Young People’s Substance Misuse

Treatment Plan 2009/10

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Maarrttiinn S
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Yoouunngg P
Peeooppllee’’ss S
Suubbssttaannccee M
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1
 Part 1
Strategic Overview and Key Priorities

2
The Overall Direction of the Strategy

This plan will evidence the work that will be undertaken in Bristol during 2009/10
to contribute to achieving the ambitions of key governmental drivers regarding
young people’s substance misuse. This work will specifically contribute to PSA
25, reducing the harm caused by alcohol and drugs, and PSA 14, increasing the
number of young people on the path to success. It will evidence actions towards
achieving contributions to national indicator 40, which records the increase in
numbers of drug users in effective treatment and national indicator 115-
substance misuse by young people, which is included as a priority within Bristol’s
Local Area Agreement.

The Drug Strategy Team (DST) and Safer Bristol are committed to delivering a
full range of substance misuse treatment, targeted prevention and universal
services to young people regarding this issue. This provision is strategically
planned and commissioned by the Young People’s Delivery Group (YPDG). This
has close links with Children and Young People’s Strategic Commissioning
Group within Bristol City Council. The YPDG is informed by the Young People’s
Manager’s Meeting (YPMM) and Worker’s Forums consisting of partners,
providers and other stakeholders from across the city. There are also service
user consultation groups within commissioned agencies that further advise
regarding the commissioning and planning processes. Through this
commissioning structure we endeavour to commission and provide support to
Bristol’s young people’s substance misuse agencies in line with the NTA’s
Essential Elements Guidance. This year’s strategy aims to further build on these
commissioning arrangements to ensure that Bristol has integrated, needs led,
outcomes focussed commissioning arrangements in place to meet the identified
needs of young people in the city.

These commissioning arrangements have led to the development of what are

now clearly established and integrated young people’s substance misuse
agencies in the city. This year’s needs assessment evidences how the
establishment and development of these services and the development of strong
strategic links with universal young people’s services has led to a significant
increase in the number of young people engaged by specialist services across
the city.

In order for these services to be further integrated into wider children and young
people’s provision it is a priority to build on the challenge of PSA 14 to further
develop how specialist services fit with Bristol’s Youth Matters agenda, Children
and Young People’s Services commissioning and Locality Governance planning,
and Common Assessment Framework Locality Panels.

3
The Overall Direction of the Strategy contd.

The DST recognizes that accurate and timely performance data is crucial to
demonstrate the effectiveness of our treatment system. We will strive to improve
data quality, specifically NDTMS, and ensure our systems are fit for purpose.
This will ensure appropriate data is available to key stakeholders such as NTA,
NHS Bristol, Children and Young People’s Services as well as building on the
emerging picture of need demonstrated in this year’s treatment plan. This will
allow for further investigation of diversity, geographic breakdown of need and
changes in ‘drug of choice’ profiles as highlighted in this years assessment.

A key challenge for the forthcoming year will be the integration of all targeted and
treatment young people’s substance misuse services in Bristol under one
common name. This will allow for clearer branding of services, afford an
excellent opportunity for re-launching and re-publicising services and facilitate
the substance misuse services being incorporated under the Integrated Youth
Support banner. This will also give a banner under which practitioners,
managers, service users and commissioners can meet at ‘Big Team Meeting’
days, ‘Cutting Edge’ conferences, ‘Workers Forums’ and ‘Service User
Consultation’ panels. This should facilitate better communication between all
stakeholders and ensure easier identification of services for young people.

Much has been achieved in recent years to target vulnerable young people and
to engage them in treatment services. However, more work is required regarding
specific groups such as children in care, homeless young people, those leaving
the secure estate for community services and a wider review of all young people
who are outside of mainstream education. A particular focus is also required on
some BME groups, particularly those who are highlighted in the needs
assessment. Also, work needs to be done to further integrate this agenda with
the work of groups engaging with gangs, group offending and dangerous
weapons agendas.

Following on from the lead in the new National Drug Strategy there is a clear
need to improve awareness and provision of services for families of substance
misusers. This will involve some key partnership working with Bristol
Safeguarding Board, with a particular focus on the issue of Hidden Harm.

In order to facilitate effective referrals into treatment services further work is

required to develop the provision of in school education. The Bristol Early
Intervention Service is a key source of referrals into treatment services and these
referral pathways need to be further reviewed and strengthened. By establishing
an effective workforce strategy, generalist agencies can be skilled in substance
misuse matters and referrals into specialist services further encouraged and
monitored This is a particular priority regarding work with Police, Youth and Play
Service, Connexions and Accident and Emergency departments.

