Agenda Item No. 5
The Vale of Glamorgan Council
Scrutiny Committee (Housing and Public Protection): 12th February 2014
Report of Director of Development Services
Cardiff and Vale Substance Misuse Performance Management Framework Report
Purpose of the Report
1. To apprise Members of the Substance Misuse performance management framework and progress against this during the first 6 months of the 2013/14 financial year.
1. THAT the report be noted.
Reason for the Recommendation
1. To inform Scrutiny of progress to date, and to consider of how progress will be maintained and improved upon.
2. Area Planning Boards (APB) have responsibility for the oversight of substance misuse services across the 7 health board areas of Wales. Membership of each APB comprises of representatives from Health, the Police, Probation, Social Services for both Adults and Children and the Prison Service.
3. Welsh Government have set national key performance indicators for each APB to report against. In addition to the national guidelines, the commissioning strategy for Substance Misuse 2013/18 has set a number of local performance indicators for which the board will be responsible.
4. The national Key Performance Indicators are as follows;
Those that Do Not Attend Post Comprehensive Assessment
Percentage of Individuals accessing treatment from referral within 20 working days
Those reporting Decreased Problematic Substance Use
Reduced Injecting Behaviour
Those reporting an improved quality of life
The number of Planned Case Closures (Successful treatment completion).
5. Each service provider is required to submit their data onto the National Database on a monthly basis. This takes into account the number of referrals and other related information as well as data on the Treatment Outcome Profile which is completed for all service users in receipt of structured treatment. The Treatment Outcome Profile measures data referred to in the final four Key Performance Indicators listed above.
Relevant Issues and Options
6. During 2012/13 5,169 people were referred to substance misuse treatment across Cardiff and the Vale of Glamorgan. In the first six months of 2013/14 this stood at 2,552. From this we can ascertain that demand for service has remained more or less constant.
7. For the Vale of Glamorgan specifically this breaks down as 1,141 individuals referred to drug and alcohol services during 2012/13. In the first 6 months of the current financial year, there were 544 referrals in the Vale of Glamorgan. Again, this represents a similar rate of referral to the previous financial year.
8. Those that failed to attend following assessment saw an improvement during the first six months of this year with a reduction from 32.9% in 2012/13 to 19%. This statistic measures those who are assessed and then stop attending treatment without treatment being classed as successfully completed. This highlights that people are being referred to the right service at the right time through the new Entry to Drug and Alcohol Service (E-DAS).
9. The percentage of individuals accessing treatment from referral within a 20 day period saw a slight drop from in performance. In 2012/13 this stood at 74%, this fell during the first six months of 2013/14 to 69% of individuals starting treatment within the 20 days of referral. This drop in performance should be addressed through the procurement of two new services in the coming months, which should have an impact on local waiting times.
10. Those individuals receiving support who report decreased problematic substance use was at 66.45% for 2012/13. The half yearly report for this for 2013/14 has seen a drop in performance to 62.95% of those in treatment reporting reduced problematic substance use.
11. In terms of reduced injecting behaviour, this performance measure saw an improvement from 42% to 50% reporting reduced risk. It is however worth noting that Welsh Government are to remove this KPI. The compliance for this KPI is poor, with percentages representing very low numbers of 4 service users across Cardiff and the Vale. Whilst Welsh Government will no longer require reports on this KPI, it will continue to be monitored locally to ensure this is recorded accurately.
12. Those receiving treatment who self report an improved quality of life throughout the duration of their care plan stands at 65% for the first six months of 2013/14, an improvement on 2012/13 when this was 55.31%. This highlights that services are having a positive impact on the holistic needs of service users.
13. The final key performance indicator is for the number of planned closures, which illustrates how many people complete their treatment successfully. This saw an improvement from 50% in 2012/13 to 59% in the first 6 months of this year. This highlights that service users are moving through the treatment system at an improved rate, this should improve further in the coming year as new services come online.
14. The impact of the Entry to Drug and Alcohol Services system are apparent in improved attendance rates following referral rates, suggesting service users are being directed to the right service at the right time. This is also evidenced in the improvements in successful completions which highlights that successes are occurring in those who are referred to the appropriate level of care for them.
15. Where performance has dropped these are in areas which will be addressed through the commissioning of new service packages which are due to commence fully at the beginning of the 2014/15 financial year.
16. Treatment Outcome Profile compliance remains an issue. The Systems Information Support service has slipped this year, however once set up this function will assist in achieving improvements against these in collaboration with service package leads.
17. The Community Addictions Unit that sustains one waiting list has set itself an achievable goal of no waiting list by the end of the financial year which should result in a further improvement against this.
18. Population of the full Commissioning Strategy Performance Management Framework will be carried out by the Systems Information Officer, once recruited.
Resource Implications (Financial and Employment)
19. Cardiff and the Vale of Glamorgan currently receives £3,646,679 from Welsh Government in terms of Substance Misuse Action Fund grant funding in order to achieve the targets set out by the national Substance Misuse Strategy.
20. The grant recipient for funding is Cardiff City Council, however the funding is for services across the Health Board area (Cardiff and the Vale of Glamorgan).
21. Delivery against targets is reliant on continued funding and support from Welsh Government.
22. Further improvements are expected once two new service packages are commissioned.
23. New service packages will be subject to TUPE implications which should safeguard staff currently in employment should providers change.
24. The new Systems Information Post will be funded from Substance Misuse Action Fund in order to progress further against these targets.
Sustainability and Climate Change Implications
Legal Implications (to Include Human Rights Implications)
Crime and Disorder Implications
27. This report covers substance misuse of individuals. By default, if improvements are made, this should impact positively on Crime and Disorder as linked to Substance Misuse (drugs and alcohol).
Equal Opportunities Implications (to include Welsh Language issues)
28. This would meet the Vale of Glamorgan's Equal Opportunity Policy by eliminating discrimination and promoting equality for all Vale residents.
29. Achievement against the performance framework will work towards the Corporate Community Safety and Wellbeing objectives. 'To make the Vale a safe and healthy place in which individuals, children and families can live their lives to the full.’
30. To work towards the targets of the Welsh Government's Ten Year Strategy on Substance Misuse, 'Working Together To Reduce Harm 2008-2018’.
Policy Framework and Budget
31. This report is a matter for consideration and information.
Consultation (including Ward Member Consultation)
32. This report is not ward specific.
Relevant Scrutiny Committee
33. Housing and Public Protection.
34. Working Together to Reduce Harm - The Substance Misuse Strategy for Wales 2008-2018.
35. Cardiff and Vale of Glamorgan Substance Misuse Area Planning Board Commissioning Strategy 2013/18.
Conrad Eydmann - Head of Substance Misuse Strategy and Development for Cardiff and the Vale of Glamorgan.
Deborah Gibbs - Principal Community Safety Officer
D.R. Thomas - Director of Development Services