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Probation

Circular

EFFECTIVE MANAGEMENT OF THE


REFERENCE NO:
DRUG REHABILITATION REQUIREMENT PC57/2005
(DRR) AND ALCOHOL TREATMENT
ISSUE DATE:
REQUIREMENT (ATR) 1 August 2005

PURPOSE IMPLEMENTATION DATE:


To provide areas with guidance on delivering the Drug Rehabilitation
Immediate
Requirement (DRR) and Alcohol Treatment Requirement (ATR).

EXPIRY DATE:
ACTION
Chief Officers and Assistant Chief Officers are asked to ensure that this circular June 2006
is drawn to the attention of all relevant staff, in particular SPOs, offender
managers and interventions staff who work with substance misusers. TO:
Chairs of Probation Boards
SUMMARY Chief Officers of Probation
The community order of the Criminal Justice Act 2003 is available to courts for Secretaries of Probation Boards
adult offenders who have been convicted of offences committed on or after 4th ACOs - Substance Misuse
April 2005. The Act provides a more flexible sentencing structure, which
enables the court to order a number of different requirements under the CC:
community order to provide an overall programme of interventions. The
Board Treasurers
attached documents provide guidance to staff on how to take forward the
Regional Managers
management and delivery of two of these requirements, DRRs and ATRs. It is
not expected that staff will read the entire documents but rather to use them as DTTO/DRR SPOs/Managers
reference guides to assist with specific problems.
AUTHORISED BY:
The guidance is issued jointly by the Intensive Interventions Team and the Sarah Mann, Head of
Criminal Justice Act Implementation Team within NPD and should be read in Interventions Unit
conjunction with a complementary circular on managing intensive community Richard Mason, Head of Criminal
orders, which is being issued simultaneously (PC56/2005 - Delivering Intensive Justice Act Implementation Unit
Community Orders Under the Criminal Justice Ac 2003).
ATTACHED:
RELEVANT PREVIOUS PROBATION CIRCULARS Annex A: DRR guidance
PC 18/2005 PC 55/2004 PC 49/2004 Annex B: ATR guidance
PC 15/2005 PC 52/2004 PC 41/2004
PC 56/2004 PC 51/2004

CONTACT FOR ENQUIRIES


Drug and Alcohol Interventions Manager: Fiona Bauermeister, 020 7217 0768
fiona.bauermeister@homeoffice.gsi.gov.uk (for DRR enquiries)
Drug and Alcohol Policy Developer: Robert Stanbury, 020 7217 0767
robert.stanbury@homeoffice.gsi.gov.uk (for ATR enquiries)
Head of Intensive Interventions: Claire Wiggins, 020 7217 8646
claire.wiggins3@homeoffice.gsi.gov.uk

National Probation Directorate 1


Horseferry House, Dean Ryle Street, London, SW1P 2AW
Meeting the Targets: Effective
Management of Community
Orders with a Drug Rehabilitation
Requirement (DRR)
Index

Page

4. Introduction

4. DRR Target Group

5. Assessments in the Community

6. Assessments in Custody

6. Prolific and other Priority Offenders (PPOs)

7. Drug Interventions Programme (DIP) and Criminal Justice


Integrated Teams (CJITs)

8. Restriction on Bail

8. Communication with the local CJIT

8. Drug Interventions Record (DIR)

9. Pre- sentence reports (PSRs) and Sentencing

13. Proposals for a Community Order with a DRR

13. Date of Offence: Pre or Post Criminal Justice Act 2003

13. Use of unpaid work requirement

14. Accredited Substance Misuse Programmes (ASRO and


OSAP)

14. Treatment under a DRR

15. Residential Rehabilitation Treatment

15. Contact Levels

16. Recording levels of contact

16. Home visit

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16. Enforcement

17. Breach

18. Transfer of DTTOs/ Community Orders with a DRR

18. Funding a Community Order which includes a DRR

19. Provisions for 16-17 year olds

19. Court Reviews

21. Drug Testing

24. Steering Groups/Forums

24. Useful Reference Material

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Introduction
This document aims to support managers and practitioners who are involved in the
delivery of community orders with a drug rehabilitation requirement (DRR). It applies
predominately to offenders who are aged 18 years and over, although there is a short
section on arrangements for 16/17 year olds. The guidance has been subject to wide
consultation and we are grateful for the feedback received. Particular thanks is due to
representatives from the Drug Interventions Programme (DIP), the Prison Service,
National Probation Directorate (NPD) and National Treatment Agency (NTA)
Regional Managers, representatives from probation areas, the Criminal Justice
Implementation Unit at NPD and the NTA Criminal Justice Manager.

DRR Target Group


The target group for the DRR is broader than for the Drug Treatment and Testing
Order (DTTO), as it encompasses all the community sentencing bands from low to
high seriousness. The DRR should capture many of the current drug users on
Community Rehabilitation Orders (CROs), with or without a condition to attend a
substance misuse accredited programme, and those subject to Drug Abstinence
Orders (DAOs) and Drug Abstinence Requirements (DARs) in the pilot areas, in
addition to those on DTTOs of higher or lower intensity.

Offenders with an Offender Assessment System (OASys) score of 4 and above on


the drug assessment section should be referred for a DRR assessment (such a score
generally indicates that they are currently using a class A drug on at least a weekly
basis). It should be noted, however, that a score of 4+ is only one method of
selection. Those offenders with a score below 4 could also be suitable, as could
those already accessing treatment through the Drug Interventions Programme (DIP)
or another treatment provider.

The amount of drug treatment delivered under a DRR can be tailored to individual
treatment needs, providing the overall restriction on liberty reflects the seriousness of
the offence.

The community order, including the DRR, can be packaged so as to give an


equivalent of the DTTO (higher or lower intensity) at the medium and high
seriousness community sentencing bands.

The DRR can also be used in the low seriousness community sentencing band,
where it should generally be proposed as a stand alone requirement, usually of no
more than 6 months duration (the minimum period). An offender manager will need
to be allocated to manage the order, including enforcement work.

The content and duration of the total community order, including the treatment
proposed under the DRR, should be commensurate with the seriousness of the
offence, even if treatment needs are high.

A minimum length DRR should be proposed in cases of low offence seriousness but
high drug treatment need. The treatment provider and/or offender manager should
work towards motivating the offender to continue treatment on a voluntary basis on
completion of the short DRR.

Offender managers should work to gain offender consent to a DRR. They should
proactively promote DRRs to offenders.

Lack of offender motivation should not be a reason for failing to propose a DRR.
Unless an offender makes it very clear that they will not comply, a DRR should be

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proposed if the other criteria are met (sentencing band, level of drug use etc) and
there are no other factors e.g. mental health of sufficient seriousness that would
preclude the offender’s suitability.

Assessments in the Community


The offender should be made aware of the purpose of the assessment, the
assessment process and the specific roles of those undertaking the assessment at
the outset.

The DTTO/DRR requirements should be clearly explained to offenders by probation


staff so they fully understand what will be expected of them and the possible
sanctions if they fail to comply. Suggested guidance is that this is done at the outset
of the assessment and also reiterated to the offender by the offender manager after
sentence.

Offenders assessed as suitable for a DRR/DTTO need to sign prior to sentence that
they consent to the requirement/order. Suggested good practice would be for this to
be done at the end of the assessment process.

Joint assessments (where probation and treatment staff conduct the assessment at
the same time) can be good practice but are not essential., Where assessments are
not jointly conducted, areas must be sure that treatment and probation staff are
working to the same criteria regarding suitability and that they liaise regarding the
outcome of the assessment. This is particularly important under the new legislation,
as the criteria for those suitable for a DRR are wider than for a DTTO. If they have
not already done so, areas should make their providers aware at the earliest
opportunity of this widening of the criteria.

In the unlikely event that there is disagreement between probation and treatment
staff regarding the suitability of an offender for a DRR, the matter should be raised
with respective line managers.

Many of the current assessment processes will remain the same, although areas
should plan to deliver a higher number of assessments given the wider suitability
criteria and the higher target (13,000 commencements in 2004/5 and 16,000
commencements for 2005/6).

