1. NDTMS Core Dataset ‘F’ Training
Regina Lally, Kellie Peters and
Michael Wallington
Drug Treatment Monitoring Unit

2. Ground Rules
Please respect those around you by not holding individual conversations whilst the sessions are in progress
Please put mobiles on silent/vibrate
Please take any calls outside of the meeting

3. Aims Clarify requirements and definitions of Core Data Set F (CDS-F)
Clarify DAAT care co-ordination pathways and practicalities surrounding TOP data submission to NDTMS
Provide updated information around data quality, reporting and monitoring

4. New for Core Dataset F Main additions to YP dataset
Adult dataset changes are:
1 new field
Reference data changes

5. TOP Care Co-ordination
Options: Yes / No
To be used from 1st April 2009
To support the monitoring of TOPs completion
Agency is care co-ordinator who has current responsibility for completing TOP

6. Parental Status Reference Data changing from 1st April 2009:
All the children live with the client
Some of the children live with the client
None of the children live with client
Not a parent
Client declined to answer

7. Drug Discharge Reasons
Successful Completions
Treatment completed - drug free
Treatment completed - occasional user (not opiates or crack)

8. Drug Discharge Reasons
Transfers
Transferred – not in custody
Transferred – in custody

9. Drug Discharge Reasons
Incomplete
Incomplete – Dropped Out
Incomplete – Treatment withdrawn by provider
Incomplete – Retained in Custody
Incomplete – Treatment Commencement Declined by Client
Incomplete – Client Died

10. Alcohol Discharge Reasons
Successful Completions
Treatment completed - alcohol free
Treatment completed - occasional user

11. Alcohol Discharge Reasons
Transfers
Transferred – not in custody
Transferred – in custody

12. Alcohol Discharge Reasons
Incomplete
Incomplete – Dropped Out
Incomplete – Treatment withdrawn by provider
Incomplete – Retained in Custody
Incomplete – Treatment Commencement Declined by Client
Incomplete – Client Died

13. Adult Alcohol Modalities
Tier 3
ALC - Community Prescribing
ALC - Structured Psychosocial Intervention
ALC - Structured Day Programme
ALC - Other Structured Treatment
Tier 4
ALC - Inpatient Treatment
ALC - Residential Rehabilitation
Tier 2 (New)
ALC – Brief Interventions
Will NOT count towards numbers in Treatment.
‘Other Structured Intervention’ – must be care planned for it to be classed as tier 3 activity.

14. Consent
Clients should give written consent to share information about their care plan. This consent should specifically state which agencies the client consents to have information received about them and which they do not. A form recording the client’s consent should be kept in the notes. Consent should be reviewed at the time of reviewing the care plan.
If a client refuses consent – NATMS and TOP should still be completed within your own system, consent flagged as no, and we will receive only minimal non-identifiable data.
If the client is not aware that the DAAT would have sight of the attributable data, their row level data cannot be shared with the DAATs.

15. Confidentiality
Agencies should have clear policies about how assessment information and care plans are shared.
Good information sharing protocols help the care planning process to be smoother and prevent the hold-ups and misunderstandings that might arise if all the relevant information for the client was not available to practitioners and keyworkers in different agencies.
(Good practice in care planning, July 2007 NTA)
Part of the assessment process should be establishing with a client how information relating to them may be shared and for what purpose. This may be done as part of the care planning process and should have started at the time of assessment.

16. NTA Confidentiality Toolkit
Confidentiality policy should be clearly explained to client (verbally and written form), before assessment for treatment.
Should cover:
What information will be collected by the agency
When and what information will be shared with other services and organisations
Who information will go to and why (NDTMS)
When the confidentiality may be breached
(NTA Confidentiality Toolkit, pending 2009 NTA)

17. Questions
Anything NDTMS related!

18. NTA Quarterly Reports Available on NDTMS.net
Providers no longer being given access to restricted section
DAAT should circulate relevant report to providers

19. TOP Care Co-ordination
Discuss the care pathways and map out the client journey. Look at
Where do they enter Structured Treatment
Which agencies are they likely to be engaged with
Who should be providing TOPs in each situation
Think about a variety of scenarios

