Appendix 2 - Terms of reference
SCOTTISH ADVISORY COMMITTEE ON DRUG MISUSE: Integrated Care Project Group - Wraparound Services Working Group
TERMS OF REFERENCE AND PROJECT OUTLINE
Background
1. The Scottish Executive's Review of Drug Treatment and Rehabilitation Services: Summary and Action Plan made several recommendations for improving the quality and consistency of services around Scotland. To begin this process, Scottish Ministers published National Quality Standards for Substance Misuse Services in September 2006 and we are planning to develop an evaluation framework over the next year which will allow services to monitor improvements in their delivery of support. The standards make clear than all the needs of clients accessing substance misuse services should be addressed and that services need to work with a wide range of partners to make sure those needs are met.
2. A comprehensive resource already exists in a series of documents previously published by the Effective Interventions Unit ( EIU). Integrated Care for Drug Misusers: Principles and Practice sets out the evidence base and best practice guidance on service integration, whilst a subsequent series of Integrated Care Pathways Guides provides the beginnings of an operational tool to support the delivery of such principles. The Executive sees adoption of the integrated care pathway approach as an essential element of good practice and a major factor in improving treatment outcomes.
3. The Executive has also launched major policies promoting the integration of service provision which are of great relevance to the long and complicated treatment journeys of many drug misusers. The primary aim of the Joint Future agenda is to improve partnership working, primarily between health and local authorities to deliver services to all community groups. Community Health Partnerships are the main NHS agent through which the Joint Future agenda is delivered, in partnership with local authorities and the voluntary sector. CHPs provide a focus for service integration for local communities, especially between primary care and specialist services and social care.
4. While there have been many developments towards improving integrated care for substance misusers across Scotland, the rate of progress is not as great as anticipated The main aim of this working group would be to build on current practice to make recommendations on how to accelerate that progress.
Remit
5. This project group would aim to:
- summarise arrangements for integrated care of substance misusers across Scotland, including identification of good practice examples;
- review developments in operational practice and methods, such as tools for single shared assessment, since previous work by the EIU;
- identify the main barriers which prevent partnership working in provision of support for substance misusers, with particular emphasis on information sharing; and
- provide practical advice on developing integrated assessment, treatment and support.
Scope and methodology
6. A wealth of evidence and practical guidance already resides in EIU documents and this working group would be expected to build on this material rather than re-examine or repeat any reviews conducted as part of previous work. There will be a need, however, to gather evidence on practical developments since the beginning of 2003. The group may find it useful to adopt a methodology similar to the EIU work, which looked at three components of the integrated care approach: accessibility of services, assessment practice and the planning and delivery of care.
7. The group is expected to produce a report and short summary of their findings for Ministers with clear and practical recommendations on how the barriers to integrated care identified in the course of the work can be overcome and on any future work that may need to be carried out.
Key outputs
8. The group is expected to produce a short report for the Deputy Minister of Justice which includes the following:
- Outlines current practice of integrated care for substance misusers in Scotland, identifying the major barriers to development and including examples of good practice of, for example, planning and assessment.
- Practical recommendations for how service commissioners and service providers can, within existing financial support levels, improve the delivery of integrated care, particularly in relation to sharing of information.
- Recommendations for any future work.