4
The Overall Direction of the Strategy contd.

Bristol DST has a clear commitment to hearing the views of all its stakeholders to
inform the commissioning and strategic planning processes. Service User
consultation groups are established in a number of specialist services. This year
we will build on this to establish a DST service user forum that will feed directly
into the Delivery Group. We will also establish members of the adult UFO group,
who have an experience of adolescent substance misuse, onto both the
Managers and Delivery Groups. Further work with service users carers will be
undertaken to ensure their representation in this process.

Improving transitional arrangements for young people leaving young people’s

services for adult services will be key piece of work this year. This will involve the
recruitment of a specialist transitions worker in adult services and completion of a
scoping exercise for a discreet service for 18 to 25’s for the city.

5
The Likely Demand for Specialist Treatment Interventions for Young People

► The needs assessment shows that 10 young people received

pharmacological interventions in 08/09. It seems likely that demand will
continue at a similar level this coming year. Work has been done with
universal services and targeted prevention services to ensure that any
young person thought to require such an intervention is referred
immediately into Young People’s Drug Treatment service for full
assessment.

► The needs assessment showed that 313 young people engaged with
specialist treatment services for psychosocial interventions. It is
estimated that this number will increase in the forthcoming year. This will
primarily be due to the increased targeting of specific vulnerable groups
such as those young people outside of mainstream education, children
in care and those who are homeless/inadequately housed.

► This document identifies the further assessment and provision of family

interventions as a key priority. Particular emphasis will be given to
monitoring and increasing provision for Hidden Harm groups and
working with Children and Young People’s Safeguarding Board to
ensure a more integrated approach to planning and commissioning.

► A working group has been established to review provision of specialist

harm reduction provision for young people. A common health screen is
now used across all treatment services to establish need and plan a
coordinated response regarding blood born viruses, safer injecting etc.

► No young people were identified as being in need of residential

placements regarding substance misuse issues in 08/09. However there
is a clear mechanism in place for identified need to be raised with the
Delivery Group.

► The needs assessment clearly demonstrates changing need in the city in

regards to diversity issues. It is a priority in this document to improve
outreach, identification and engagement of specific BME groups of
young people into the treatment provision. Similarly the past year has
seen a shift in the gender profile engaging with services and work needs
to be done to ensure that we are adequately engaging young males in
specialist services.

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The Key Findings of the Current Needs Assessment

► Overall this year has seen an increase in activity from the young people’s
substance misuse services in Bristol. Early Intervention Service, Youth
Offending Team and Drugs & Young People Project have all shown an
increase in young people accessing their services.

► As regards treatment outcomes, within the young people’s substance

misuse services planned discharges have decreased, but more young
people are currently in treatment, whilst unplanned discharges have
reduced. These will be monitored through out the year.

► There has been a significant increase in young people presenting to

services with alcohol as their primary drug of choice. This has been due to
more effective targeting of young people with alcohol problems and the
shifting of emphasis at specialist services to respond to this need. These
trends will be reviewed through out the year.

► Changing trends of drug use by young people have been noted.

Encouragingly crack and heroin use amongst young people has
decreased. However new drugs of choice are emerging amongst young
people, such as ketamine, that will need investigating. Further work also
needs to be done on new drug profiles emerging amongst young people.
For example, based on national research, steroid use and tanning drugs
are increasingly being used but have not been identified within this year’s
needs assessment data.

► Young people in Bristol appear to be following the profile of

ACCE’rs(Alcohol, Cannabis, Cocaine & Ecstasy) when looking at poly
drug use. In addition to this the majority of young people are aged 17 and
over in the young people’s services. This provides further evidence of the
need for a ‘transitional’ service that caters for young adults with different
needs to those of adults in adult drug treatment services.

► Through out the young people’s substance misuse services there has
been an increase in accessing vulnerable groups of young people.
However further action is required to target these groups. This work will
ensure we have a clearer picture of any unmet need amongst these
groups-

• Hidden Harm-There is a need for a greater service provision to

meet identified need.
• Truants/excludees- A review of ‘out of school provision’ is taking
place.
• Children in care- Increased targeting especially by D&YPP.

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The Key Findings of the Current Needs Assessment contd.