If a DRR is going to include substitute prescribing the offender should be assessed


by the relevant clinical personnel as to his/her suitability for such treatment. This
clinical assessment is generally in addition to the usual probation/treatment provider
assessment. There are times when it is difficult to arrange a clinical assessment prior
to sentencing. In such cases, it is good practice for the Pre-Sentence Report (PSR)
author to state that the person responsible for prescribing is agreeable to the DRR
being made without prior assessment as to the suitability of the offender for
substitute medication, in order to ensure that the court is aware of this.

Issues around dual diagnosis (i.e. both enduring mental health and drug problems
present) need to be addressed at the assessment stage. As much information as
possible should be obtained about an offender’s mental health (if this appears to be
an issue) e.g. contact with relevant mental health professionals, access to psychiatric
reports etc., in order to fully assess if a DRR is a suitable requirement.

Offenders not assessed as suitable for any of the drug treatment modalities under a
DRR (see ‘treatment’ section of this guidance) or who decline consent to a DRR
should be considered for alternatives, which might include a supervision requirement

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or a supervision requirement plus a programme requirement. It should be made very
clear to offenders who are not prepared to consent that any requirement(s) imposed
instead of a DRR are likely to be as restrictive and equally punitive.

A DRR can also be a requirement of a suspended sentence order (custody minus)


for offences committed on or after 04/04/05. Requirements as part of a suspended
sentence should be less intensive given the more serious sanction for non-
compliance.

Assessments in Custody
Areas need to ensure they have some flexibility to be able to offer assessments in
custody.

Treatment provided in prison should be taken into account as part of a DRR


assessment. A large number of this particular offender group will have been in
contact with CARAT teams and other prison drug treatment. Assessments, clinical
services and CARATs casework may have already taken place: some of those on
remand will have accessed the Short Duration Programme (SDP).

CARATs are in a prime position to motivate offenders to take up treatment and can
help to promote DRRs as a sentencing option. It is therefore important that (with
offender consent) information is shared between CARAT workers and DRR
assessors.

It is good practice to establish good working relations with CARAT teams in prison
and develop mutually agreed protocols regarding sharing information on those
offenders with whom CARATs have had contact. For example, CARATs could (with
offender consent) flag up potential DRRs that have been assessed by CARATs so
probation staff could track these offenders. Initial contact is best affected through the
Area Drug Co-ordinator (ADC) who can ensure consistency of approach.

CARAT workers also need to be made aware of the “widening” of the criteria for
DRRs to enable them to discuss DRRs at the earliest opportunity with all potential
offenders.

Prolific and other Priority Offenders (PPOs)


A high proportion of those identified as PPOs, particularly in the highest crime areas,
are problematic drug users committing volume acquisitive crime to support a drug
dependency. As such, many offenders who are PPOs will be eligible for and/or
subject to a DRR (even those in the low seriousness community sentencing band).

Areas need to ensure that all PPOs with a drug problem are assessed for a DRR.
Areas (particularly those which have a designated PPO team) should look at the
early identification and management of these cases in relation to DRRs.

PPOs in custody will have been treated as priority for CARATs and other non-clinical
drug treatment. It is therefore important that the relevant links are made with
CARATs (as outlined above in ‘Assessments in Custody’).

This early identification of a PPO with a substance misuse problem could mean that
an assessment for a DRR could be carried out earlier in the PSR process.

This does not apply to PPOs on licence, as a DRR cannot be a condition of a licence.

It should be noted that drug testing as part of a DRR is separate from arrangements

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for and guidance on testing PPOs on licence (see PC 34/2005).

Drug Interventions Programme (DIP) and Criminal Justice Integrated Teams


(CJITs)
The Drug Interventions Programme (DIP) (which was formerly known as the Criminal
Justice Interventions Programme or CJIP) is a large-scale programme, established in
April 2003 as a critical part of the Government’s Updated Drug Strategy (2002). Its
principal focus is to reduce drug related crime by engaging with problematic drug
users and, using a case management approach, moving them into appropriate
treatment, retaining them in treatment and supporting them through and after
treatment, whether in a custodial or community setting.

Interventions such as drug testing on charge for trigger offences and drug workers
being based in police custody suites means that increasingly drug related offending
will be identified pre-sentence through assessments undertaken by Criminal Justice
Integrated Teams (CJITs) in custody suites and/or courts.

Areas need to discuss effective working protocols with local CJITs relevant to the
particular way in which DRRs/DTTOs are managed in their locality. Areas have
different approaches to working with CJITs and these are at different stages of
development around the country. Some probation areas are more engaged with
CJITs than others. In some areas Probation Officers are part of the CJIT e.g. they
have been seconded to work as a member of the team.

It is important to note that interventions delivered by CJITs through the Drug


Interventions Programme (DIP) are an important route into a DRR and that they
are not competing interventions.

Where an existing CJIT client appears to be a suitable candidate for a DRR (if a
community order with a DRR is going to be proposed at court for an existing CJIT
client), the CJIT can continue to case manage the offender and help prepare him/her
for a DRR e.g. begin rapid prescribing or undertake motivational work to reduce the
risk of the offender dropping out of treatment whilst waiting to be sentenced. This is a
crucial time and the quicker an offender can be engaged in some form of treatment
before the DRR is imposed the better, as it may result in more offenders being
reluctant to give consent to a DRR.

There may be instances where offenders are reluctant to consent to a DTTO/DRR.


For example, offenders who have been participating in substitute prescribing or other
voluntary community treatment prior to sentence may fear that a DRR will result in
more intensive treatment and more frequent drug testing. In the main, such offenders
should be suitable for a DRR and staff should work with them to gain their consent to
the DRR. Their treatment should be taken over by the DRR treatment provider(s)
once the community order has been made. Probation should manage this ”handover”
of treatment as part of the planning and implementation of the order.

Probation will take over responsibility for case (offender) management from the CJIT
at the point the DRR is made and the offender’s treatment will be taken over by the
relevant contracted DRR treatment provider(s). With the consent of the offender,
CJITs will also pass relevant paperwork to the offender manager.

Where an offender is on the CJIT caseload, the CJIT will usually suspend the case
during the period that the Probation Service is responsible for offender management.
Probation will subsequently liaise with the CJIT when the offender is coming to the
end of the DRR and they still have ongoing drug related needs or in the event of an

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unplanned exit from treatment.

It is suggested good practice that the CJIT is contacted if an offender is transferred to


another probation area or leaves residential treatment (either planned or unplanned)
in order for the CJIT to identify what action they need to take.

Drug related crime should be dealt with by drug related punishment (DRR). The
focus of the DRR is treatment but it is still within a criminal justice framework and the
more intensive treatment and testing practices reflect this.

Restriction on Bail
Probation need to ensure they work with CJITs in the Restriction on Bail pilots in
identifying suitable DRR candidates and developing effective referral processes for
DRRs.

Offenders subject to Restriction on Bail should be particularly targeted for DRRs.


Compliance with restriction on bail conditions can also assist in identifying potential
DRR candidates and working on their motivation.

Under the restriction on bail provisions, in certain cases, where a defendant has
tested positive for heroin, crack or cocaine the court, if it grants bail, has a duty to
impose as a condition of bail that the person undergoes an assessment of their drug
misuse and/or participates in any relevant follow up proposed.

Communication with the local CJIT


Irrespective of the working arrangements which are established in the locality, it is
crucial that, at a minimum, areas establish lines of communication with the CJIT
regarding:-

• Where an offender appears to be a suitable candidate for a DRR, CJIT


workers should take every opportunity to raise awareness about the DRR and
encouraging offenders to give consent for the workers to share information
with probation in order to facilitate early identification of potential DRR cases.

• Information sharing protocols between CJITs and probation.

• Arrangements for DRR exit plans (planned or unplanned). With regard to


continuity of care, CJITs could, where appropriate, work with offenders who
still need treatment after the DRR finishes and those who leave treatment.

• The "widening" of the criteria for DRRs under the Criminal Justice Act 2003
(CJA 2003) and ensuring that CJIT/DIP workers are discussing DRRs at the
earliest opportunity with potential suitable offenders.

Drug Interventions Record (DIR)


The DIR has three main roles. These are to:-

• Facilitate and improve standards of continuity of care for drug users and
minimise duplication of assessments, especially when they are moving
between custody and community but also when information is passed
between case managers and/or treatment providers.

