constant is represents the level of completions achieved in 2010-11. The red line represents the average of completions in 2011-12 between the three providers.

6.3 It should be noted that this simply represents those who have completed drug free and does not take account of the volume of clients each hold. It also suggests that some providers are at particular points in the recovery programme and if the partnership is working effectively some providers especially working with clients at the end of that treatment journey should be doing better than others in delivering the recovery agenda. It nonetheless also suggests that the whole team plays a part in these outcomes and as such should contribute to the end result.

6.4 What the table also shows is the comparison of performance against last year’s position. If a line is higher than ‘0’ then it is doing better than last year if it falls below, performance is below last year’s level.

Table 14: Growth in Successful Completions Opiates from 2010/11 Baseline.


6.5 The table above shows the comparative change (in some cases this is growth and in others decline) in year on year percentages of successful completions by provider. It shows that MACS project is by far the greatest achieved in successful completions, although this may in part be because it has a number of programmes which support successful completions. Also when compared to last year both SWLStG and CDSSL have declined in their profile of achievement.

Table 15: Growth in Successful Completions Non Opiates from 2010-11 Baseline

6.6 The table above shows the percentage change for successful completions for non-opiates

comparing the borough’s three main providers. It shows that MACS Project as in the case of Opiates is the best achieving provider. SWLStG has also increased its profile when compared to last year but is below the profile of growth shown last year. CDSSL has dropped beneath its successful completions level although it has a more volatile level of growth and is currently dipping from its September high.

Table 16: Merton Successful Completions compared to National and Regional All Drugs Over 18


Table 17: Merton OCU/PDU Successful Completions Year to date to Jan 2012

6.7 The two tables above show the actual successful completions for Merton DAT based on a count (month on month) of individual exits for Opiates and Non-Opiate clients. It shows the total exits, successful completions, % of successful completions (Green) and compares this with regional and national level percentages. It shows that successful completions for both Opiate and Non-Opiate clients is above both the national and regional average, which suggests a very positive set of results.

6.8 The table below describes the level of total exits (all drugs) by each provider in the borough and identifies the level s of drug free completions and treatment completions. It does not include those who have dropped out or who have been in transit both custodially and not. It shows that the range of successful completions and a percentage of total exits is varied from 87% (MACS Project) to 30% (SWLStG CDT). The profile of successful completions drug free is also great ranging from 73% MACS Project to 26% SWLStG CDT.

Table 18: Merton Successful Completions by Provider

Outcomes of discharges by provider April 11 to Jan 12

Total exits

Treatment complete drug free

Treatment complete

Total Complete/ Drug Free

% Successful

Completions

% of Successful

completions drug free

MACS Project 114 83 16 99 87% 73%

SWLStG NHS Trust - CDAT Merton

42 16 13 29 69% 38%

SWLStG NHS Trust CDT

23 6 1 7 30% 26%

CDSSL 19 12 3 15 79% 63%

Merton Total 198 117 33 150 76% 59%

6.9 The two tables below show the MACS Project successful completions and a percentage compared to the same time last year for both opiate and non-opiates. It also identifies the baseline growth rate for 2010-11 and shows this as a green line. MACS performance in 2011-12 so far has been extremely strong.


Table 19: MACS Project Successful Completions Opiates

Table 20: MACS Project Successful Completions Non-Opiates

6.10 The two tables below show the SWLStG NHS Trust’s successful completions and a percentage compared to the same time last year for both opiate and non-opiates. It also identifies the baseline growth rate for 2010-11 and shows this as a green line. SWLStG has dipped in its successful completions when compared to last year quite considerable inspite of a strong May, June and July. Its Non-opiate performance in 2011-12 however has been strong although its performance has spiked and dipped throughout the year so far.


Table 21: SWLStG NHS Trust Successful Completions Opiates to Jan 2012

Table 22: SWLStG NHS Trust Successful Completions Non-Opiates to Jan 2012

6.11 The table below shows the CDSSL successful completions and a percentage compared to the same time last year for both opiate and non-opiates. It also identifies the baseline growth rate for 2010-11 and shows this as a green line. CDSSL Opiate completions were strong in 2010-11 but this year’s performance has dipped to January 2012. Its non-opiate performance has also dipped below its achievements in 2010-11. It should be noted that the exit level for its completions for drug free are high at 63% which is above national norms.


Table 23: CDSSL Successful Completions Opiates to Jan 2012

Table 24: CDSSL Successful Completions Non-Opiates to Jan 2012

6.12 What these table show is that Merton is performing above the regional and national averages and that the bulk of this success is coming from the MACS Project who are best placed to secure drug free completions. CDSSL seems to have dipped from the year before and SWLStG is performing in broadly the same way as it did in 2010-11 for non.-opiates but has dipped in its successful completions for opiate users.


7 Treatment Planning Implications 7.1 .

7.2 .


8 Recommendations 8.1 .

8.2 .

8.3 .

Table 25: .


Appendices 9 one 10 two 10.1 .


11

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