commissioning a crack service megan jones lambeth dat manager
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Commissioning A Crack Commissioning A Crack ServiceService
Megan JonesMegan Jones
Lambeth DAT ManagerLambeth DAT Manager
LambethLambeth South-west inner London BoroughSouth-west inner London Borough
Brixton, Clapham, StreathamBrixton, Clapham, Streatham Population ~270,000Population ~270,000
62% white62% white 26% Black26% Black 5% Asian5% Asian 5% mixed5% mixed
3,000 – 5,000 problem drug users3,000 – 5,000 problem drug users ~2000 drug users in treatment per year~2000 drug users in treatment per year
Key providers in DAT/BoroughKey providers in DAT/Borough
NHS Trust (SLAM)NHS Trust (SLAM)Prescribing service – specialist and GP shared carePrescribing service – specialist and GP shared carePsychology servicesPsychology services
CDPCDPArrest referralArrest referralAssessment for access to structured drug treatmentAssessment for access to structured drug treatmentDay careDay care
MainlinersMainlinersOpen accessOpen accessHarm reduction Harm reduction
Commissioning Lambeth HarbourCommissioning Lambeth Harbour Needs assessment 2002Needs assessment 2002
Current services – specialist and generalCurrent services – specialist and general UsersUsers Criminal justice agenciesCriminal justice agencies
Lambeth DIP positive testers 2005/6:Lambeth DIP positive testers 2005/6: Cocaine 51%Cocaine 51% Cocaine & opiates 42%Cocaine & opiates 42% Opiates 7%Opiates 7%
2005/6 Treatment data 2005/6 Treatment data (primary and secondary drug use)(primary and secondary drug use) 58% report heroin use 58% report heroin use 50% report crack/cocaine use50% report crack/cocaine use
93%}
Crack-specific Service?Crack-specific Service?
Funding availableFunding available Lambeth: Lambeth:
93% problem drug users use crack93% problem drug users use crack~70% budget funds “opiate" services~70% budget funds “opiate" services
Diversify existing services?Diversify existing services? Develop crack expertise?Develop crack expertise?
Lambeth HarbourLambeth Harbour
Tier 2/3 stimulant serviceTier 2/3 stimulant service
Partnership approachPartnership approach
Staff seconded from all key providersStaff seconded from all key providers
Development of specialist expertiseDevelopment of specialist expertise
Opportunities for learning to be absorbed Opportunities for learning to be absorbed back into host agenciesback into host agencies
Partnership ApproachPartnership ApproachCDP as Lead Provider CDP as Lead Provider
PremisesPremises Operational managementOperational management Staffing of direct access servicesStaffing of direct access services Key working within tiers 2 and 3 provisionKey working within tiers 2 and 3 provision Group workGroup work
SLAM as key providerSLAM as key provider Psychological treatments Psychological treatments Dual diagnosisDual diagnosis Clinical practiceClinical practice
MainlinersMainliners Recruit, train and support volunteers Recruit, train and support volunteers Support all project activitiesSupport all project activities
Service SpecificationService Specification Strong managementStrong management The “hook”The “hook”
Crisis interventionCrisis intervention Complementary therapiesComplementary therapies Shower/laundry provisionShower/laundry provision FoodFood
Assessment , referral and care planning Assessment , referral and care planning Psychological interventionsPsychological interventions
Motivational interviewingMotivational interviewing CBTCBT Relapse preventionRelapse prevention
Life skillsLife skills HousingHousing
ConsiderationsConsiderations
Staffing capacityStaffing capacity
LocationLocation
Opening hoursOpening hours
Physical space – day servicePhysical space – day service
User involvementUser involvement
MethamphetamineMethamphetamine
Where are we nowWhere are we now
Up to 93% PDUs use crackUp to 93% PDUs use crack Two year reviewTwo year review
Staff capacity issuesStaff capacity issuesRe-think volunteeringRe-think volunteeringMore in-reach into other servicesMore in-reach into other services
User involvementUser involvement Crack Needs AssessmentCrack Needs Assessment
Wish ListWish List
Loads more money!Loads more money!
Safe houseSafe house
Dual diagnosisDual diagnosis
Email: [email protected] Email: [email protected]