• Criminal Justice- Increased targeting at YOT, a review of young

people who are being released from the secure estate needs to
take place.
• Homeless/inadequately housed- More work done in hostels/drop-
ins.
• At risk of sexual exploitation- Through the BASE service.
• Teenage mothers- more links established with maternity services
and the teenage pregnancy agenda.
• NEETS(Not in Education, Employment or Training)- established
links with out of school provisions/Connexions.

► In terms of ethnic minority groups accessing young people’s services,

‘Mixed: White & Black Caribbean’s represent a much higher % to that of
Bristol’s overall % for this group, this will require further research. In
addition to this, work will need to be done on how we can engage young
people from ‘newly arrived communities’ in Bristol, such as Somalians or
Eastern Europeans.

► This year’s needs assessment has seen an increase in females accessing

young people’s services. A further review will need to be done to ensure
we are still effectively engaging males in young people’s services.

► We will review the postal districts of the young people accessing services.
Postal areas which have either a high or low entry in to the young people’s
substance misuse services will be investigated and the reasons behind
this.

► Recently published data for Bristol(TellUs3 and Every Child Matters

surveys) has informed us that, overall, drug use amongst young people is
above the national average(however the sample in Bristol contained more
older young people compared to the national average).

► These 2 surveys explained that young people in Bristol are more satisfied
with the advice and information received compared to the national
average. However there is a still a significant number of young people who
are unsure whether they have a local drug service available to them. This
supports the work that has started in Bristol to integrate the young
people’s services and have a common branding for the services to make
them more identifiable to young people.

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The Key Findings of the Current Needs Assessment contd.

► The release of Dataset F next year will increase the young people’s data
that is uploaded on to NDTMS. This will enable us to produce a more
detailed needs assessment, with a focus on young people’s entries and
exits in to the treatment system, next year.

► More work needs to be done to identify the points of attrition for young
people from the treatment system. Cases of young people who are leaving
the treatment system in an unplanned way need to be reviewed in order to
ensure that similar drop outs from treatment will be avoided in future
cohorts where at all possible.

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The improvements to be made in relation to the impact of treatment in
terms of its outcomes

► NDTMS data will be closely monitored to assess the effectiveness of our

treatment system for young people. With the aim of delivering
improvements in individuals health and social functioning. We will continue
to incorporate monitoring of TOP’s completions in our quarterly
performance monitoring meetings.

► The completion of the Early Intervention Service evaluation, in partnership

with John Moore’s University, will also inform review of the effectiveness
of the referral pathways into treatment services.

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Key priorities for developing specialist young people substance misuse
treatment interventions

In order to further to develop this work the Delivery Group has identified four
priorities for the Treatment plan for 09/10. These priorities were developed based
upon the findings of the needs assessment and consultation with key stakeholder
groups such as service users, managers and practitioner’s.

These four priorities are:

1) We need to improve transitional arrangements for young people moving

from young people’s specialist services into adult services.

2) We need to review and improve access to whole families work. Within this
there needs to be a focus on work with children who are living with adult
substance misuse.

3) We need to build on this year’s service Integration work to ensure that

young
people’s substance misuse services are delivered under a common
branding to respond to the needs of young people in their localities.

4) We need to further review the work we are doing to target the most
vulnerable groups. We need to have a strong focus on targeting those
BME young people who are particularly vulnerable.

In order to meet these priorities key actions have been identified:

Priority 1: Transitional Arrangements

► Development of and recruitment to specialist transitions worker in adult

services.
► Referral pathways between young people’s services and adult specialist
services to be formalised.
► Review of transitional needs of young people with emerging mental health/
substance misuse dual diagnosis issues.
► Develop and cost a model of an 18-25 service. Developed in consultation
with young people’s and adult’s services and service users.
► Present to DST Joint Commissioning Group and Young people’s Delivery
Group proposals for new service.

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Priority 2: Families Work

► Carry out a mapping exercise of services for families of drug service users
in Bristol, including relevant national services.
► Review gaps in this provision, including an emphasis on support for
parents of young substance misusers. Present findings to commissioning
groups.

► Work with Bristol City Council Safeguarding Board to prioritise work with
young people affected by parental substance misuse.
► Draw together a database of services available and promote this.

► Establish close links with Anti Social Behaviour and Child Poverty Family
Intervention Projects.
► Complete a detailed needs assessment of Hidden Harm needs across the
city.

