Planning and Provision of Drug Misuse Services

Drug Misuse Performance Indicators for Local Consideration and Development

Polkinghorne suggested a choice of performance indicators which might assist DATs and those responsible for ensuring the provision of drug misuse services to evaluate their progress in tackling drug misuse and supporting the implementation of national policy.
These suggestions are replicated below. Polkinghorne considered that those marked *
are the most appropriate for initial consideration.

Whilst the choice of local indicators is very much for local consideration, they should reflect the national objectives and priorities (AppendixA) as well as local service needs and priorities.

Items for Measurement

Outreach (4.2)

1. Numbers of new clients contacted in a 4week period (ie not seen by any other service during last 3months)

2. Numbers of clients remaining in contact with worker longer than 3months.

3. Number of clients referred per month to other services for help with drug misuse problems.

*4. Cost per new client contacted.

GPs (4.7)

1. Percentage of specialist service clientele registered with a GP.

2. Percentage of participating GPs with clear guidelines for "shared care" including
well-defined liaison arrangements.

*3. Percentage of GPs prepared to take/undertaking "shared care" responsibility.

*4. Percentage of specialist drug service clients cared for in general practice.

5. Costs per GP-managed client.

Pharmacies (4.8)

1. Percentage of pharmacies participating in:

needle-exchange;

supervised consumption;

offering advice.

2. Numbers of exchange packs given out per month.

3. Numbers of needles/syringes sold to drug misusers per month.

4. Numbers of individuals using the service (by gender).

*5. Number of pharmacies prepared to provide facilities for return of used equipment.

*6. Return rates of used equipment.

*7. Costs per pack distributed.

Hepatitis B (5.3)

*1. Percentage of clients offered vaccination.

*2. Percentage of clients reporting completed vaccination.

Syringe exchange schemes (5.3)

*1. Percentage of injectors who report sharing injecting equipment in previous 4weeks.

2. Numbers of new attenders (not used a scheme in past 3months) per month.

3. Numbers of exchange packs given out per month per client.

4. Numbers of individuals using the service by gender.

*5. Return rates of used equipment.

6. Numbers moving on to engage in treatment.

7. Percentage of staff trained in giving basic health checks. [Will not be required if following The Scottish Office Department of Health model specification]

*8. Costs per registered client month.

Counselling (5.4)

1. Percentage of people working in drug services with accredited counselling qualifications or equivalent professional qualification.

*2. Percentage of clients receiving counselling who report improvements in one or more of the following outcomes:-

drug use;

physical and psychological health;

social functioning and life context.

*3. Cost per completed counselling course.

Detoxification (5.5)

1. Numbers of clients entering detoxification programmes.

*2. Percentage of patients (by main drug use) who complete detoxification.

3. Percentage who attend follow up treatment.

4. Percentage of completers who remain drug free after

3 months;

6 months;

1 year.

Related to main drug of use, location and type of detoxification programme applied.

*5. Costs of detoxification per client completing.

Methadone reduction (5.6)

1. Numbers of clients entering reduction programmes

*2. Percentage who become drug free by:

3 months;

6 months;

1 year.

3. Percentage of clients in treatment who report improvements in one or more of the
following outcomes:-

drug use;

physical and psychological health;

social functioning and life context.

4. Number using other support eg Narcotics Anonymous or other self help group after
treatment completion.

*5. Cost of methadone reduction per client completing.

Methadone maintenance (5.7)

*1. Numbers of clients:

- taken into maintenance programme

- retained at one year

- Average duration of retention.

2. Percentage of clients who report improvements in one or more of the three broad
outcome domains defined by Task Force.

3. Percentage of clients whose urine tests positive for other opiates.

*4. Cost per client per year.

Residential rehabilitation (5.9)

1. Percentage assessed within a defined period.

2. Percentage gaining admission within a defined period.

*3. Percentage remaining in treatment after 4weeks (by main drug of use,
eg cocaine).

4. Percentage successfully completing programme (by type of programme and length)

5. Percentage of clients who report improvements in one or more of the following outcomes:-

drug use;

physical and psychological health;

social functioning and life context.

*6. Cost per completed programme.

Inpatient detoxification (5.10)

*1. Percentage successfully completing inpatient detoxification (by main
drug of use).

2. Percentage of clients who report improvements in one or more of the following outcomes:-

drug use;

physical and psychological health;

social functioning and life context.

*3. Costs of inpatient detoxification per client (by main drug of use).

Interface between purchasers and providers (6)

*1. Quality standards in contracts for:

- assessment of need (ie number of days from first contact to date
of appointment).

- access to treatment within prescribed timescale.

Training (6.6)

*1. Numbers of drug service managers who have received training in
management skills.