Transcript NTA presentations

NTA Residential Rehabilitation Event
Welcome
Rosanna O’ Connor
NTA Director of Delivery
Welcome to all...................
Key aims:
 to support closer relationships between residential providers and
commissioners
 to provide an opportunity for networking
 to facilitate the sharing of ideas and models of delivery
The new drug strategy
 2010 drug strategy sets out a clear ambition to help people recover and to
overcome their dependency
 Companion public health white paper makes clear reducing drug use, enabling
people to overcome dependency and recover fully are a key priority
 Improving successful completions are a component part of the success of any
partnerships approach to recovery
Residential rehabilitation has a key part to play in providing abstinence-based
treatment and enabling people to successfully complete treatment
 There are also a range of residential models available, some of which we are
highlighting today
NTA role in delivering the drug strategy
 Mandated to work with others to support the transformation of
treatment systems into recovery systems
 Ensure integration of treatment into wider systems of recovery:
 Ensuring that the system links to housing, employment, education,
children services, families and Mutual Aid
 Ensure a holistic tailor-made response to the whole needs of an
individual’s recovery journey
 Assisting partnerships to develop recovery orientated systems in
prisons – bringing together the clinical and CARAT services
Transition year
 Transitional year as some NTA functions transfer to Public Health
England
 New local accountability structures from April 2012 – e.g. Health &
Wellbeing Boards
 ‘Building Recovery in Communities’ to replace Models of Care
Snapshot of the 2011/12 work plan
 Implementation of BRiC
 Patient placement criteria – segmenting treatment population
 Support Payment by Results
 Secretariat to the National Skills Consortia
 Supporting recovery networks & champions and Mutual Aid groups
Key themes for Commissioners &
Providers
March 2011
Mark Gillyon
Head of Delivery - North
Models
of Care
(3?)
Building
Recovery in
Communities
MoC 3  Building Recovery in Communities
2007 Clinical Guidelines
Integrated Drug Treatment System (IDTS)
Recovery
 Mutual Aid, successful completions, the supportive role of families,
the importance of housing and employment
Support through the system
User choice and responsibility
Families and safeguarding
Targeting the right interventions, to the right people, at the right time.
The new framework
The over arching aim of the new framework is to support local areas in
developing their systems and services to become recovery focused,
highly ambitious and offer a real opportunity for sustainable
recovery.
The sector is changing...
Different models of delivery
‘Traditional’
Locally commissioned and locally provided
‘Quasi-residential’
The commissioning environment is changing...
Funding in 2011/12
Funding in 2012/13
Funding from 2013 onwards
Outcome-based systems, Payment by Results, and the leadership of
Directors of Public Health / Health & Wellbeing Boards
Other things will change...
Successful completions
 The number of people leaving drug treatment free of their drug(s) of
dependency
Payment by results
 Model / length focus vs. specific required outcomes
Data
 About 2/3 report to NDTMS
 New models / new data problems
The future of PTB
 Within Public Health ring-fence, for Health & Wellbeing Boards
Data support
NDTMS Regional Teams
 Data collection, support, training, analysis
Rehab Online
 Marketing
 Testimonials
 Vacancies
Evidencing outcomes and value
Client
Provider
Commissioner
Future developments
Colin Bradbury
Residential Rehabilitation Event
March 2011
Contents
1. Payment by Results
2. Case Mix Adjustment
3. Residential Rehabilitation Outcomes
Payment by Results - Background
Payment by
Results
A recovery programme, not a treatment programme – aiming to attract
new providers
Around 6 pilot local authority areas
April – Sep 2011: co-design, running 2011-2013
Independent evaluation
4 outcomes (interim & final) identified:
 Leaving treatment free from drug(s) of dependency
 Re/Offending
 Employment
 Health & Wellbeing (interim only)
Opportunities and challenges
Payment by
Results
Moving away from process/ front end targets
Giving providers freedom and flexibility to innovate and sub-contract
what they need
Letting the market show “what works”
Encouraging new providers to enter the market
Developing a single point of contact model
A need to avoid perverse incentives
Delivering more outcomes with the same money
Ensuring small/ new providers are able to compete
Case Mix
Case
Mix
Using outcome and re-presentation data to predict risk for new
treatment entrants
Push and pull factors for recovery
Allowing comparisons of outcomes in similar areas and
services – segmenting on the basis of probability of
recovery
Limited to the data we have
Says something about an individual’s chances, but nothing
about how best to help them...
RR outcome research
Rehabilitatio
n Outcomes
a prospective outcome study of publicly funded
providers of drug and alcohol residential
rehabilitation
expert academic and provider advisory group
Peer reviewed academic journal
Consult on which sort of models should be included
In summary...
How might we further incentivise recovery, moving beyond the existing
evidence base?
 Payment by Results
How can we ensure accurate tariffs are set and there is a level playing field?
 Case Mix Adjustment
How could we ensure people get the right treatment at the right time?
 Patient Placement Criteria
What role can residential rehabilitation play in this?
 Outcomes Study