► Endeavour to ensure the continuation, development and strategic linking

of Hidden Harm provision in targeted and specialist services.
► Review provision of training for key staff working with Hidden Harm issues
eg social workers, health visitors, staff in children’s centres.

Priority 3: Service Integration

► Services launched under common branding. Publicised using leaflets,

websites etc. Service re launch day to be organised and publicised.
► Current arrangements for Big Team Meeting, Cutting Edge Days,
Worker’s Forums and Service User Consultation Panels to continue.

► Membership of Locality Governance Groups to be established.

► Early Intervention Service staff to link into Children and Young People’s
Services Common Assessment Framework Practice Panels.

► EIS staff to link in with Locality Integrated Youth Support Teams. Providing
substance misuse expertise in each locality and facilitating referral from
locality teams into EIS and treatment services.
► Common practice protocols to be agreed and implemented.
► Closer linking with Teenage Pregnancy agenda as part of IYSD.

► Progress with all of the above to be regularly reviewed and monitored.

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Priority 4: Targeting Vulnerable Groups

► Continued targeting of Children in Care to encourage referral into Drugs

and Young People’s Project. Review training available for social workers
working with this group.
► Targeting of homeless/inadequately housed young people by links into
hostels/drop-ins.

► Review arrangements for young people moving from secure estate into
community substance misuse services.
► Review provision for young people who are out of mainstream education.
Review service availability with PSA 14 Group. Map current delivery
against available provision.

► Use DCSF Equality and Diversity Audit Tool for Commissioning to

produce a diversity and equality action plan.
► Establish closer links with key BME groups eg Asylum Dispersal Centre,
Somalian Youth Groups etc.

► Continue to link Nilaari young people’s service in with other provision.

► Review links with socially excluded groups through groups working with
gangs, group offending and dangerous weapons agendas.

The intended outcomes for these actions is a young people’s substance misuse
service that can be clearly marketed and publicised, in close collaboration with
other Integrated Youth Support Services in the city. This service would be able to
provide much improved transitional arrangements for young people post 18
years. There would be a clearer idea of current provision and need regarding
whole families interventions, particularly for those young people living with adult
substance misuse. Finally, specifically identified vulnerable groups would be
further engaged by specialist services, building on work that has been started
over recent years.

This will increase the engagement of Bristol’s young people with specialist
services, building on the increased engagement identified in this year’s need
assessment. This will improve the engagement of those small numbers of young
people requiring specialist treatment interventions who can be more clearly
identified from a number of strongly developed referral routes.

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 Part 2
Treatment Planning Grids

14
Key to Abbreviated Job Titles/Responsibilities

YPM - Young People’s Manager (Safer Bristol)

YPDG - Young People’s Delivery Group (Multi agency)

SHPS - Senior Health Promotion Specialist (PCT)

NTA - National Treatment Agency

CPO - Commissioning Projects Officer (Young People, Safer Bristol)

WDM - Workforce Development Manager (Based at Safer Bristol)

TPSL - Teenage Pregnancy Strategy Lead (PCT)

ADPH - Associate Director of Public Health (PCT)

YPDTS - Young People’s Drug Treatment Service (Senior Manager)

DYPP - Drugs and Young People’s Project (Senior Manager)

BASE - Barnardo’s BASE (Senior Manager)

SMC - Substance Misuse Consultant (LEA)

DSUC - Drug Service User Co-ordinator (Safer Bristol)

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 1. Commissioning and Systems

Objective 1 Ensure further integration into mainstream Children and Young People’s Services By when: September
(C&YPS) commissioning, planning and delivery ‘09

Actions Membership of Strategic Commissioning Group, and linked into Young People’s Substance YPM
Misuse (YPSM) Delivery Group

Review YP substance Misuse, as priority in Children’s Plan, Annual Performance YPDG

Assessment (APA), needs assessment documents/refreshers.

Review Delivery Group Terms of Reference, membership of Group and relationship with YPDG
other commissioning groups/functions
YPDG to ensure that there is a comprehensive system for commissioning young people’s YPDG
specialist substance misuse services. This to ensure effective provision of pharmacological
and psychosocial interventions.
Close monitoring of data to ensure that at least 90%of young people requiring specialist YPDG
treatment are catered for in a young people’s service.
YPDG to monitor that all five treatment elements as identified in Essential Elements are YPDG
offered.
YPDG to monitor that at least 20% of referrals to specialist substance misuse treatment are YPDG
from Children and Families services.
Continue to commission Young People’s Drug Treatment Service to target young people YPM
with mental health needs. Further develop their role in providing consultation and training to
colleagues in CAMHS working with this group.

