Work Streams > Substance Misuse
Opening Doors Project
The Substance Misuse programme is currently focused on a joint
project with the National Treatment Agency for Substance Abuse (NTA).
About the NTA
The NTA is a special health authority, established by the government
in 2001, to increase the availability, capacity and effectiveness
of treatment for drug misuse in England. They do this by providing
advice and support to those responsible for purchasing and providing
treatment services.
Why Opening doors
Improving treatment is central to the Government’s updated
drug strategy. This has been backed up with an unprecedented increase
in central government funding The National Treatment Agency is here
to oversee improvements. But with this increased funding, comes
increased accountability and a need to reform and modernise.
One of the most obvious areas requiring reform is how people can
access treatment and, in particular, how long they need to wait
for that treatment. As with other healthcare services, the objective
is to ensure that clients can access the service they need, when
they need it and where they need it.
As a range of treatment options are useless if you cannot gain
access to them, the NTA has issued maximum acceptable waiting times
targets so that by 2004, people should not have to wait for more
than two weeks to access a community-based prescribing service.
Table 1
National Waiting Times Targets for Specialist Drug Treatment
|
Treatment modality
|
Average baseline waiting time (weeks*)
1999/00
|
Maximum acceptable lengths of wait (weeks*)
|
|
2002/03
|
2003/04
|
|
Inpatient detoxification
|
6.1 weeks
|
4 weeks
|
2 weeks
|
|
Community prescribing - specialist
|
10.2 weeks
|
6 weeks
|
3 weeks
|
|
Community prescribing - GPs
|
5 weeks
|
4 weeks
|
2 weeks
|
|
Structured counselling
|
4 weeks
|
4 weeks
|
2 weeks
|
|
Structured day-care
programme
|
3.3 weeks
|
4 weeks
|
3 weeks
|
|
Residential rehabilitation
|
5.4 weeks
|
4 weeks
|
3 weeks
|
|
* week=5 working days
For services that feel they are already working to capacity, such
targets are likely to be a challenge. However, it is the experience
of the Opening doors programme that, given the right tools and techniques,
there is always room for improvement. It is the role of the Opening
doors programme to provide local DATs and service providers with
support to use these tools and techniques effectively.
What Opening doors involves
Opening doors is aimed at the providers and commissioners of drug
treatment services, drug action team co-ordinators, service users
and carers.Some of the key elements of the programme include:
Involving users: Service users have to be at the
heart of the process. Involving service users at the beginning of
the process is essential and process mapping is a useful tool for
enabling users and carers to become involved. It is impossible to
get a view of a service user’s journey through the treatment
system without actually asking them to describe it.
Working in partnership: People throughout the
drug treatment system need to work together to improve access both
in and out of services. Waiting times and bottlenecks at either
end of the client access delay the appropriate care. These bottlenecks
if unchecked can effect services that currently do not have a waiting
list may well develop them. Sustainable changes and improvements
in services are unlikely if partnerships are not formed.
Being honest: When being asked to explore the
service you offer to clients two things are of paramount importance.
Objectivity and honesty. If a service is examined there will always
be areas for improvement, this can be seen as weakness and a threat
to the service, therefore the most comfortable way of coping is
to do nothing. If honest then the changes can make positive changes
to the service users and to the staff working in the treatment provider.
Passion: The programme has evoked a high level
of passion from those who have undertaken to use the tools and techniques
offered by the service redesign tool.Local change champions, from
various backgrounds, carer, service user and provider emerge with
enthusiasm that becomes infectious.
Update on Progress
For an update on our progress to date, download
a summary of current projects and feedback from those involved.
How to get involved
You can contact members of the national waiting times team, see
left hand panel.
Related web sites
National Treatment Agency for Substance Misuse: www.nta.nhs.uk/
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