20. TOP Feedback

21. Client Information Agency ID: P0000 First Initial: A Second Initial: W
DOB: 22/10/1973
Gender: Male
Referral Date: dd/mm/yyyy
T3 Assessment Date: dd/mm/yyyy
Main Problem Substance: Alcohol
PCT of residence: Kent
DAT of residence: Kent
Postcode: ME14 1HH Referral Source: Self
Client Ref: 123
Previously Treated: No
Consent for NATMS: Yes
Sexuality: Heterosexual
Ethnicity: White
Local Authority: Maidstone
Nationality: GBR
- What is the trigger for sending NDTMS data to DTMU?
Full postcode / truncated
Consent must be populated
All fields must be populated to best of client’s knowledge and happy to respond. Not keyworker’s choice.
(East Midlands lookup facility for new PCT codes)
Nationality codes – are those listed within the ISO Alpha-3 standard
- Check on your system, that you have correct options. E.g. BOMIC – not known, british and other are NOT acceptable options.
From 1st October 2007, if you are drug and alcohol service, please provide clients presenting with both Drug and Alcohol as a main problem drug. NTA will require a baseline in 07-08, so we hope to be able to provide 6 months worth of data. Consent must be provided, as with all clients and confidentiality will be the same.

22. Referral Date Definition
(referral to agency date) date agency becomes aware that the client is waiting.
Date of receipt of phone-call, letter, client walks through door asking to be seen etc.

23. Care Planning
“As soon as possible, the allocated keyworker will ensure that the client undergoes a comprehensive assessment of needs. Following this a comprehensive care plan is drawn up”.
(Care Planning Practice Guide, August 2007, NTA)
“…service user involvement [is] an integral part of the development of care plans, with the users as the central focus of care planning, review and ongoing treatment.”
(Good Practice in Care Planning, July 2007, NTA)

24. Care Planning Domains Drug & Alcohol Use
Care Plan Start Date: dd/mm/yyyy
Drug & Alcohol Use
Route of Administration of Primary Substance: Oral
Age of first use of Primary Substance: 23
Problem Substance Two: Cannabis
Problem Substance Three: Amphetamines Unspecified
Injecting Status: Never
Injected in last 28 Days: No
Ever shared: No
Drinking Days: 28
Units of Alcohol: 17
NDTMS information that will be captured as part of the care planning process and as the care plan progresses.
We have tried to pull the various fields under one of the four care planning domains – the care planning domains continue as a theme on the TOP form.
Care Plan Start Date – must be before modality start date!
As you can quite clearly see the new data items fit neatly within the Care Plan domains that we (DTMU) have mentioned in previous training sessions.
You will also note that ‘units of alcohol’ has appeared, as you may be aware there has been much debate around alcohol collection for a number of years, and this is the first data item that looks at alcohol consumption other that the drug fields. Alcohol is likely to be collected from 1st April 2008, if you are a drug and alcohol agency and wish to submit alcohol data (with the understanding that Alcohol clients will not be counted towards the LDP figure) the DTMU will process this alongside the drug client data. Over the next 12months the DTMU will be contacting alcohol only agencies about engaging with NDTMS.
If you complete drinking days, you must populate units of alcohol – otherwise a warning will be created.
Drinking days is out of 28 / Units is average daily consumption.
If “Drinking Days” completed, “Units of Alcohol” MUST be completed as well
“Units of Alcohol” is typical number of units consumed on a drinking day

25. Care Planning Domains
Physical & Psychological Health
Hep C Latest Test Date: dd/mm/yyyy
Hep C Intervention Status: Offered and accepted
Hep C Positive: No
Hep B Intervention Status: Offered and accepted
Hep B Vaccination Count: One vaccination
Previously Hep B Infected: No
Referred to Hepatology: No
Dual Diagnosis: No
For latest hep c test date: If client just knows year, then enter 01/01/yyyy – if they know month and year enter 01/mm/yyyy
Should be recorded whether hep c test is offered etc under hep c intervention status.
Dual Diagnosis – for those clients who are also in contact with mental health teams. This is simply a yes/no field.
This is appearing in quarterly reports – again, populate with yes or no, not blank.
Harm reduction is high on the current NTA agenda and are focusing on Hep B / C interventions being offered via NDTMS quarterly reports. Importance of populating the fields to indicate that something has occurred rather than left blank (not offered is the acceptable).
Not likely to be as relevant for Alcohol only clients. Report if it is relevant for the client.