• Support the monitoring and research functions around DIP in line with the
Programme’s, and other related, performance management frameworks.

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• Be the Substance Misuse Triage Assessment form to be used by all CARATS
cases, whether or not they are likely to become DIP cases.

The DIR is now in use in all DAT areas in England and all prison establishments
across England (it is expected to have phased introduction within the community in
Wales during 2005/06).

Most Probation staff will not complete any of the DIR. The main exception to this will
be where a Probation Officer is a member of the CJIT. Pre-sentence the DIR will
usually be started by CJIT staff (e.g. in police custody suites or court) in the
community. A CARAT worker (where contact has been made in custody) will start the
DIR pre-sentence if an offender on remand in custody has not been seen by a CJIT
worker.

Arrangements set out in related guidance (DIR Context Guidance) highlight when the
DIR is shared between CJITs and CARAT workers to inform what action is needed
when the offender is remanded or sentenced to custody.

The CJIT will usually suspend the case of an offender already on the CJIT caseload
at the time the DRR is made during the period that probation are responsible for case
management. Probation staff will subsequently liaise with the CJIT when the
offender comes to the end of the DRR if there are ongoing drug related needs. CJITs
have been advised how case suspension is recorded using the DIR and the related
activity form.

Probation staff can be assisted in identifying those offenders who may be suitable for
a DRR through the CJIT assessment and use of the DIR. With the offender’s
consent, the DIR can be passed to probation to inform the DRR assessment.

Pre-sentence reports (PSRs) and Sentencing


Generally, those offenders with a high offence seriousness would have a full PSR
prepared (exceptions to this are outlined in the “Criminal Justice Act 2003 -New
Sentences and the New Report Framework” - Annex A to PC 18/2005).

A fast delivery report could be prepared in those cases where the offence is in the
low seriousness band (and full risk analysis is not required) or medium cases where
the Offender Group Reconviction Scale (OGRS) score is less than 41 and the risk of
harm screening does not indicate that a full risk analysis is required. It is suggested
that staff managing the Restriction on Bail Scheme should be contacted for relevant
information about the offender where he/she is subject to Restrictions on Bail.

It may be possible to have an assessment for a DRR available quickly if an offender


is already in treatment with a local treatment provider and/or Probation are seconded
into the local CJIT team, in order to be able to make a proposal for a DRR in the fast
delivery report.

It may be more likely, however, that a fast delivery report has been requested for
example on a low seriousness offence and it is clear that a DRR is/may be
appropriate but the assessment is not able to be completed within the five day
guidance limit for preparing fast delivery reports. In this case, the fast delivery report
could request an adjournment in order to have a DRR assessment. An addendum
could be prepared with the outcome of the assessment (avoiding the preparation of a
full PSR).

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In order to assist fast delivery report writers in quickly identifying potential DRRs, it
may be useful to complete the drug assessment section of OASys. Any offender with
a score 4 and above should be assessed for a DRR. This is irrespective of what type
of report is prepared.

A full PSR will normally need to be prepared in those cases where a mental health
issue has been identified.

The report should include:

• A statement that the offender has been assessed as being dependent on or


having a propensity to misuse drugs and the offender’s dependency or propensity
is such as requires and may be susceptible to treatment.

• A proposed plan of treatment

• The name and address of the treatment provider and whether the treatment is
residential or non- residential (this information needs to be specified in the order).

• Confirmation that arrangements for this treatment are in place.

• The suggested length of the requirement bearing in mind the seriousness of the
offence and treatment needs (this should be decided in conjunction with the
treatment provider).

• That the offender has signed to confirm that the requirements of the order and the
consequences of a failure to comply have been fully explained by the responsible
officer and that the offender is willing to comply with the order and consents to the
order being made.

• Date of the proposed first court review (this should be in accordance with
National Standards for court reviews).

• A proposal for the minimum frequency of drug testing (low seriousness DRRs
only need to be tested a minimum of once a week)

• The date of the first appointment with the treatment provider (which, as for the
DTTO, should be arranged to take place within two working days of the order
being imposed) and the date of the first appointment with the offender manager
(within one working day).

• Any anticipated sequencing with other requirements of the order.

• Sufficient information about the offender’s pattern of drug use to ensure that the
appropriate length of DRR is made e.g. nature of drug misuse, extent and length
of use, previous treatment episodes.

Areas differ in the amount of information there is in a PSR regarding “specific drug
assessment” (some include a more thorough drug assessment). This is more
relevant now given that the court determines the initial level of offence seriousness
but probation staff propose the length of the DRR depending on the offender’s
treatment needs.

Previously a DTTO was a sentence in its own right and an offender was therefore

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either suitable or not for a DTTO and a proposal was made in the PSR depending on
the outcome of the assessment. Under the CJA 2003, the DRR is only one of a
number of requirements of a community order. It is important therefore that PSR
authors agree any other requirements that they are considering proposing with those
probation staff managing DRRs.

Similarly, it would be good practice for DRR staff to liaise with treatment providers
regarding any additional requirements that are being considered, especially the
inclusion or otherwise of a substance misuse accredited programme.

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Model combination of requirements as outlined in CJA 2003 ‘National
Implementation Guide’ adapted to reflect model requirements in cases where a
community order with a DRR is appropriate

Low seriousness Short DRR (6 months). No additional requirements.


Model 6
Likelihood of reconviction: low-medium A 6 month DRR would be appropriate for either low,
Risk of harm: low-medium medium or high treatment need, as any longer DRR
Maximum nos. of requirements: 1 would not be commensurate with the offence.
Levels of contact: One contact per week (no Offenders with medium or high treatment needs but
minimum hours specified) during first 16 weeks. low offence seriousness should be encouraged to
continue treatment voluntarily (possibly through the
CJIT or other relevant treatment provider) after the 6
month DRR has ended.

Medium seriousness Supervision + DRR + accredited programme (or


Model 8 residence or activity).
Likelihood of reconviction: medium-high
Risk of harm: low-medium Example depending on treatment need:-
Maximum nos. of requirements: 3 Low treatment need- 6 month DRR,
Levels of contact: Minimum 8 hours per week 12-18 month supervision, ASRO/OSAP or Think
during first 16 weeks (for total requirements not just First/ETS (or possibly activity).
DRR).
Medium treatment need- 6-12 month DRR,
12-18 month supervision, ASRO/OSAP.

High treatment need- 9-12 month DRR,


12-18 month supervision, ASRO/OSAP.

High seriousness Supervision + DRR + (any of the following


Model 10 requirements, if appropriate – unpaid work (use
Likelihood of reconviction: high infrequently), programme, activity, residence,
Risk of harm: low-high prohibited activity, exclusion, curfew).
Nos. of requirements: 2+
Levels of contact: minimum 15 hours per week Examples depending on treatment need:-
during the first 16 weeks (for total requirements not Low treatment need- 6 month DRR, 12 month
just DRR). supervision, ASRO/OSAP or Think First/ETS,
activity.

Med treatment need- 9-12 month DRR, 12-36


months supervision, ASRO/OSAP, activity.

High treatment need- 12-36 months DRR, 12-36


months supervision, ASRO/OSAP, activity.

High seriousness / intensive control Supervision + DRR + programme + activity (and any
Model 12 of the following requirements if appropriate – unpaid
Likelihood of reconviction: high work (use infrequently), mental health treatment,
Risk of harm: low-high residence, prohibited activity, exclusion, curfew)
Nos. of requirements: 3+
Levels of contact: minimum 15 hours per week This is likely to be similar to the package suggested
during the first 16 weeks (for total requirements not in "High seriousness" see above.
just DRR).

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Proposals for a Community Order with a DRR
The equivalent of a high intensity DTTO would include four requirements:
supervision, DRR, programme and activity.

Proposals for DRRs in the medium-high seriousness band should be accompanied


by a proposal for a supervision requirement.

A supervision requirement is not always necessary in the low seriousness band,


where the proposal should normally be for a singleton DRR. In these cases,
however, an offender manager will need to be appointed in order to manage
enforcement, liaison with treatment providers etc.

The length of the requirements should vary depending on the needs, risk, and
seriousness of offence. For example, a shorter length DRR, but possibly a higher
punishment and/or other rehabilitation requirement, could be proposed for an
offender with a high seriousness of offence but a low-medium treatment need.
Alternatively, a longer DRR requirement with shorter other requirements could be
proposed for an offender with a medium seriousness of offence but a high treatment
need. An offender with a high treatment need but low seriousness of offence should
have a short DRR proposed but be encouraged to remain in treatment on a voluntary
basis at the end of the DRR where there is a continuing treatment need.

Whilst the length of treatment under a DRR should be matched to individual need,
the total length of all the requirements of the community order i.e. the restriction of
liberty has to be commensurate with the seriousness of the offence(s).

The requirements proposed by a PSR author should be based on offence


seriousness, any stated purpose of the sentence e.g. punishment or rehabilitation,
the needs of the offender and the risk of reoffending/harm, taking into account the
views of the treatment assessor and all other relevant information/assessments.

Treatment under a DRR has to be arranged to start within two working days of the
order being made. Any additional requirements should usually be worked alongside
the DRR. Requirements other than the supervision requirement can be sequenced to
start after the DRR (or at some point during the DRR).If it is considered, however,
that to start them in conjunction would either hinder treatment under the DRR or the
offender needs to be stabilised before being able to realistically comply with the other
requirements, the requirements should be appropriately sequenced.

The court should be made aware in the PSR of all cases where sequencing is likely
and it should also be stated in the Sentence Plan.

Date of Offence: Pre or Post Criminal Justice Act 2003


If an offender is being sentenced for a number of offences which were committed
either side of 04/04/05 the PSR should invite sentencers to sentence on the most
serious offence (even if this was committed prior to 04/04/05 and could subsequently
result in a DTTO being imposed). If the offences are of equal seriousness the courts
should be invited to sentence on the offence(s) that were committed on or after
04/04/05.

Use of unpaid work requirement


It is unlikely that an unpaid work requirement will be proposed in conjunction with a
DRR. There may, however, be some cases where unpaid work may be appropriate
but these will probably be limited to those offenders with low treatment needs and a
high seriousness of offence. Each case needs to be looked at individually and should

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be balanced against the offender’s level of treatment intervention and an assessment
as to his/her realistic capacity to comply with an unpaid work requirement.

Accredited Substance Misuse Programmes (ASRO and OSAP)


ASRO/OSAP tackle a range of thinking and social skills but are unlikely to be
sufficient on their own to tackle the wide range of needs of drug misusing offenders.
In view of this, a community order plus an accredited substance misuse programme
(ASRO or OSAP) without a DRR should be proposed in relatively limited
circumstances.

ASRO/OSAP should generally be proposed in the medium to higher sentencing


bands alongside a DRR.

A separate programme requirement must be specified in the community order where


an accredited programme is to be delivered with a DRR. This includes where the
accredited programme is to be delivered as an integral part of the structured day care
programme.

Most of the programme requirements used alongside a DRR will be substance


misuse programmes (e.g. ASRO, OSAP). General accredited offending behaviour
programmes (e.g. ETS, Think First etc) will need to be used in those areas that do
not have access to an accredited substance misuse programme.

The supervision requirement, where applicable, needs to be long enough to


accommodate the completion of any accredited programme requirement or any other
requirement of the order.

Alongside ASRO and OSAP, there is also PRISM, which is an accredited programme
delivered on an individual basis. It has not been rolled out nationally.

Treatment under a DRR


Treatment delivered under a DRR should be structured treatment as outlined under
NTA Models of Care.

This should include one or more of the following:-

• Structured day care


• Care planning
• Substitute prescribing and detoxification (residential or community based)
• Residential rehabilitation

It is anticipated that many DRRs will consist of the same treatment packages as are
currently delivered under a DTTO.

Areas may want to consider reviewing the current treatment they commission from
external drug agencies to reflect the new National Standards and CJA 2003. For
example, areas might consider commissioning either a low, medium and high
intensity treatment intervention to reflect different sentencing bands or alternatively
two levels of treatment intensity. This is with particular reference to structured day
care provision and care planning i.e. areas may not need the high number of
treatment hours per person as they did under a DTTO.

It is anticipated that more DRRs should be made but some will be for fewer minimum
treatment hours than under a DTTO.

14
It is the total number of hours of all the requirements of the community order which
must total the minimum hours required by National Standards not just the "treatment"
time under the DRR.

Residential Rehabilitation Treatment


Generally, DRRs with residential treatment as the main treatment
modality/intervention would fall within the high seriousness of offence sentencing
band given the restriction of liberty residential rehabilitation involves.

It may be appropriate to propose a minimum length DRR in cases when offenders


have a low seriousness of offence but a high treatment need and they themselves
wish (and could possibly already be in the process of applying) to access residential
treatment. Areas may wish to draw the court’s attention to the fact that the
"punishment" was more restrictive and not commensurate with the original offence if
the offender subsequently breaches the DRR e.g. unplanned exit from the rehab
facility.

Where an offender moves to another area for residential treatment, it is the area
where the treatment takes place that holds the order. These cases cannot be
supervised temporarily and the order must be formally transferred to the area where
the offender is residing (see PC 52/2004 for more guidance on case transfers).

Contact Levels
Under the revised National Standards, levels of contact are dependant upon the
community sentencing band (high, medium, low) and also the particular case
management tier the offender falls into. The contact levels outlined below are the
total contact required across all the requirements of the community order (not just the
DRR requirement).

Community Sentence First contact Minimum level of After 16 weeks


Band contact during first
16 weeks
Low DRRs must be One contact per Contact levels thereafter
Offence Seriousness seen within one week (no minimum shall be defined by the
working day of hours specified) offender manager following
sentence by an OASys review (see
probation and below)
treatment must
start within two
working days of
sentence.

Medium As above Minimum 8 hours per Same as above


Offence Seriousness week

High As above Minimum 15 hours Same as above


Offence Seriousness per week

15
National Standards state that offenders in tiers 2, 3 and 4 must be seen weekly by
the offender manager during the first 16 weeks unless other weekly requirement
contacts have been arranged. Thereafter, contact must not fall below once every four
weeks (with offender manager or other designated contact). The offender manager
must have at least two contacts during the whole order in tier one cases in addition to
any requirement contacts. These are minimum levels of contact and it is expected
that under the DRR (together with other requirements) the contact levels will be
significantly higher depending on the sentencing band and case management tier.

Whilst most of the required contact hours may be met by the treatment provider
(depending on local treatment delivery arrangements), offender managers should
assess what level of contact they personally have with the offenders (there may be
locally agreed guidance on this). This contact needs to be sufficient to manage risk,
enforce the Order, monitor the offender’s progress and to prepare the court review
reports.

Offender managers also have a role in working to increase and maintain offender
motivation and in increasing retention. Levels of offender manager contact with
offenders should reflect these aims and be detailed in case management recording
systems

National Standards do not give guidance about the levels of contact after the first 16
weeks of the order but leave it to the offender manager based on an OASys review.
Given that the DRR is about treatment, contact levels (with both offender manager
and the treatment provider) on the DRR after 16 weeks should be based on
offenders’ treatment need. Contact with the offender manager should be based on a
wider range of factors, including other requirements of the community order, risk of
reoffending and risk of harm. National Standards are minimum reporting
requirements and contact under a DRR is likely to be in excess of the minimum.

Anything that is to be counted as a "contact" needs to be in the sentence plan and


have an audit trail (i.e. can be checked). Collecting substitute medication and testing
can both be counted, as can travel if offenders have to travel over half an hour (each
way).

Additional factors, such as offenders living in rural areas who have to travel many
hours to get to a treatment delivery centre, should be considered on an individual
basis and a decision made locally regarding how many travelling hours can be
counted towards contact time.

Recording levels of contact


It is crucial that the offender manager records all contacts (arranged and achieved)
properly across all the requirements of the order. Performance against the contact
requirement for DTTOs has been unacceptably low and evidence suggests that this
has been due, at least partly, to poor recording of the total number of hours in
integrated case management systems.

Home visit
A home visit must be undertaken by the offender manager within 10 working days of
the order being made in tier 3 and 4 cases if the risk of harm posed by the offender is
identified as high or very high. This should be subject to local guidance on health and
safety/risk and home visiting.

