1. A public health programme addressing substance misuse: “North Yorkshire’s experience of commissioning a recovery focussed adult drug and alcohol service”
Angela Hall
Health Improvement Manager
Caroline Townsend
Commissioning Manager
Public Health Team & Commissioning Team, Health and Adult Services

2. What we’ll cover Rationale Process Mobilisation
Commissioning arrangements
Impact so far

3. Rationale
Feedback
NY Population c.600,000. Cover 7 District Councils, 6 CCGs. 3 Coroner’s Officers. 2 Mental Health Trusts. 5 main NHS CCGs

4. Project decision, risk, action records
May 2012
Service reconfiguration programme approved
Local Authority – lead organisation due to imminent transfer of public health responsibilities April 2013
May 2012 – March 2013
Engagement – including market place event
Options appraisal
Preferred model agreed
Dedicated website launched
March 2013 – June 2013
Consultation launched by Director of Public Health
Consultation on preferred model (12 weeks) – mixed method
Process
Including meetings; dedicated website; letters; briefings; FAQs; Overview & Scrutiny; presentations
Communications:
Project steering group: Public Health, procurement, legal, comms, corporate project management
Project decision, risk, action records
June 2013 – October 2013
Consultation Report completed and shared
Feedback sessions completed
Model refinement
Procurement preparation
Council approval processes
October 2013 – May 2014
Procurement launched - via YorTender
Tender evaluation – including clinical and service user input
Contracts awarded
June – Oct 2014
Mobilisation
1st October 2014 – Service Go Live

5. Mobilisation June 2014 September 2014
Initial joint meeting with senior leadership teams to establish expectations and timescales
Fortnightly joint mobilisation meetings with senior leadership teams
Mobilisation plan
Mobilisation decision, action and risk record – including communications
September 2014
Brand developed
Data transfer requirements and arrangements agreed
Briefings – including service user briefings
Provider due diligence
Property sourced and planning requirements explored and satisfied
NHS sponsorship obtained for SystmOne
Meetings with interdependent services – e.g. Pharmacies, CMHTs, GP practices
Transferring service users notified
Including meetings; dedicated website; letters; briefings; FAQs; Overview & Scrutiny; presentations
Communications:

6. Model Group Work Mutual Aid Community Groups & Activities GPs
SPOC
Group Work
Mutual Aid
Triage
Recovery & Mentoring Service
Community Groups & Activities
GPs
Pharmacies
Next Steps
e.g.Dentists,
Smoking cessation,
Housing, ‘ETE’
Volunteers
Treatment
Treatment Service
Recovery & Mentoring Service
Recovery & Mentoring
Visible recovery communities

7. Commissioning arrangements

8. Impact so far… Have a clear and consistent access point √
To better meet the needs of people across the county √
Have a clear and consistent access point √
Support increased numbers of dependent drinkers √
Have a clear focus on recovery – supporting as many people to recover as possible, including abstinence √
Provide a cost effective solution by offering best value for money √ GH

9. Impact so far - better meet needs
“When they all merged into Horizons the difference was massive. There is more support there now. There are more activities to do, there is more group work… If somebody’s feeling down, they can just drop in whereas before if you’d have dropped in, they’d have been saying ‘you’ve not got an appointment.’” (Peer Mentor 2, Recovery & Mentoring Service Scarborough) GH
Source: Academic evaluation, Public Health Institute, Liverpool John Moores University, December

10. Impact so far - support increased numbers of dependent drinkersGH
Source: Public Health England Local Area Trend Report

11. Impact so far - have a clear focus on recovery
Source: Public Health England Diagnostic Outcomes Monitoring Executive Summary Reports*

12. Impact so far - provide a cost effective solution by offering value for money
Opiate only clients
3♥ clients gained 3 years of quality adjusted life expectancy through services moving people into recovery, increasing their quality of life, and making them live longer.
£72k Services produced £72k in cost savings over a client’s lifetime, through reducing the risk of crime associated with drug use, which can add up to a considerable cost over an individual’s drug taking career.
Alcohol only clients
8♥ clients gained eight years of quality adjusted life expectancy through services moving people into recovery, increasing their quality of life, and making them live longer.
£60k Services produced £60k in cost savings through reducing the healthcare costs of alcohol use, and through a reduced risk of crime and antisocial behaviour associated with alcohol use.
Non-opiate only clients
3.6♥ clients gained 3.6 QALYs more than if treatment was not available through improved quality of life while in treatment and recovery.
£64/QALY Treatment for non-opiate users cost £64 per QALY gained which would be considered to be very cost effective, although not cost saving.
Alcohol and non-opiate clients
8.5♥ clients gained 8.5 years of quality adjusted life expectancy through services moving people into recovery, increasing their quality of life, and making them live longer.
£56k services produced cost savings of £56k per client through reduced healthcare costs (such as hospital admissions) and reduced crime and antisocial behaviour costs.
Source: Academic evaluation, Public Health Institute, Liverpool John Moores University, December

13. Questions Angela Hall E: angela.hall@northyorks.gov.uk/W:
North Yorkshire Horizons
SPOC: W: