Primary Health Networks
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1 Primary Health Networks Drug and Alcohol Treatment Activity Work Plan to Central Queensland, Wide Bay, Sunshine Coast 1
2 1. Strategic Vision for Drug and Alcohol Treatment Funding Aligning with the National Drug Strategy and the Queensland Alcohol and Other Drugs Action Plan , the Central Queensland, Wide Bay and Sunshine Coast PHN s (our PHN) Strategic Vision for the Drug and Alcohol Treatment Activity Work Plan is to reduce the adverse impact of alcohol and other drugs on the population of our catchment. Our PHN will utilise the Drug and Alcohol Treatment Needs Assessment findings to guide further analysis, service development and implementation to address service gaps, invest in workforce capacity and focus on improved regional and service provider coordination and efficiency. Working within the strong governance structure of a regional Mental Health Drug and Alcohol Council (MHDAC) (further detailed in the Mental Health Activity Work Plan), our PHN will streamline service mapping and detailed assessment processes and minimise duplication of service commissioning in these two very closely related domains of care. Recognising the need for clients to access a continuum of services, our PHN investment will focus on improving availability, accessibility and efficiency of drug and alcohol treatment, with priority given to regional and remote areas; vulnerable populations including youth, Aboriginal and Torres Strait Islander and low socioeconomic groups. The service mix to be commissioned over time will be founded on the existing service profile. Over the long term, we aim to provide locally-configured, needs-based services. Recognition that Aboriginal and Torres Strait Islander peoples experience a disproportionate amount of harm from drug and alcohol use, our PHN seeks to engage Aboriginal and Torres Strait Islander communities in a meaningful way to design culturally safe, competent and respectful service improvements. Our PHN acknowledges that a key factor in successful implementation of The Plan is the need to work with providers to stimulate the market and explore opportunities to co-design innovative approaches, making the best use of available workforce, particularly in the rural and remote areas. Foundations for our approach include working with providers to best utilise electronic data systems (including My Health Record) and other person-centred systems to improve sharing of consumer history within privacy provisions and critically assessing commissioned services to ensure they are appropriate to local needs, safe and effective. 2
3 2. (a) Planned activities: Drug and Alcohol Treatment Services Operational and Flexible Funding Proposed Activities Drug and Alcohol Treatment Priority Area / Reference (e.g. Priority Reference 1, 2, 3) Activity Title / Reference (e.g. Activity 1.1, 2.1, etc.) Description of Drug and Alcohol Treatment Activity This activity is in line with the objectives of the PHN Drug and Alcohol Treatment funding, in particular: Undertake an evidence based regional needs assessment process and subsequent drug and alcohol treatment planning in consultation with relevant stakeholders and including service mapping to identify gaps and opportunities, determine priorities, and identify the strategies that will be implemented to better align funding to the region s drug alcohol treatment health and service needs. This activity relates to all priorities as identified in the Initial Regional Needs Assessment Drug and Alcohol Treatment for the PHN. DA01 Sector Engagement and Strategy Development Under this activity, our PHN is committed to directly investing the majority of funds towards enhancing drug and alcohol services for the region. It is acknowledged that a component of this activity relates to planning and service mapping functions which are above and beyond those planning and consultation activities funded provided under operational funds. After initial consultations with key stakeholder, this small but vital complementary investment in planning and service mapping is considered to be an essential component in the pathway towards the development of appropriate service delivery activities. This additional investment will ensure that funds allocated to the delivery of treatment services are best placed to address the right need, in the right place, to the right people whilst reducing duplication and capitalising on current opportunities across the region. The majority of the funding assigned to this activity is related to those strategies outlined in sections DA01.2 and DA01.3. A Mental Health Drug and Alcohol Council (MHDAC) will be established to ensure that the needs of the local communities in our region are accurately addressed, by prioritised and evidence-based plans founded on local knowledge of existing services and workforce. The MHDAC will provide governance over service mapping, gap identification, co-design and co-investment across Mental Health and Drug and Alcohol domains in recognition of the intertwined aetiology of these areas. 3
4 DA01.1 Develop a comprehensive regional drug and alcohol treatment service needs assessment Under the auspices of the MHDAC and associated Regional Strategic Collaboratives (as detailed in Section 1a of the Mental Health Activity Work Plan), a comprehensive Regional Drug and Alcohol Treatment Service Needs Assessment (The Needs Assessment) will be conducted in Building on the Initial Needs Assessment, it will include a detailed appraisal of existing patterns of drug and alcohol consumption, with emphasis on vulnerable population groups such as, rural and remote communities, young people, Aboriginal and Torres Strait Islander people, women, and LGBTI populations. A comprehensive service mapping of drug and alcohol services, examining the type of services provided, workforce profiles, service capacity and utilisation and the populations being served will also be included. Drawing on the strong existing evidence base relating to treatment interventions, priorities for action, co-design and co-investment will be identified. DA01.2 Develop and implement integrated assessment processes and referral pathways Under the auspices of the MHDAC and associated Regional Strategic Collaboratives and in collaboration with Hospital and Health Services and other providers, a Regional Drug and Alcohol Treatment Plan (The Plan) for the region will be developed. The Plan will be tailored to the needs of the region and target groups, while focused on improving service integration and care coordination at the local level. It will also seek to promote linkages with broader social services, including those relevant to mental health to ensure a cross-sectoral and integrated approach. To ensure an integrated and coordinated approach to drug and alcohol services, referral pathways will be developed and implemented in consultation with HHSs and other key stakeholders across the health (i.e. mental health service providers, drug and alcohol service providers and primary care providers) and other relevant support sectors (i.e. social welfare, employment services and child and family services). An important focus of improved referral pathways will be strengthening links between primary care and specialist drug and alcohol services as well as ensuring specialist services are accessible to those most in need. DA01.3 Workforce development The Drug and Alcohol Needs Assessment identified important challenges for workforce development in the region that this activity seeks to address, including: a) limited resources available for community workers to achieve the qualifications, training and development required to support drug and alcohol treatment, particularly when taking into consideration regional variations in types of drug used and the challenges of responding to multiple comorbidities and changing patterns of drug use (e.g. mental illness, drug or alcohol addiction, chronic disease); 4
5 b) insufficient capacity to deliver culturally appropriate services to Indigenous communities, families and individuals; and c) challenges in recruiting, supporting and retaining staff, particularly in regional, rural and remote areas. In consultation with key stakeholders strategies to address these and other challenges will be developed and implemented. Collaboration Indigenous Specific Duration The MHDAC will be led by our PHN and comprised of executive level representatives of the Queensland Health Mental Health and Alcohol and Other Drugs Branch as well as members of each of the PHN Regional Strategic Collaboratives (RSC) i.e. Central Queensland, Wide Bay and Sunshine Coast. The three RSCs are facilitated by our PHN (as the Lead Agency) in collaboration with the respective Hospital and Health Services across the region. Whilst the exact membership composition for each of the RSCs across the region is responsive to local organisational architecture, key representation perspectives are consistent across each council and include a wide range of membership from those with lived experience through to Aboriginal and Torres Strait Islander groups as well as experts and clinicians. To further facilitate planning with a specific Aboriginal and Torres Strait Islander focus, a Regional Aboriginal and Torres Strait Islander Advisory Group is being established to engage with communities and community leaders as well as local Aboriginal Community Controlled Health Services. Responsibilities for assessing processes and referral pathways will be outlined The Plan, however It is envisaged that the PHN will play a significant role, with focus on facilitating, securing and integrating the inputs of key stakeholders to ensure effective development of processes and referral pathways. The development and implementation of workforce strategies, including training and accreditation, will be implemented with appropriate peak bodies, universities and/or professional colleges and vocational training organisations. The Plan will outline the roles and responsibilities for other related workforce strategies, such as those related to staff retention and support mechanisms required to address high staff turnover due to burnout. No, however Aboriginal and Torres Strait Islander people will be a predominant target population from a planning perspective. The development of a comprehensive Regional Drug and Alcohol Treatment Service Needs Assessment will take place in
6 As required by the DoH, the Regional Drug and Alcohol Treatment Services Plan for the region will be drafted by 1 October. During 2017, work on joined up assessment processes and referral pathways will be initiated. It is envisaged that workforce development related activities will commence in early 2017 in accordance with The Plan and continue through Coverage Commissioning approach Data source This activity will cover the entire PHN region. We will use a co-commissioning approach to engage drug and alcohol experts to complete the service mapping, needs assessment and planning work. PHN Corporate records 6
7 Proposed Activities Drug and Alcohol Treatment Priority Area / Reference (e.g. Priority Reference 1, 2, 3) Activity Title / Reference (e.g. Activity 1.1, 2.1, etc.) Description of Drug and Alcohol Treatment Activity Increase local availability of withdrawal management and support services DA02 - Drug and alcohol withdrawal management program DA02.1 Identification of opportunities and barriers for withdrawal management and support services Building on the Initial Needs Assessment, our PHN will consult and engage further with local drug and alcohol service providers to identify opportunities and barriers to increasing the availability and accessibility of withdrawal management and support services. DA02.2 Development of locally appropriate service delivery models Service delivery models, including clinical governance arrangements to increase the availability and quality of withdrawal management and support services within the region will be explored. For these purposes, different withdrawal service modalities including day patient, and home-based withdrawal will be examined. Local stakeholders will be consulted to identify barriers and opportunities for increasing availability of services under each modality. Particular emphasis will also be placed on developing effective pathways to post-acute withdrawal support and relapse prevention services. To ensure services operate within a continuous quality improvement framework, clinical governance arrangements will be developed to ensure high standards of clinical performance, clinical risk management and clinical audit as well as adequate processes to manage adverse events within withdrawal and support services in our PHN. DA02.3 Commission withdrawal management and support services In 2017, our PHN will begin work to commission withdrawal management and support services in accordance with the developed service models. In particular, services commissioned will aim to ensure that there are appropriate, accessible and integrated services available for those most in need. The choice of which services to be commissioned will thus take into consideration various factors, including the range of 7
8 treatments available that can be targeted to the regional needs, identified gaps in services, and the associated cost. Collaboration Indigenous Specific Duration Coverage Commissioning approach Data source The development of service models and clinical arrangements will be jointly undertaken with key stakeholders including (but not limited to) the HHSs, non-government organisation service providers, peak bodies, Aboriginal and Torres Strait Islander health services, social welfare services and consumer organisations. Commissioning activities will be undertaken by our PHN (unless in the development of The Plan it is agreed with other stakeholders that joint commissioning approaches would be warranted). No, however Aboriginal and Torres Strait Islander people will be a priority target population from a planning perspective. Drawing on The Needs Assessment and The Plan, in late 2016 activities will commence to develop locally appropriate service delivery models and clinical governance arrangements for withdrawal management and support services. It is envisaged that in early 2017 the PHN will start commissioning appropriate withdrawal management and support services. The entire PHN region, though it is envisaged that, taking into account the different regional patterns of drug and alcohol use, the service mix will differ across areas. Our PHN will use co-design and/or service-based commissioning approaches as appropriate for the specific service(s) being commissioned. Market sounding, with a focus on outcomesbased commissioning will be taken into account. Direct engagement approach may be used in instances where there is immediate opportunity for capacity development. Commissioned services will be monitored and evaluated via quarterly meetings; monthly or quarterly outcomes-based reporting requirements as specified in the contract. PHN-commissioned services will be required to report against the performance indicators (developed in consultation with state and peak bodies) as part of contractual arrangements. 8
9 Proposed Activities Drug and Alcohol Treatment Priority Area / Reference (e.g. Priority Reference 1, 2, 3) Activity Title / Reference (e.g. Activity 1.1, 2.1, etc.) Description of Drug and Alcohol Treatment Activity Increase availability of after hours counselling and crisis care services DA03 - Drug and Alcohol After Hours Counselling and Crisis Care DA03.1 Commission after hours drug and alcohol treatment services Guided by The Needs Assessment and The Plan, our PHN will initially explore opportunities to enhance PHN commissioned mental health counselling services to offer, where possible, additional face-to-face after hours drug and alcohol and crisis care services for individual s and families, and commission services. Following additional service mapping and needs assessment work, further commissioning activity will be undertaken to fill identified service gaps in specific locations. DA03.2 Increase awareness and utilisation of after hours services In the context of collaboratively developing The Plan, strategies could include the communication and promotion of, and/or increasing the availability of after hours counselling and crisis care services for drug and alcohol treatment Our PHN, in conjunction with regional partners, will promote the availability and use of regionally developed after hours counselling and crisis care services as well those services provided nationally and/or state wide. Collaboration Identification of opportunities and co-design of counselling services will be jointly undertaken with key stakeholders including (but not limited to) the HHSs, Non-government organisation service providers, peak bodies, Aboriginal and Torres Strait Islander health services, social welfare services and consumer organisations. 9
10 Commissioning activities will be undertaken by our PHN (unless in the development of The Plan it is agreed with other stakeholders that joint commissioning approaches would be warranted). Indigenous Specific Duration Coverage Commissioning approach Data source No. Drawing on The Needs Assessment and The Plan, in late 2016 activities will commence development of locally appropriate service delivery options for after hours counselling and crisis care. It is envisaged that in early 2017 the PHN will start commissioning appropriate after hours counselling and crisis care services. The entire PHN region, taking into account differences in the availability of existing services and level of need. Our PHN will initially explore options to enhance contract scope with current PHN commissioned mental health counselling services. If additional services are required, our PHN will use codesign and/or service-based commissioning approaches as appropriate. Market sounding, with a focus on outcomes-based commissioning will be taken into account. Direct engagement approach may be used in instances where there is immediate opportunity for capacity development. Commissioned services will be monitored and evaluated via quarterly meetings; monthly or quarterly outcomes-based reporting requirements as specified in the contract. PHN-commissioned services will be required to report against performance indicators as part of contractual arrangements. 10