Enforcement
National Standards for enforcement of the community order with a DRR remain the

16
same as for the DTTO.

A failure to report etc. is considered as an unacceptable failure to comply only once


in respect of any one day, regardless of the number of contacts arranged for that
day.

The order is taken as a whole for the purpose of breach, with an unacceptable failure
to comply in relation to any requirement counting as one unacceptable failure to
comply with the whole sentence.

Good practice would suggest that all enforcement decisions are discussed with
treatment providers i.e. acceptable/ unacceptable absences and decisions regarding
whether or not to propose revocation or to continue the order. This may have more
significance with DRR cases, as the breach may be in respect of another
requirement and not specifically about treatment.

There may be differences in opinion regarding the proposed outcome of breach


proceedings between probation and treatment staff. If this is the case, good practice
would suggest that any unresolved differences in opinion should be taken to the
respective line managers.

In all cases, NPS has the overriding decision in all matters regarding enforcement.

Breach
Under the CJA 2003, a court cannot take "no action" on a breach or use a financial
penalty as a means of dealing with a breach. It can only amend the community order
so as to impose more "onerous" requirements or revoke and resentence. If the court
revokes the order it can impose a custodial sentence of up to 51 weeks even if the
original offence was not punishable by imprisonment.

The removal of a fine or "no action" as options for breach may have a significant
impact on the DRR target group.

Areas should not generally recommend to the court that DRRs/DTTOs be revoked
and the offender resentenced on the first or second breach, unless of course the
offender indicates he/she will not comply with the order, there are significant risk
issues or the order is clearly not working.

The proposed outcome of the breach should be based on an offender’s compliance,


response to and progress on an order and the point in the order where the breach
occurs.

Areas can deal with breaches where the order could be allowed to continue by
proposing:-

• One of a residence, prohibited activity, curfew or exclusion requirement.

• Any other requirements, if relevant, or

• An extension in the length of one or more of the original requirements (if this is a
DRR the offender must consent to any amendment).

The Sentencing Guidelines Council states that " There may be cases where the court
will need to consider re-sentencing to a differently constructed community sentence

17
in order to secure compliance with the purposes of the original sentence, perhaps
where there has already been partial compliance or where events since the sentence
was imposed have shown that a different course of action is likely to be effective."

Any amendment to the requirements must not exceed the maximum length available
for that particular requirement e.g. a DRR cannot be extended beyond 3 years (2
years for suspended sentence orders-custody minus).

The length of the proposed extension to a requirement should be commensurate with


the seriousness of the breach e.g. a very short extension for a minor breach.

The Act does not stipulate or give any guidance on what "onerous" means. In effect,
it could be an extension to current requirement(s) or the imposition of an additional
requirement(s), within the legislative restrictions on the operational periods allowed
for each type of requirement and the overall length of the order.

If an offender reoffends on a DTTO on or after 04/04/05 and the offender manager


wants the offender to continue to be subject to statutory drug treatment, probation
staff could propose that the court revoke the DTTO and effectively take no action in
respect of the revocation (i.e. the court is not resentencing on the DTTO) and impose
a community order with the relevant requirements, in respect of the new offences.

Transfer of DTTOs /Community Orders with a DRR


PC 52/2004 should be referred to regarding transfer of orders. A DTTO/DRR should
not be temporarily supervised and areas need to be able to respond quickly to
requests for transfers and pick up the offender’s treatment without any significant gap
in treatment delivery.

Funding a Community Order which includes a DRR


Commissioning and funding arrangements for treatment and testing under the DRR
will be the same as for the DTTO. This means that in 2005/6, as previously, NPS has
made a central contribution to the Department of Health Pooled Treatment Budget.
This has been allocated to DATs by the NTA according to the York Formula. PC
06/2003, which was agreed with the NTA, will continue to apply.

In Wales treatment and testing for the DTTO/DRR is commissioned directly by


probation areas from the treatment provider and the areas are directly responsible for
managing the contracts.

• Treatment and testing under the DRR (in England) will be commissioned and
funded by the DAT.

• Exceptionally, a community order with a DRR might include a programme


requirement which is not primarily aimed at reducing/addressing drug use. For
example, drug use may be a disinhibitor for offences of domestic violence or sex
offending. The DAT would not be expected to fund a domestic violence or sex
offender programme. Joint assessments and close liaison between CJITs, the
treatment assessor and PSR author should enable agreement to be reached on a
case by case basis, but, as a general principle, if a DRR is combined with a
substance misuse accredited programme (or a generic thinking skills programme,
where no substance misuse programme is available), the programme should be
funded via the DAT (as is currently the case with a DTTO). Accredited
programmes proposed for sexual or violent offending should be funded by the
probation area.

18
• The accredited programme will be funded by the probation area where the
community order includes an accredited programme (substance misuse or other
programme) but there is no requirement for a DRR.

• ‘Wrap around’ services – e.g. interventions (or referrals to other agencies) to


address accommodation, health, education, training and employment needs
(ETE), which are part of a structured day care or other treatment programme, will
be covered by the DRR (i.e. no additional requirements need to be specified for
these interventions). Structured day care and other treatment packages will be
commissioned by the DAT as part of the DRR.

• An activity requirement will need to be included in the community order, in


addition to the DRR, where ‘wrap around’ services are delivered as a specific and
separate intervention from the DRR and it is not part of the commissioned
treatment programme e.g. an offender is required to attend x number of ETE
sessions. Packages delivered as part of an activity requirement will not usually be
funded via the DAT. Probation areas and DATs will need to be clear when a
‘wrap around’ intervention is being delivered as part of a treatment programme.
The content and likely duration/intensity of the treatment proposed by the
treatment provider therefore needs to be sufficiently detailed for the PSR author
to determine exactly which requirements should be included in the community
order.

• It is important that probation staff of an appropriate level play an active role in


DAT business.

• There should be robust processes in place in order to performance manage


commissioned treatment providers.

Provisions for 16-17 year olds


The CJA 2003 for community orders does not currently apply to offenders under 18
year of age. This means 16-17 year olds will continue to be made subject to pre-CJA
2003 orders (CROs, CPOs, DTTOs) for offences committed on or after April 4th 2005.

Areas need to discuss continuing DTTO arrangements for this age group with local
YOTs. The Youth Justice Board has advised, however, that juveniles should continue
to be proposed for juvenile sentences (e.g. Supervision Orders) in most cases.

16-17 year olds on DTTOs will usually be managed by the local YOT, although this
will be determined by existing local arrangements and may need to be considered on
a case by case basis.

Court Reviews
There are two changes to the court review process:-

• The Act requires reviews to be held only where the DRR is over 12 months
(unless requested by the court). National Standards, however, require
reviews to be proposed for DRRs of 12 months length and over.

• National Standards require that the offender manager submits a written progress
report to the court once every four weeks for the first 16 weeks and a minimum
of 16 weeks thereafter where reviews are mandatory or requested by the court.

Consideration should be given to proposing reviews in all cases, irrespective of the

19
length of the DRR, where the offender:-

• is a PPO

• is assessed at the time of sentence as being high or very high risk of harm

• has an OASys score of 100 or more.

Areas could consider holding reviews:

• bi-monthly after the first 16 weeks for the next third of the order
• with one final review in the last third of the order (this is based on a 12 month
order and could be amended depending on the length of the requirement).

It remains good practice to have, at the very least, one magistrate from the previous
review(s) sitting at the next one in order to have continuity for both the offender and
the review panel. Many areas have specific review panels of magistrates in order to
facilitate this.

The court review report should include:-

• The views of the treatment provider as to the progress of the offender in


respect to treatment.

• Test results

• The record of the offender in keeping all appointments

• Judgements by the offender manager as to the offender’s attitude and


response to the order as a whole.

• Any further charges, convictions or breaches.

• Information regarding progress on any other requirements that the offender


may be subject to alongside the DRR.

At a review hearing the court, after considering the content of the progress report,
may amend the order so far as it relates to the DRR. The court can only amend the
DRR if:-

• The offender expresses his/her willingness to comply with the proposed


amendment.

• The amendment does not reduce the requirement below the minimum length (6
months).

The offender must consent to any amendment if an appeal against the order is
pending.

