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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*)

Maximum acceptable lengths of wait (weeks*)



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

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:

* * See Also * *
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  • 1 Project
  • 14 Local Delivery Stories
  • 2 News Items
  • 3 Publications
  • Contacts
    National Waiting Times Team
    Nicola Woodward
    Joint Programme Lead NTA
    Jackie Ardley
    Joint Programme Lead NIMHE
    Peter McDermott
    Service User Lead
    Alison Kerins
    Programme Coordinator
    Nick Coulter
    Programme Coordinator
    Ruth Kent
    Programme Administrator

    Related Work

  • Access, Booking and Choice
  • Downloads

  • Current Opening Doors Projects
  • Related web sites

  • IIMHL Dual Diagnosis channel
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