11 2. (b) Planned activities: Drug and Alcohol Treatment Services for Aboriginal and Torres Strait Islander people Flexible Funding Proposed Activities Drug and Alcohol Treatment Priority Area / Reference (e.g. Priority Reference 1, 2, 3) Activity Title / Reference (e.g. Activity 1.1, 2.1, etc.) Description of Drug and Alcohol Treatment Activity This activity is in line with a focus for the PHN Drug and Alcohol Treatment funding, in in relation to: Ensuring that Indigenous-specific Drug and Alcohol Treatment services are commissioned and that culturally appropriate mainstream treatment services are available for Indigenous Australians. This activity also relates to the Aboriginal and Torres Strait Islander priority area identified in the Baseline Comprehensive Needs Assessment for our PHN. DA04 - Increase availability of specific services for Aboriginal and Torres Strait Islander people DA04.1 Withdrawal management, counselling and rehabilitation services for Aboriginal and Torres Strait Islander people Adopting a focus on community ownership, our PHN will meet with Aboriginal and Torres Strait Islander elders, community leaders and service providers to respectfully listen and seek to understand specific community challenges in this area. The objective will be to identify strengths and barriers of existing services and know which providers are known and trusted by community as being culturally safe. Particular emphasis will be placed on understanding existing community-controlled service models to identify their strengths and opportunities for further investment. A holistic approach that is culturally safe, competent and respectful will drive any strategies adopted by the PHN to improve the quality and availability of services targeting Indigenous populations. DA04.2 Commission appropriate drug and alcohol treatment services for Aboriginal and Torres Strait Islander people. 11
12 Based on consultation as described above, our PHN will co-create or commission appropriate drug and alcohol treatment services for Aboriginal and Torres Strait Islander people. DA04.3 Increase workforce capacity and capability This activity aims at improving the capacity and capability of the drug and alcohol services including those that are community controlled and their workforce to deliver quality, effective drug and alcohol services in the catchment. This will involve identifying workforce needs and co-designing strategies to increase the capacity and capability of the workforce (within Indigenous organisations and among non-indigenous specific drug and alcohol treatment services) to deliver services to Indigenous communities, families and individuals. Consultation will be undertaken to assess workforce needs to inform the co-design of strategies including but not limited to-: o o cultural awareness training (for mainstream services); educational resources and greater support to improve staff retention and skills enhancement. Collaboration Indigenous Specific Duration The intended approach will maximise existing community strengths and will focus on fostering community ownership, following community cultural protocols and cultural acceptance. Identification of opportunities and co-design of services will be jointly undertaken with Aboriginal and Torres Strait Islander organisations, HHSs, alcohol and other drug service providers, social welfare services and consumer organisations. Commissioning activities will be undertaken by our PHN (unless in the development of The Plan it is agreed with other stakeholders that joint commissioning approaches would be warranted). The development and implementation of workforce strategies will be undertaken with appropriate peak bodies, service providers, Aboriginal and Torres Strait Islander organisations, universities and/or professional colleges and vocational training organisations. Yes During 2016, consultation activities to identify opportunities and barriers to enhancing existing services and increase their availability will commence. To ensure a genuine consultation process and Indigenous ownership, it is envisaged that such consultation activities will continue long term. 12
13 Drawing on the above consultation process, the commissioning of appropriate drug and alcohol treatment services will start in Likewise, identification of workforce needs will commence in late 2016 as part of the consultation process. This will inform the co-design of appropriate strategies to take place in Coverage Commissioning approach Data source Our PHN is home to approximately 23,415 Indigenous people. The vast majority (10,525) are located in the Central Queensland regional area, which is also home to Woorabinda LGA, where 92.8% of the population is Indigenous and to Rockhampton LGA, which has the largest number of Indigenous people in the catchment (4,889). Other LGAs with a large number of Aboriginal and Torres Strait Islanders are, Sunshine Coast (4,082), Fraser Coast (3,417), Bundaberg (2,981), and Gladstone (2,049). Therefore, although services will be provided across the entire PHN, these LGAs with a large number of Indigenous populations will be given priority. Enhanced services for Aboriginal and Torres Strait Islander populations will adopt a place-based commissioning approach where appropriate. Commissioning approaches intend to be inclusive and consultative, particularly of Community Elders and leaders. Our PHN will use co-design and/or service-based commissioning approaches as appropriate, for the specific service(s) being commissioned. Market sounding, with a focus on outcomes-based commissioning will be taken into account. Direct engagement approach may be used in instances where there is immediate opportunity for capacity development. Commissioned services will be monitored and evaluated via quarterly meetings; monthly or quarterly outcomes-based reporting requirements as specified in the contract. PHN-commissioned services will be required to report against performance indicators as part of contractual arrangements. 13
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