Expected outcomes: Integrated, needs led, outcomes focussed commissioning to meet the identified needs of young
people in Bristol regarding substance misuse.

16
Objective 2 Ensure further integration with C&YPS Locality Planning and IYSD provision. By when: June ‘09

Actions Membership to be established on emerging Locality Commissioning/Governance Groups. YPM

Re-organisation of Early Intervention Service (EIS) provision according to C&YPS locality YPM
planning model and Integrated Youth Support (IYS). Ongoing monitoring of links with IYSD
provision in order to establish model of joint working.

Service Integration Plan to be completed March 09. Ongoing review required of new service YPM
developments.

Monitor referrals to EIS from CAF panels SHPS

Link into new positive activities agenda / other outreach YPM

Attendance at PSA 14 & IYSD Stakeholder Groups YPM

YPM
Improve links with Teenage pregnancy agenda (inc joint training through PCT)

Expected outcomes: Young People’s substance misuse agenda represented in locality commissioning and Common
Assessment Framework planning. Integrated YP substance misuse service developed and launched.

17
Objective 3 Ensure YP substance misuse performance is accurately entered into LAA data sets By when: September
against key indicators. ‘09

Actions Ensure EIS data is accurately reported into key data sets (Sparnet, Be Healthy Quarterly YPM
Report Cards etc)
Ensure accurate NDTMS data for treatment services is similarly recorded and entered YPM
Develop agreed targets from 08/09 baseline for 09/10 and 10/11 for LAA.

Ongoing monitoring of TellUS3 data and Every Child Matters survey to assess performance YPM
against indicators.
Ongoing monitoring of OC2 data to monitor performance regarding looked after children YPM

Expected outcomes: Accurate data reported into key datasets in a timely way.

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Objective 4 Building on 08/09 Needs Assessment exercise By when: June ‘09

Actions Include issues arising from this year’s exercise including diversity, geographic breakdown, YPM
changes in drugs of choice, etc

Quarterly review of service performance to ensure increases/reductions in service activity. YPM

Quarterly review of data to monitor changes in patterns of ‘drug of choice’ to map emerging YPM
patterns of use amongst this cohort.

Quarterly review of ethnicity data to review engagement with BME groups, with particular YPM
focus on identified groups such as newly arrived Eastern Europeans and Somalians.

Quarterly review of age profile of those young people being engaged by services. YPM

Quarterly review of data illustrating gender breakdown of young people being engaged by YPM
services.

Quarterly review of sources of referrals into services with particular focus on CAF panels, YPM
housing support services and self/parental referral.

Review Bristol’s performance against national data sets, comparative cities, etc YPM

Expected outcomes: Clearer picture of emerging need established.

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Objective 5 Review YP substance misuse data collection/quality By when: September
‘09

Actions Review link with C&YPS and IYSD data systems YPM

Review with DST Manager processes for YP data collection in relation to other DST data YPM
sets.

Ensure completion of cleansing of National Drug Treatment Monitoring System (NDTMS) YPM
data and all new data entered successfully and up to date.

Data set F training rolled out and adherence to submission requirements confirmed by April YPM
2009

Ongoing monitoring of NDTMS accuracy YPM and NTA

Expected outcomes: Accurate and timely data collected and reported to commissioning Group and key partners.

Objective 6 All key Service Level Agreements (SLAs) to be written/reviewed By when: September
‘09

Actions Ensure all SLAs are reviewed and up-to-date YPM

Ensure quarterly review of commissioned services against key performance indicators in YPM
refreshed SLAs, focussing on key outcomes achieved.

Expected outcomes: More effective performance management to inform service development and commissioning

20
processes.

Objective 7 Ensure effective communication of work done by the services to service users, By when: June ‘09
carers, partner agencies and media.

Actions New name for services to be agreed in early 09 followed by service relaunch. YPM

Youngb people to be consulted and involved in the rebranding and remarketing of services. YPM

New service information, leaflets etc published as part of re launch. YPM

Write and publish information for Youth Offer/IYSD website YPM

Expected outcomes: Key stakeholders including young people and carers are aware of newly launched integrated service.

