Reshaping Recovery Services

Clinical Audit

Therapeutic Solutions (Addictions) worked with our partners Illy Systems and CGL to support Northamptonshire County Council in understanding the nature of service delivery over two time periods (2011 and 2014). This study incorporated two main components to understand the case-mix of clients accessing treatment services in Northamptonshire:

  • The first builds on recommendations within the Medications in Recovery: Re-Orientating Drug Dependence Treatment report to undertake a clinical audit of practice. An audit was undertaken based on a random sample of over 300 case records held on Illy System’s Care-Path Management Information system. This is a representative sample of individuals known to treatment at 95% confidence and 5% margin of error. This study was compared to a baseline audit (n=121) undertaken in 2011-12.
  • The audit was supplemented by development of two multivariate models of Northamptonshire DAAT records as held on the National Drug Treatment Monitoring System (NDTMS) using an array of explanatory variables including socio-demographic context (age, ethnicity, gender); home location; treatment duration and type of intervention received and drug or alcohol-using profiles. An initial bivariate test was undertaken prior to developing the models to avoid the concept of statistical ‘over-fitting’. The first model examined the factors that predicted a ‘successful treatment’ outcome as defined by NDTMS and the second specifically examined correlates to disengagement (drop-out).
  • The study identified a range of enhancements that needed to be made across a range of service provision including the links between criminal justice and community-based services.

    Developing Assessments to Improve Recovery

    In Northamptonshire we have worked with CGL and the County Council to implement use of the Addiction Dimensions for Assessment and Personalised Treatment (ADAPT) assessment tool (Marsden et al, 2014) across local services. The aim of this project is to identify factors that predict abstinence from Class A drugs among opiate users in treatment in one English local authority area. In addition to staff interviews, we undertook detailed analysis of 776 opiate users in treatment were using the ADAPT tool. Our analysis encompasses three domains and 14 subdomains covering addiction severity, recovery strengths and coexisting health and social needs. These data were matched to information held on the National Drug Treatment Monitoring System (NDTMS) including outcome measures via the Treatment Outcome Profile (TOP). We created models to predict predict whether individuals in treatment were abstinent or still using Class A drugs concurrently. The study will provide CGL with the opportunity to develop interventions personalised to the individual’s recovery needs.

    Northamptonshire County Council Illy Systems Change Grow Live

Recovery Services

We have offered a range of services to support the development of recovery services across the substance misuse sector including a number of reports and academic peer-reviewed papers. We have a paper written in partnership with Birmingham University on influences to 12-Step mutual self-help groups published in the European Addiction Research in September 2014.

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Our Services

We have developed a range of analytical and methodological approaches aimed at understanding the health and substance misuse needs of individuals including extensive interviews with a cross-section of service users in contact with healthcare and other related services. We have also worked to develop methods aimed at understanding the nuances of prisoner satisfaction of clinical services received. Our paper testing use of SERVQUAL as a mechanism for understanding ‘real’ satisfaction rates has been published here.

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Studies and Assessments

We have undertaken over 50 health and substance misuse specific needs assessments since 2006. These have included studies across community settings and across the criminal justice system (including detainee needs in police custody; service users in contact with Sexual Assault Referral Centres (SARCs) and prisoners in contact with health services in secure settings).

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