1. 18/03/2016Presentation name118/03/2016Presentation name1 The Stockton-On-Tees Solution: A model for the delivery of alcohol services in Primary Care Jo Heaney – Modernisation Manager, Public Health (Lead Commissioner alcohol & Young Peoples Substance Misuse)

2. 18/03/2016Presentation name218/03/2016Presentation name2 Background Alcohol Prevalence Primary Care delivery then Service Model Primary Care delivery and now Outcomes to date Challenges Questions Activity 23/18/2016 Aims and Objectives 2

3. 18/03/2016Presentation name318/03/2016Presentation name3 3 Background Unitary Authority Population- 192,406 Ethnicity- 97% White Absolute deprivation versus absolute affluence Alcohol and Drug services separate 24 General Practices

4. 18/03/2016Presentation name418/03/2016Presentation name4 4 Alcohol Prevalence 37,269- Binge drinkers 26,300- Increasing risk 8,678- High risk 2470 dependant drinkers 831 in treatment Jan-Dec 2013

5. 18/03/2016Presentation name518/03/2016Presentation name5 53/18/2016 Primary Care Model 2012 Local Enhanced Contract Level 1 Level 2 Screening & B.I Supporting detoxification Q.I.P.P Project Project reviewedLessons learnt T.A.P Pilot

6. 18/03/2016Presentation name618/03/2016Presentation name6 Criminal Justice SelfGeneral Practice Other E.g. Drug Services / Social Care Assertive Outreach (where needed) Assessment of Need / Recovery Planning (within base or hub setting) P SYCHO - SOCIAL I NTERVENTIONS P HARMACOLOGICAL Disengage Rehab AFTERCARE/Mutual aid groups (ALCOHOL & TREATMENT FREE) R ECOVERY C OMMUNITY R ECOVERY S UPPORT Hospital

7. 18/03/2016Presentation name718/03/2016Presentation name7 73/18/2016 Present Primary Care Model General Practice (24) Enhanced Contract (20) No Enhanced Contract (4) All patients Screened prior To referral Can refer Without screening TeamAroundThePracticeTeamAroundThePractice Pharmacotherapy P.S.I Recovery Treatment/ Interventions Complete recovery Transfer to central site Transfer to Community hub M.O.U/Action Plan

8. 18/03/2016Presentation name818/03/2016Presentation name8 83/18/2016 Outcomes Referrals received from all practices into the T.A.P team There are 20 practices with an enhanced contract There are 15 clinics ran within general practice Clinics available within area’s of deprivation and affluence and in practices that had previously been reluctant. There have been 16,249 people screened, 3901 full AUDIT and BI and 236 referred into specialist services during 13/14 Referrals into the T.A.P team continue to grow

9. 18/03/2016Presentation name918/03/2016Presentation name9 93/18/2016 Challenges Commissioner Effectively engaging all practices in meaningful use of the enhanced contract and T.A.P Building trust and confidence with practices that the whole treatment system would be responsive to referrals. Data collection from enhanced service activity. Ensuring that it is general practice doing the screening and not the T.A.P. T.A.P Team Reluctance by some practices to have clinics within surgery Communication between surgery staff Physical space in practices and the increased for home visits High D.N.A rates- more apparent in some practices.

10. 18/03/2016Presentation name1018/03/2016Presentation name10 Questions

11. 18/03/2016Presentation name1118/03/2016Presentation name11 3/18/2016 Workshop Activity: In groups of five for 5 minutes I want you to discuss and identify what you would need to do in your localities, to ensure an effective model for the delivery of alcohol services does NOT develop within primary care!