21
Objective 8 Ensure links with/completion of key strategies By when: June ‘09

Actions Link into PCT/ NHS Bristol Training Plan. Attend steering Group CPO

Implementation of DST workforce strategy including website, degree development, etc WDM

Workforce competence to be monitored in line with 2007 clinical guidelines. WDM

Link to alcohol strategy and task groups YPM

Continue with Safer Bristol Induction sessions YPM

Increased training for PCSOs/ Police officers via YP Induction and SUST training. YPM

Link in with youth work provision in Fire & Rescue Service YPM

Expected outcomes: YP Substance Misuse delivery linked in with other key strategic planning.

Objective 9 Completion of Early Intervention Service evaluation exercise and act on findings By when: August ‘09

Actions Evaluation to be completed with John Moores University. Findings to be reviewed at Delivery SHPS
Group and action plan developed.

Action plan to be implemented and monitored to ensure service delivered in line with best SHPS
practice recommendations.
Outcomes focussed approach to be utilised for ongoing review of service. SHPS
22
Expected outcomes: Evaluation used to inform EIS service development.

Objective Review YP substance misuse services link to Black and Minority Ethnic (BME) groups By when: August ‘09
10

Actions Establish closer links with those working with Key vulnerable BME groups. Eg Asylum YPM
Dispersal Centre , Somalian Youth Groups, Right Track etc

Review Needs Assessment data re ethnicity to inform review of current performance YPM

Amend data collection tools to collect data re engagement of key groups. Eg Somalian, CPO
newly arrived Eastern European groups.
Continued work to link Nilaari BME YP Team in with other service provision. SHPS
Use DCSF Equality and Diversity Audit Tool for Commissioning to produce a diversity and YPM
equality action plan
Staff access to annual equality and diversity training YPM

Expected outcomes: Increased access to specialist YP substance misuse services for vulnerable BME groups.

Objective Review membership, effectiveness, communication between stakeholder groups By when: June 09
11

Actions Ongoing review of stakeholder meetings in line with new meeting structure including Big YPM
Team Meeting, Worker’s Forum, Cutting Edge and service user consultation groups.

23
Expected outcomes: Service users, practitioners, service managers better linked into commissioning process, best
practice and other key stakeholders.

Objective Establish links with Child Death Review Panel By when: Sept 2009
12

Ensure membership and actions on recommendations from Local Safeguarding Children Service Director,
Board regarding Child Death Review Panel Safer Bristol

Expected outcomes: Responsive responses to Child Death panel Review findings to inform better practice.

Objective Link in to newly recommissioned CAMHS service. By when: September

13 2009

Ensure YPDTS is able to continue to practice under agreed model commissioned by Safer YPM
Bristol. Engage in negotiations re key issues. E.g. premises etc.

YPDTS link into CAMHS to offer substance use expert advice and training. YPM

Expected outcomes: YPDTS continuing to offer excellent service under new provider.

24
 2. Access and Engagement

Objective 1 Improve levels of support and consultation with families and carers By when: September
‘09

Actions Carer consultation to be included in ‘user involvement’ work CPO

Carry out a mapping exercise of services for families of drug service users in Bristol and Adult CPO
relevant national services.

Review need for specialist young people’s parental support provision. Adult CPO/CPO

Draw together a centralised data base of services available and relevant advertising Adult CPO
material.
Ensure that relevant assessment forms (START/ CAF) are reviewed in line with best practice DST Families Group
within CYPS.
Review provision for supervision for those providing families based interventions.
YPM
Review Bristol’s Parenting Strategy to identify suitable parenting classes/ services within the YPM
city.
Ensure close links continue with Anti Social Behaviour and Child Poverty Family Intervention YPM
Projects
Expected outcomes: Improved awareness and provision of services for families of substance misusers.

25
Objective 2 Review services targeting vulnerable groups By when: Sept ‘09

Actions Review services not currently being targeted by EIS who work with vulnerable groups SHPS

Work with PSA 14 Group to develop service directory for ‘out of school’ provision YPM

Work with PSA 14 Group to further review correlations between vulnerabilities and protective YPM
factors across related agendas eg teenage pregnancy, youth crime, poor attainment etc.

Review EIS targeting of truants/excludes/other vulnerable groups SHPS

Review targeting of Looked After Children (LACs), including those in privately run homes. DYPP
Further work to encourage Social Workers to refer this vulnerable group to specialist services.

