o Improve communications and information flow
between Unity and Mill and service users.
o Improve publicity, and advertise is places where
people are, for example public libraries and
supermarkets. Self-referral to the service should be promoted since some GPs don’t take alcohol issues seriously.
o More information could be provided on the impact of
alcohol on a person’s body. Service users want to find out as much information as they can about alcohol misuse.
o The Substance Misuse Team provides a ‘9 to 5’ service.
This is a barrier to people who need access an alcohol treatment services, including complementary
therapies.
o Alternative arrangements should be made if a therapist
is away, rather than cancelling the service or offering appointments some distance away from home.
o The Service could improve ways of listening to service
users’ experiences.
o The Service could arrange group sessions, or
introduce a ‘feedback group’. One participant
commented, “It’s nice to know the Service is working for someone else too”.
• Complaint about the Substance Misuse Team
o Details remain confidential – though the main issue
arises from a cancelled appointment (by the Unity Mill Team) and subsequent poor communication between the Substance Misuse Team and the service user.
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Table 17 – Listening to Derbyshire Voice
• The Derbyshire Voice service user representative on the
Derbyshire Mental Health Services NHS Trust Substance Misuse (Alcohol and Drugs) Best Practice Group enjoys participating in the meetings, particularly working with people interested in improving services.
• The Derbyshire Voice representative is not involved in the
development of the Agenda for these meetings.
• The Derbyshire Voice representative on the Best Practice
Group may provide information to the Group on plans to further develop services from a personal perspective. He does not have the resources to make detailed or
representative contributions.
• The Derbyshire Voice representative is not invited to training
sessions relating to new initiatives or service developments that other members of the Best Practice Group has access to.
• What works well?
o Being part of a team interested in improving substance
misuse services.
• What could be improved?
o Links between the Best Practice Group and the
strategic direction of the Trust.
o Developing links between the Best Practice Group
service user representative and service users.
o Agenda planning arrangements, involving service
users.
o Participation in Best Practice Group meeting by senior
managers.
o Best Practice Group findings and outcomes, at times,
appear to be compromised by costs and professional views.
o The Best Practice Group should also look elsewhere
for evidence of good practice, rather than starting from scratch.
o Improved recompense for participating in the Best
Practice Group – all other members are salaried Trust staff.
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Table 18
Summary of key issues arising from a Derbyshire Mental Health Services NHS Trust survey of North Derbyshire Community Alcohol Team services (NDCAT), 2005 (26 responses)
Gender
62% male, 31% female, 7% not identified Age
Two service users under 35 years, twenty-one over 35 years, three not identified age
Ease of access to service
92% found it easy to access the NDCAT service Waiting time
58% seen within 10 days, 35% seen between 10 days and one month.
Change of alcohol use?
81% had changed their alcohol use since going to NDCAT Help wanted
The three main areas of need were:
• Talking through problems with a worker • Admission to hospital / detox unit
• Help with mental health problems
Did the client get the help they wanted?
65% got the help they had sought, 23% did not get the help they sought
What other services could be available?
Most respondents wanted support with relapse prevention. Did the client feel involved in their treatment?
69% reported that they did feel involved in their treatment. Were clients involved in writing their care plan?
39% of clients were involved in writing their care plan, whilst 35% were not involved. The Mental Health Trusts comments that these figures may reflect that there are a limited number of treatment options available at NDCAT, which would mean that the number ‘not involved’ would be higher than usual.
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KEY ISSUE 17 – driving recommendation 4
We would welcome more emphasis given to patient involvement in shaping improvements in alcohol treatment services.
We are pleased that Derbyshire Mental Health Services NHS Trust undertakes a survey of service users every two years. Information yielded from the survey gives a good indication of service users and their needs. However, the final report does not isolate service users with alcohol issues, from service users with drugs issues, or drugs and alcohol issues.
This issue was raised in the round table interviews, and by the Swadlincote Alcohol Self Help Group and by Derbyshire Voice. It was also an issue raised at the round table event on 31 October by Commissioners, Service Providers and by service users. In particular, John Stamp, the DAAT Co-ordinator, indicated that if a Pooled Treatment Budget for alcohol services is established, then service user involvement activity will be introduced. Paul Yates, The National Probation Service – Derbyshire, and Chair of the Alcohol Commissioning Group also agreed that the service user involvement would be beneficial.
The NDAAS Team also identified patient involvement as an area for improvement.
KEY ISSUE 18 – driving recommendation 2
Service users also identified opportunities for alcohol treatment services providers to signpost, in some way, service users towards learning, development and employment opportunities. Interventions may be around lifestyle issues, or personal
development, such as assertiveness or confidence building. At the round table event on 31 October, Rachel Boulton, DAAT Commissioning Manager, commented that it is important to help people into employment and education, including people coming out of prison, and that this is an area for further development. Mary Johnson, Hepatology Team at Derby City Hospital, and Steve Miller, North Derbyshire Community Alcohol Team and Maggie Mousley, Substance Misuse Team all concurred with the benefits of supporting service users into education and employment.
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We don’t feel that these services should be provided directly by Tier 2 and Tier 3 service providers, but rather that networks with appropriate providers are established and maintained.