In most cases, if the offender is not willing to comply with the proposed amendment
the matter would need to be adjourned to a properly constituted court where the
prosecution would be present and the offender has the opportunity to seek legal
representation. A properly constituted court can:-

20
• Revoke the order or the suspended sentence order to which it relates.

• Deal with the offender, for the offence in respect of which the order was made, in
any way in which the offender could have been dealt with for that offence by the
original court at the time of sentence. If this course of action is taken, the court
must take into account the extent to which the offender has complied with the
requirements of the order and may impose a custodial sentence (if the original
offence was punishable by imprisonment).

There are different powers for those under 18 set out in the CJA 2003.

It is possible to have a review without a hearing (where the offender manager


prepares the review report but the offender does not have to attend the court
hearing). The court makes the decision regarding these cases. If the review report
indicates poor progress etc. the court can then require the offender to personally
attend the next review.

Good practice would suggest that offenders should attend all the reviews during the
first four months of the order and then be excused attendance if they are progressing
well. In practice, however, offenders often want to keep attending reviews,
particularly when they are doing well.

The court responsible for the order should hear the reviews (i.e. the court the order is
made out to). A magistrates’ court that makes the order can make another
magistrates’ court responsible for the order and the reviews i.e. where the order is
made in an area outside of where the offender resides.

Good practice would suggest that if two orders are running concurrently (one Crown
and one magistrates) the offender only needs to appear at the Crown Court and the
magistrates are given a copy of the review report, if required. An order made at the
Crown Court should have reviews held at Crown Court.

An order made on appeal is taken to mean that the order was made at the Crown
Court.

The above information regarding court reviews also applies to suspended sentence
orders with a DRR.

Drug Testing
Frequency of testing
Offenders sentenced to a DRR for a low seriousness offence i.e. where the DRR is
the only requirement of the order, have to be tested only once per week throughout
the requirement. Those offenders in the medium and high seriousness bands need to
be tested a minimum of twice a week for the first sixteen weeks of the requirement,
with discretion for this to be reduced to once per week thereafter if the offender
manager evidences that sufficient progress has been made.

Those offenders in residential rehabilitation treatment centres need to be tested only


once a week during their time in rehab. Corrections to National Standards have been
agreed to support this guidance.

There should usually be at least two clear days between screening tests. Offenders
should not normally be tested on fixed days of the week.

The testing requirement may also be varied when probation staff are satisfied that

21
the offender has an acceptable explanation for missing a test, for example due to a
child care emergency, or a test result is deemed void due to the offender’s inability to
provide a sample. Where the offender has missed a test, or the test is deemed void,
a second test should be carried out on the next working day.

Who carries out tests?


Testing is to be carried out “by the responsible officer or by the person specified as
the person by or under whose direction the treatment is to be provided” i.e. probation
or treatment staff.

A full record of all tests (including failures to attend, failures and refusals to produce a
sample and results of confirmation tests) carried out on offenders must be kept for
the duration of the order.

The results of any tests carried out by the treatment provider must be communicated
to the supervising officer. This should usually be done within two working days of the
test taking place.

Type of testing
The only forms of testing which may be used as part of a DRR, without prior written
authority, are urine and/or oral fluid testing. These two modalities should not be
viewed as mutually exclusive. In fact, there could be positive benefits in using both
for DRR testing. For instance, greater flexibility (e.g. if an offender proves unable to
provide one type of sample the other form of testing could be used) and adulteration
will be more difficult if offenders do not know in advance how they are going to be
tested.

If oral fluid tests are used there may be more benefits to having a supplier that
provides an immediate screening test result.

As with DTTOs, areas will still require prior permission in writing from the NPD
Interventions Unit, however, to use any other modality for DRR testing, as some
forms of testing that are available are likely to be insufficiently robust or unsuitable.

Observation
Urine tests no longer have to be routinely observed, as was the case for DTTOs.
Care should be taken, however, to ensure that, as far as possible, samples are
unadulterated. For example, by the use of temperature pots, ensuring the offender
hands the sample directly to the staff taking the test in order to feel temperature
(should be body temperature), checking the colour of the sample, ensuring that the
offender takes his/her jacket or coat off, leaves any bags outside etc.

There may be some situations when it could be an option to observe urine tests e.g.
if there is genuine suspicion that an offender is adulterating samples or for
clinical/medical reasons. Where practicable, the decision to observe any urine test
should be decided in conjunction with clinical treatment staff.

Oral fluid tests have to be observed.

If the supervising officer/treatment provider is concerned about false tests then the
offender could be tested again, possibly by a random test.

Which drugs to test for


Offenders should usually be tested for drugs which are most closely associated with
their offending.

22
Probation/treatment staff have the discretion to require tests for other drugs that
offenders may be taking, as well as for substitute medication, if this is appropriate.

Use of confirmatory testing (lab test)


It would be expensive and unnecessary to send samples for confirmatory testing
after every positive screening test. A confirmatory test could be used in those cases
where the offender disputes a test result; however this needs to be balanced against
the fact that failed drug tests in themselves are not grounds for breach.

Confirmatory tests should be conducted to chain of custody standards (i.e. that there
is a trail of evidence that shows that the sample has not been tampered with).

Provision of samples
The only circumstances in which offenders shall not always be required to provide a
sample is if they have admitted drug use in advance of the test and are willing to sign
a form to this effect (SS 8.13 of National Standards refers). Areas need to ensure
they record admitted drug use.

Good practice would suggest that an offender is only allowed to sign (and not be
tested) on two consecutive occasions before being required to be tested again.

Definition of “failure” to provide a sample


“Failure” in SS8.14 of NS means refusal to provide a sample. Inability to provide a
sample for genuine medical reasons should not be considered as an unacceptable
failure to comply with the order and is therefore not grounds for breach.

If an individual repeatedly cannot comply for reasons beyond his or her control, e.g. if
they suffer from Paruresis (also known as "shy bladder syndrome") or dry mouth and
there is no other form of testing available for use then the DRR should be regarded
as unworkable. The case should be returned to court on those grounds and it would
then be for the court to determine how it should be dealt with.

Implications of positive tests for breach


Taken in isolation drug test results are rather a blunt instrument by which to measure
progress. Many offenders who continue to use drugs while on the order will do so in
greatly reduced quantities and on a much less frequent basis but will still provide
positive samples. The results of drug tests therefore need to be considered,
alongside other indicators, in the context of the offender’s overall progress on the
order.

Failed drug tests are not grounds for breach proceedings taken in isolation but can
be indicative of a failure to engage in the programme. If, for example, an offender is
not engaging in other aspects of the DRR (and has also possibly reoffended) and is
therefore in breach, failed drug tests may then be used as added justification as to
why the order should be revoked and the offender resentenced.

There are, however, situations when repeated failed drug tests could lead to an order
being taken back to court and deemed unworkable. In those cases where offenders
are attending appointments and otherwise complying with the DRR but continuing to
take drugs and making little or no effort to stop, the DRR could be revoked and/or the
offender re-sentenced if it appears to the court that "having regard to circumstances
which have arisen since the order was made, it would be in the interests of justice" to
do so. Legal advice is that consistent positive tests over a period of time would
constitute such “new” circumstances.

23
Before any order is taken back to court as unworkable, everything possible must
have been done to encourage the offender to produce negative drug tests. The
review court should be kept informed throughout as to the offender’s progress and it
has an important role to play in motivating the offender. The review court should be
party to any decision (or anticipated proposal) to return the offender to court and
apply to revoke the DRR on the grounds of unworkability.

Steering Groups/Forums
Areas have developed various forums and meetings (both locally and regionally) to
provide oversight, review the multi-agency operations of local DTTO programmes
and/or to bring practitioners and/or managers together to discuss best practice,
inform commissioning etc. Areas (and regions) need to evaluate the most effective
meeting structures that meet their local needs.

Good practice would suggest that (over and above any local performance monitoring
forums - of treatment providers) some form of meeting at a regional level is
beneficial.

It is important to have links and good communication channels with local CJITs and
Prison Area Drug Co-ordinators on both a strategic and operational level in order to
maximise the identification, engagement and retention of potential DRRs from arrest
to sentence and also at the end of a DRR if there are ongoing drug related needs.

