Transcript Document

The Stockton-On-Tees Solution: A model for the delivery of
alcohol services in Primary Care
Jo Heaney – Modernisation Manager, Public Health (Lead
Commissioner alcohol & Young Peoples Substance Misuse)
17/07/2015
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Aims and Objectives
• Background
• Alcohol Prevalence
• Primary Care delivery then
• Service Model
• Primary Care delivery and now
• Outcomes to date
• Challenges
• Questions
• Activity
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Background
• Unitary Authority
• Population- 192,406
• Ethnicity- 97% White
• Absolute deprivation versus
absolute affluence
• Alcohol and Drug services
separate
• 24 General Practices
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Alcohol Prevalence
2470 dependant
drinkers
831 in
treatment
Jan-Dec 2013
8,678- High risk
26,300- Increasing risk
37,269- Binge drinkers
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Primary Care Model 2012
Level 1
Local Enhanced
Contract
Level 2
Screening & B.I
Supporting detoxification
Project reviewed
Q.I.P.P
Project
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Lessons learnt
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T.A.P
Pilot
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RECOVERY COMMUNITY
(ALCOHOL & TREATMENT
FREE)
Rehab
PHARMACOLOGICAL
PSYCHO-SOCIAL
INTERVENTIONS
Disengage
Assessment of Need / Recovery Planning
(within base or hub setting)
Assertive Outreach (where needed)
Hospital
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Criminal
Justice
General
Self
PresentationPractice
name
Other E.g. Drug
Services / Social
Care
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RECOVERY SUPPORT
AFTERCARE/Mutual
aid groups
General Practice (24)
Present Primary Care Model
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Enhanced
Contract
(20)
All patients
Screened prior
To referral
T
e
a
m
A
r
o
u
n
d
Pharmacotherapy
No
Enhanced Contract
(4)
Can refer
Without
screening
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T
h
e
P.S.I
Recovery
M.O.U/Action Plan
Treatment/
Interventions
Complete
recovery
P
r
a
c
t
i
c
e
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Outcomes
• Referrals received from all practices into the T.A.P team
• There are 20 practices with an enhanced contract
• There are 15 clinics ran within general practice
• Clinics available within area’s of deprivation and affluence and
in practices that had previously been reluctant.
• There have been 16,249 people screened, 3901 full AUDIT and
BI and 236 referred into specialist services during 13/14
• Referrals into the T.A.P team continue to grow
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Challenges
Commissioner
T.A.P Team
• Effectively engaging all practices in
• Reluctance by some practices to have
meaningful use of the enhanced contract
and T.A.P
clinics within surgery
• Building trust and confidence with
practices that the whole treatment system
would be responsive to referrals.
• Data collection from enhanced service
activity.
• Communication between surgery staff
• Physical space in practices and the
increased for home visits
• High D.N.A rates- more apparent in some
practices.
• Ensuring that it is general practice doing
the screening and not the T.A.P.
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Questions
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Workshop Activity:
In groups of five for 5 minutes I want
you to discuss and identify what you
would need to do in your localities, to
ensure an effective model for the
delivery of alcohol services does NOT
develop within primary care!
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