Review EIS links with socially excluded groups through gangs, group offending, dangerous SHPS
weapons

All of above in line with EIS evaluation work SHPS

Work with Barnardos BASE to increase targeting of runaways/ those at risk of sexual BASE
exploitation.
Closer links with partner agencies,IYSD/Connexions to identify and engage NEETS. YPM
Review Accident and Emergency Pilot. Link into Early Intervention Service. YPM
Increase availability of prevention resources e.g. FRANK/Alcohol Concern literature to CPO
vulnerable groups across city.
Review provision for homeless/ inadequately house young people through links with hostels/
housing provider drop ins etc SHPS
Develop closer links with smoking cessation agenda YPM

Expected outcomes: Services more accessible to targeted vulnerable groups.

26
Objective 3 Review future development of EIS work outside main SLA By when: October
‘09

Actions Development of new Comic Relief funded post in ARA to further target EIS work outside of SHPS
mainstream provision.
Review out of school provision across the city and map EIS activity to ensure best YPM
engagement with vulnerable groups.

Expected outcomes: Development of further EIS work to target specific groups e.g. over 16s

27
Objective 4 Further develop the quality of drug/alcohol education in schools By when: September
‘09

Actions Work with Healthy Schools Plus team to review target for completion of Personal, Social and SMC
Health Education (PSHE) certificate with drug/alcohol specialisation

Development of new scheme of work for teacher’s delivering drug education. SMC

Review provision of support for parents of substance misusing young people in school YPM
settings

Review provision for independent sector schools SMC

Review provision for independent sector schools becoming academies SMC

Expected outcomes: Improved quality of substance misuse education in schools

Objective 5 Increase the number of referrals from generalist/Tier 1 agencies into early intervention By when: September
service ‘09

Actions Work with key partner agencies—Youth and Play Service, Connexions, Police, A&E, etc—to SHPS
facilitate training and onward referral to EIS and linked with teenage pregnancy agenda.

Expected outcomes: Increased referral from partner agencies into early Intervention Service.

28
Objective 6 Increase the level of user consultation/involvement in service planning By when: September
09

Actions Continue to link in with individual service user groups. CPO

Develop DST YP service user consultation Group CPO

Review consultation of YP issues with User Feedback Organisation (UFO) group DSUC

Review service user (UFO) input into Delivery Group and commissioning process YPM

Require services to report on service user consultation activity in quarterly reports/ YPM
performance management meetings.

Expected outcomes: Service users having an increased voice in service planning and provision.

29
Objective 7 Increase the provision for young people affected by adult substance misuse By when: September
09

Actions Review HAWKS Primary School Hidden Harm Project (awaiting bids re future funding) SHPS

More detailed needs assessment completed of Hidden Harm needs. CPO

Hidden Harm issues to be reviewed in DST families Action Group. YPDG

Ensure hidden harm is represented in the updated CYPS safeguarding plan and Bristol’s YPM
parenting strategy. Ensure continued membership of Local Safeguarding Children’s Board to
promote this agenda.

Ensure continuation of hidden harm provision and further development across targeted and YPDG
specialist services
Targeting of YP involved in dealing, drug running. YPM
BDP mentoring work linked in with other provision YPM
Training needs of health visitors/staff in children’s centres reviewed and training offered. SHPS
Need to ensure closer links with Hidden Harm work and adult focussed interventions/ YPM
families work.
Training needs of CYPS Social workers to deliver consistent reponse to child protection SHPS
issues regarding children of drug misusing parents.

Expected outcomes: Greater understanding of need regarding Hidden Harm and increased coordination of response to
this need.

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Objective 8 Increase the numbers of appropriate referrals from EIS into treatment services By when: April ‘09

Actions Continue to review with EIS staff service users appropriate fro referral to specialist treatment. SHPS

Coordinator to meet with EIS staff on monthly basis to identify appropriate treatment SHPS
referrals.

Monitor passage of YP into treatment services, encourage joint working and engagement of SHPS
this cohort.

Review prevalence of emerging drugs of choice. Monitor national data re steroids etc. YPM

Expected outcomes: More appropriate young people accessing relevant treatment services.

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 3. Treatment Services

Objective 1 Ensure acceptable waiting times and numbers of unplanned discharges are achieved By when: September
by all treatment agencies ‘09

Actions Waiting times to be monitored from local data and NDTMS YPM

Close monitoring to ensure that all young people have a comprehensive assessment YPM
undertaken within 5 working days of referral to specialist treatment.

Close monitoring to ensure that all young people assessed as requiring treatment to YPM
commence treatment within 10 working days of the comprehensive assessment.

Close monitoring to ensure that all young people in treatment have a care plan specifically YPM
related to their treatment needs.

Numbers of unplanned discharges to be monitored from local data and NDTMS YPM

Close monitoring to ensure that 65% of young people leave treatment in an agreed and YPM
planned way.

Introduction of exception reporting for long waiting and unplanned discharges YPM

Expected outcomes: Clearer monitoring of outcomes for young people in specialist treatment services

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Objective 2 Review harm reduction strategy for YP By when: September
‘09

Actions Produce YP Harm Reduction Strategy YPM

Review provision of health assessments for all YP engaged in treatment YPDTS

Review provision of BBV advice, testing and treatment/ Needle exchange YPDTS

Close monitoring to ensure that all young people with a history of injecting or are at risk of YPDTS
injecting are offered a personal Hepatitis C test with pre and post test counselling.

Develop locally agreed pathways of care for the management of BBVs YPDTS

Develop local protocols that clearly define clinical responsibility for the management of BBVs YPDTS

Expected outcomes: Implementation of strategy to reduce harm to young substance misusers

Objective 3 Review provision/need for residential treatment By when: September

‘09

Actions Regularly review local needs with team managers YPM

Present findings to Delivery Group YPM

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Expected outcomes: Clear mechanism established for review of residential need.

Objective 4 Review provision for YP being released from secure estate By when: September
‘09

Actions Work with Ashfield YOI to establish closer links with specialist Bristol Services. YPM

Review referral pathways from custodial establishments are consistent with YJB/NTA YPM
guidance.

Expected outcomes: Clearer referral pathways for young people leaving custody.

Objective 5 Develop a means of clear outcome monitoring By when: June ‘09

Actions Monitor completion of Treatment Outcomes Profile (TOP) from providers. To be used at the YPM
start of treatment and in care plan reviews for those over 16 years.

Development of EIS outcome monitoring tool SHPS

Monitor completion of tool SHPS

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Expected outcomes: Clearer monitoring of outcomes for young people in substance misuse services

Objective 6 Develop clear information sharing protocols for EIS By when: August ‘09

Action EIS Info sharing/ confidentiality policy to be developed in line with IYSD policy YPM

Clear protocols to be developed in line with C&YPS/ IYS policies YPM

Expected outcomes: Consistent information sharing between substance misuse services and key partners.

Objective 7 Review need and develop provision for specialist counselling modality By when: September
‘09

Actions Review/monitor need from Tier 2 & 3 providers CPO

Work with SWAN Project to develop YP focused counselling service YPM

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Expected outcomes: Counselling modality developed and linked with other provision.

Objective 8 Ensure effective model of practice governance is introduced By when: August ‘09

YP representative attendance at DST practice governance meetings YPDTS

Actions
Implement forthcoming NTA YP Governance Guidance. YPM
Review all clinical governance and audit arrangements to ensure that they are in line with
YPDG
guidance.
Ensure monitoring is in place to demonstrate that practice is in line with 2007 Clinical
YPM
Guidelines.

Expected outcomes: Effective practice governance for young people’s services is in place.

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 4. Young People Leaving Treatment

Objective 1 Develop provision for effective transitions for young people moving into adult By when: September
services ‘09

Actions Transitions sub-group to work on action plan to meet estimated need Adult CPO

Development and recruitment to specialist transitions worker post placed in adult services. Adult CPO

Review prioritisation of YP by adult services Adult CPO

Referral Pathways to be formalised between all young people’s specialist substance misuse Adult CPO
treatment services and adult drug and alcohol services.

Conduct a review of the transitional needs of young people with emerging dual diagnosis YPM
needs including issues relating to capacity and thresholds of adult mental health services.

Develop and cost a model for an 18-25 transitions service. Developed in consultation with YPM/Adult CPO
young people’s and adults services and service users.

Present to adult Joint Commissioning Group and YP Delivery Group proposals for new YPM/Adult CPO
service.

Expected outcomes: Effective transitions between young people’s and adult services planned and delivered.

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Objective 2 Review provision of services for 18–25 age group By when: April ‘10

Actions Work with DST adult commissioning team to review need, and plan for targeted service Adult commissioning
provision for this group. Develop service spec/ tendering process. team

Expected outcomes: New service planned and commissioned for commencing April 2010

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