It is also important to have relevant links with agencies that can assist with other
criminogenic factors e.g. housing/ETE/Learning and Skills.

Useful Reference Material


• Drug Interventions Record Context Guidance
• DIP and NOMS Case Management of Offenders (Annex G to PC 55/2004).
Currently being revised.
• Mental Health Policy Implementation Guide: Dual Diagnosis Good Practise
Guide
• NTA: Models of care for treatment of adult drug misusers (presently being
revised)
• Sentencing Guidelines Council Guidance: Overarching Principles:
Seriousness and New Sentences: Criminal Justice Act 2003.

24
Managing the Alcohol
Treatment
Requirement (ATR)
Index

Page

3. General

3. Legal requirements

4. ATR Target Group

4. Assessment

4. Pre-sentence reports (PSRs)

5. Treatment

5. Models of Care for Alcohol Misusers (MOCAM)-the 4 tier model of alcohol


treatment
6. Meeting the six months ATR minimum
7. Prison Service Model Treatment framework
7. Limited treatment provision – implications for start of ATR and working with
DAATs to address the gaps
7. Change of treatment provider
8. Revocation for good progress

8. Use of accredited programmes

8. Testing

8. Court reviews

8. Enforcement

General

2
NPS is developing an Alcohol Delivery Strategy for offenders under probation supervision
based upon evidence of best practice. A detailed framework is in place and the results of
research commissioned to inform strategy development are expected shortly. In the
meantime, areas may find the following interim guidance on the Alcohol Treatment
Requirement (ATR) helpful.

Legal requirements
Section 212 of the Criminal Justice Act 2003 makes available to the courts an ATR as one of
the possible requirements of a community order. This replaces and largely replicates
paragraph 6 of Schedule 2 to the Powers of Criminal Courts (Sentencing) Act 2000 (the old
Schedule 1(a) (6)), which allows courts to make it a requirement of a community
rehabilitation order (CRO) or community punishment and rehabilitation order (CPRO) for an
offender to receive alcohol treatment. These pre-CJA measures continue to be in force for
offenders committing offences before the 4 April 2005 and for juveniles.1

The main differences with previous provision are that:

- an ATR can be made part of a community order or a suspended sentence order for a
minimum of six months and maximum of three years.

- to impose an ATR the court does not have to be satisfied that the offender’s
dependency on alcohol caused or contributed to the offence(s) for which he has been
convicted; and

The ATR is available to courts as a sentencing option for offences committed on or after 4
April 2005 by offenders aged 18 or over.

The ATR obliges the offender to submit to “treatment by or under the direction of a specified
person having the necessary qualifications or experience with a view to the reduction or
elimination of the offender’s dependency on alcohol”.

Under Section 212 of the Act, a court can impose an ATR provided:
• the offender is dependent2 on alcohol
• this dependency is such as requires and may be susceptible to treatment
• arrangements have been or can be made for the treatment intended to be
specified in the order (including arrangements for the reception of the offender
where he is to be required to submit to treatment as a resident) and
• the offender expresses his willingness to comply with its requirements.

The treatment required by an ATR for any particular period must be either:
• as a resident in such institution or place that may be specified in the order
• as a non-resident in or at such institution or place, and at such intervals, as may
be so specified or
• by or under the direction of a person having the necessary qualifications or
experience as may be so specified
but the nature of the treatment shall not be specified in the order except as above.

ATR Target Group

1 The National Implementation Guide for the Criminal Justice Act 2003 community sentence provisions
(Edition 2, Version 5F) provides further information.
2 See following section of this guidance on ATR target group for definition.

3
The ATR is targeted at much the same group of offenders who were previously suitable for a
CRO or CPRO with an alcohol requirement, although, as stated in the previous section, for
an ATR to be made the offender’s dependency does not have to be linked to the index
offence(s).

Legal advice suggests that “dependency” under the Act does not mean simply clinical
dependence characterised by “psychological dependence” with an increased drive to use
alcohol, difficulty controlling its use, despite the consequences, and in more severe cases
physical withdrawals upon cessation of use. It could also include hazardous and harmful
drinkers3.

Assessment
When alcohol misuse has been identified as an issue in OASys the offender should first be
further assessed using a specific alcohol assessment tool e.g. Alcohol Use Disorders
Identification (AUDIT), Christo Inventory for Substance Misuse (CISS), Short Alcohol
Dependence Data (SADD). This will help to identify the offender’s alcohol related needs and
the type and level of intervention that should be used to tackle them. This level of
assessment can be carried out by suitably trained probation staff (of any level) or treatment
staff depending upon local arrangements.

Offenders assessed at this stage as requiring treatment for their alcohol related problems, as
opposed to information or advice, should be referred for assessment, in line with Models of
Care for Alcohol Misusers (MoCAM)4 and any local Care Pathway, by staff competent and
designated to undertake such assessments. This is to identify the seriousness of their
problems, the urgency with which they require treatment and in the case of those with the
most serious problems, enable an individual care plan to be prepared.

Pre-sentence reports (PSRs)


An ATR can be proposed wherever the PSR author is satisfied that the requirements of
section 212 of the Act (above) are met.

In addition, PSR authors should bear in mind the Sentencing Guidelines Council advice5 that
“the decision on the nature and severity of requirements to be included in a community
sentence should be guided by:

(i) the assessment of offence seriousness (LOW, MEDIUM OR HIGH);


(ii) the purpose(s) of sentencing the court wishes to achieve;
(iii) the risk of re-offending;
(iv) the ability of the offender to comply; and
(v) the availability of requirements in the local area.

The resulting restriction on liberty must be a proportionate response to the offence that was
committed."

3 The World Health Organisation’s tenth revision of the International classification of diseases (ICD-10)
defines:-
hazardous use of a psychoactive substance, such as alcohol, as an “occasional, repeated or
persistent pattern of use…which carries with it a high risk of causing future damage to the medical or
mental health of the user but which has not yet resulted in significant medical or psychological ill
effects” ;and
harmful use of a psychoactive substance, such as alcohol, as “a pattern of use which is already
causing damage to health. The damage may be physical or mental.”
4 Consultation document available at www.nta.nhs.uk.
5 Page 9 of the Guideline on New Sentences: Criminal Justice Act 2003 available from

www.sentencing-guidelines.gov.uk.

4
The guidelines also say:

"There will clearly be ... requirements of a rehabilitative nature, such as a treatment


requirement or an accredited programme, which may be appropriate depending on the
specific needs of the offender and assessment of suitability. Given the intensity of such
interventions, it is expected that these would normally only be appropriate at medium and
high levels of seriousness, and where assessed as having medium or high risk of re-
offending."

In addition to the requirements set out in National Standards, a PSR or fast delivery PSR
recommending an ATR must include:
• the results of any assessments undertaken (OASys and/or alcohol assessment)
indicating that the offender is dependent upon alcohol and that this dependency requires
and may be susceptible to treatment
• a treatment plan, including the type of treatment (residential or non-residential), the name
and address of the provider and for non-residents suggested intervals of treatment, if
appropriate.
• evidence that arrangements for this treatment are in place or can be put in place
• a signed statement from the offender that he/she is willing to comply with the ATR
• the suggested length of the ATR, taking into account the views of the provider
• an indication as to when the ATR will start and, if there is likely to be any significant
delay, any work that will be done with the offender in the interim
• any anticipated sequencing with other requirements of the order

Treatment
Like the drug rehabilitation requirement (DRR), the amount and type of treatment delivered
under the ATR should be tailored to the offender’s assessed need providing the overall
restriction on liberty imposed by the community order in its totality is commensurate with the
seriousness of the offence(s). An ATR will usually be combined with a supervision
requirement (and possibly other requirements) at the medium and high seriousness bands of
the community sentence. The ATR can be used as a stand alone requirement for those in
the lowest band of the community sentence but an offender manager will still be needed for
enforcement and general compliance with the order.

Models of Care for Alcohol Misusers (MOCAM)-the 4 tier model of alcohol treatment
Alcohol treatment can be broken down according to the 4 tiers identified in MOCAM. These
are:

- Tier 1: Screening, brief advice and referral. This is defined as provision of


identification of hazardous and harmful drinkers and those who drink in excess of the
sensible drinking limits; information on low risk drinking; ‘brief advice’ to reduce alcohol-
related harm; and referral of those with alcohol dependence or harm for more intensive
interventions. Tier 1 interventions include targeted screening for those drinking in excess
of Guidelines on Safer Drinking (DH)6, provision of brief advice to hazardous drinkers and
referral of those requiring more than brief advice for services in higher tiers. These will
often be delivered in non-alcohol specialist settings by non-specialists e.g. probation,
nurses with the necessary Drug and Alcohol National Occupational Standards (DANOS)
competences.7

6 www.dh.gov.uk.
7 Available at www.skillsforhealth.org.uk/danos/competences.php.

5
- Tier 2: Open access support to reduce alcohol-related harm, assessment and
referral services. This is defined as provision of open access facilities and outreach
delivering alcohol-specific advice information and support, brief interventions to reduce
alcohol-related harm; and assessment and referral of those with more serious alcohol-
related problems for care-planned treatment. Interventions also include mutual aid
groups e.g. Alcoholics Anonymous, assessment and low threshold prescribing for
assisted withdrawal. This may be offered in non-alcohol specialist settings if the required
competencies are available and will generally be appropriate for hazardous and harmful
drinkers who have not responded to brief advice.

- Tier 3: Community based care-planned treatment. This is defined as specialised


alcohol misuse assessment, care planned treatment and care co-ordination, when
required. Interventions provided include evidence based psychosocial therapies and
support, interventions for assisted alcohol withdrawal “detoxification”8 and
pharmacotherapies to address alcohol misuse. These interventions should be provided
within specialist substance misuse services or within non-alcohol specialist settings with
the necessary expertise and resources for treating alcohol misusers and will be generally
appropriate for moderately dependent drinkers.

- Tier 4: Residential/inpatient care-planned treatment. This is likely to be suitable for


those who have severe dependence or alcohol dependence with other problems and may
be provided by practitioners with the necessary specialist competence, in community or
residential settings, as appropriate. Tier 4 also includes in-patient assisted withdrawal –
typically a relatively brief intervention lasting 7-10 days (and sometimes less if treatment
starts in-patient and is completed in the community). In-patient assisted withdrawal is
indicated when service users would be at risk if treatment were provided in the
community. Assisted withdrawal can also be provided at the start of a residential
treatment placement.

An ATR can include some Tier 2 provision and interventions in Tiers 3-4. Interventions in Tier
1, including alcohol education or information, brief advice and support which can be delivered
by probation staff to offenders with very low level alcohol problems, should not form part of
an ATR but be delivered routinely as part of a supervision requirement or activity
requirement. However, all offenders who are recommended to the court for an ATR should
have received screening and brief advice prior to being referred to the assessment which
confirmed the appropriateness of the ATR. All probation staff involved in delivering these Tier
1 interventions must be trained & competent to the relevant DANOS standards.

Meeting the six months ATR minimum


It is envisaged that areas will continue to use whatever alcohol treatment provision they
already have in place to deliver the ATR, although we acknowledge that the requirement for
an ATR to last a minimum of six months could create problems in some areas where existing
contracts with providers do not cater for that length of treatment and there is insufficient
funding to extend provision. There may also be offenders assessed as suitable for an ATR
who require less than six months treatment.

Constructing an ATR of at least six months duration may not present too great a problem at
the medium/high seriousness bands of the community sentence where there will generally be
other requirements running alongside the ATR, which could be sequenced alongside ATR
provision to cover the whole of the minimum time period. It may be more difficult to resolve,
however, at the low seriousness band where the ATR is a stand alone requirement.

8 Otherwise known as “prescribed medication.”

6
Wherever meeting the six months ATR presents a problem, areas should consider arranging
a frequency of appointments with the treatment provider which allows the total treatment
episode to be spread over the minimum ATR duration. For example, a 12 weeks treatment
programme could be delivered on a fortnightly basis for six months. In this scenario, to meet
the minimum NS contact requirements, offender managers (OMs) would need to schedule
additional appointments for the first 16 weeks with offenders in the medium/high seriousness
band of the community sentence to take place in weeks in which there were no treatment
appointments.

Alternatively, on completion of the agreed treatment programme, additional sessions could


be arranged, including less intensive treatment, relapse prevention work or re-referral for
treatment in the event of a relapse.

Under an ATR, anything specified in the supervision plan can be counted as contact
providing there is an audit trail. This might include motivational work or work on related
activities such as housing, finance etc. Some areas may be interested in a short motivational
package (8 sessions) that is being piloted by the programmes team.

Prison Service Model Treatment framework


Areas may find it helpful to refer to the Prison Service model treatment framework, as there
are many parallels between effective treatment interventions in custody and the community.
The framework is included in the “Alcohol Treatment/Interventions Good Practice Guide.”9

Limited treatment provision – implications for start of ATR and working with Drug and Alcohol
Action Teams (DAATs) to address the gaps
We recognise that alcohol treatment provision is limited in some areas and that waiting times
can be lengthy, which may have implications for when the ATR can start. Where the ATR is
just one requirement of a community order, work can be done with the offender relating to
other requirements until the ATR component can begin within the timings of the community
order. This will need to be reflected in the sentence plan.

The NPD commissioned research due for publication in September should provide
information about the gaps that exist in some areas regarding the provision of services for
alcohol users and more detail about the gaps nationally. In the meantime, areas should work
with local Drug and Alcohol Action Teams (DAATs) to ensure a comprehensive assessment
of local need is available and the DAAT commissions services to meet these needs. This
requires probation areas to play a full and active role in all the business of the DAAT, not just
in the commissioning of treatment for DTTOs/DRRs and ATRs. Areas may also address
some shortfalls in provision by partnership funding of appropriate services. Probation areas
are well placed to provide information on the extent of alcohol related offending in their area
and such information should be bought to the attention of the Crime and Disorder Reduction
Partnership (CDRP). ROMS and NPD regional managers should ensure gaps in provision
are addressed under the drugs and alcohol pathways of the regional reducing re-offending
resettlement strategies.

Change of treatment provider


Where the treatment provider assesses that treatment can be better or more conveniently
carried out by another suitably qualified provider not specified in the ATR e.g. in-patient or
community based detoxification, then he may with the consent of the offender make
arrangements for such treatment to be provided. The person making the arrangements must
notify the supervising officer of the change, specifying where and by whom the treatment is

9 Available at www.hmprisonservice.gov.uk/news/index.asp?id=2173,22,6,22,0,0.

7
now being carried out. For residential treatment, the guidance on case transfers set out in PC
52/2004 applies.

Revocation for good progress


The supervising officer or offender may apply for the ATR to be revoked early for good
progress or for responding satisfactorily to supervision or treatment where this is applicable.

Use of accredited programmes


If an offender is assessed as likely to benefit from a substance misuse programme
(ASRO/OSAP/DIDS) or any other offending behaviour programme instead of or in addition to
alcohol treatment, this must be delivered through a programme requirement. It cannot be
part of the ATR. The offender’s suitability for an accredited programme therefore needs to be
assessed separately from suitability for an ATR. The sequencing of interventions will be
determined by the use of the selection matrix and availability of treatment. Details of the
accredited programme should be specified in the PSR, sentence plan and be delivered in
accordance with National Standards and NPS programme performance standards.

Accredited programmes such as ASRO/OSAP should generally only be used alongside an


ATR for offenders in the medium/high seriousness community sentencing band.

Offenders who have committed drink drive offences and are suitable for the Drink Impaired
Drivers Scheme (DIDS) should be recommended for a programme requirement. An ATR
should only be added where this can be justified by the seriousness of the offence and
offender need.

Testing
Human rights issues preclude the imposition of mandatory testing (a requirement of a DRR)
for alcohol. However, alcohol misusing offenders under probation supervision can still be
tested on a voluntary basis at the discretion of the supervising officer or treatment provider
when this is considered helpful as a way of assessing their progress in treatment.

Court reviews
Unlike the DRR, court reviews are not applicable to the ATR as part of a community order
but the court has discretion to decide that a suspended sentence order be subject to periodic
review, including those with an ATR10.

Enforcement
Existing National Standards apply in respect of attendance and behaviour.

10 Section 5.6 of the National Implementation Guide provides advice on Reviews of Orders.