26. Care Planning Domains Social Functioning
Accommodation Need: Housing Problem
Employment Status: Unemployed
Children: 3
Pregnant: Yes
Parental Status: All the children live with client
NDTMS fields captured under “social functioning” care planning domain
Note of options for drop down lists to be handed out.
Highlights other needs that may need to be addressed with the client and with partnership agencies.
Accommodation need (previously accommodation status) – separate lists for Adult and YP.

27. Parental Status Reference Data changing from 1st April 2009:
All the children live with the client
Some of the children live with the client
None of the children live with client
Not a parent
Client declined to answer

28. Adult Alcohol Modalities
Tier 3
ALC - Community Prescribing
ALC - Structured Psychosocial Intervention
ALC - Structured Day Programme
ALC - Other Structured Treatment
Tier 4
ALC - Inpatient Treatment
ALC - Residential Rehabilitation
Tier 2 (New)
ALC – Brief Interventions
Will NOT count towards numbers in Treatment.
‘Other Structured Intervention’ – must be care planned for it to be classed as tier 3 activity.

29. Modality Data Referral Date: dd/mm/yyyy
T3/4 Assessment Date: dd/mm/yyyy
Referral Source: Community Alcohol Team
Referral to Modality Date: dd/mm/yyyy
Date of First Appointment Offered: dd/mm/yyyy
Modality: ALC- Community Prescribing
Modality Start Date: dd/mm/yyyy
If modality start date is populated and care plan start date is empty a validation message will be returned!
Referred to Mod date and Modality are linked – error if one left blank
Do not input Mod Start in the future – wait until actually happens.
MOD START IS KEY FIELD – now trigger for TOP and Waiting Times. Therefore pay special attention to getting the field right.
This is client’s first intervention in the DAAT Treatment System, and therefore by the time you’ve entered the modality start date a care co-ordinator must have been identified and therefore responsible for completing TOPS form.

30. Treatment Outcomes Profile
Short, validated outcome monitoring tool released by the NTA June 2007
Intended for implementation in all Drug services that provide structured Tier 3 & Tier 4 treatments
Data to be reported to NDTMS from 1st October 2007
Should be completed at:
Modality Start
Care Plan Review
Discharge
Post Discharge [Optional]
Further information available on NTA website.

31. Treatment Outcomes Profile
Validated for clients with Alcohol as main problem substance.
No initial requirement by NTA to complete TOPs at Alcohol Only agencies.
Recommended/Encouraged completion of TOP forms.
Further information available on NTA website.

32. TOP NDTMS Data You should aim to ask and complete every question.
Do not leave any of the blue boxes blank
Enter “NA” if a client refuses to answer a question or cannot recall.
Where DAAT areas have incorporated the form into their own paperwork, the questions should be replicated exactly as they appear on the TOP form and need to be input into the NDTMS at the appropriate points in the client treatment. The above points apply to locally adapted paperwork as well.

33. DAATs should have agreed care co-ordination pathways locally.
TOP NDTMS Data
Modality Start Date: dd/mm/yyyy [Trigger for first TOP]
TOP Date: dd/mm/yyyy
TOP Treatment Stage: Treatment Start
TOP Care Co-ordination: Yes
When multiple agencies are providing treatment, it is envisaged that responsibility for reporting TOP data will lie with the agency responsible for care co-ordination.
DAATs should have agreed care co-ordination pathways locally.
Where there is more than one agency simultaneously providing treatment, the agency should send copies of the TOP information to other services (subj. to Info Sharing Prot in place and client consent).

34. TOP NDTMS Data Section 1: Substance Use Alcohol Use: 15 Opiate Use: 0
Crack Use: 0
Cocaine Use: 15
Amphetamine Use: 4
Cannabis Use: 10
Other drug use: 0
Information sought:
Number of days out of last 28 client has used each drug.
Permissible values:
Number in range “0-28”
“NA” if client is unable to or refuses to answer question

35. TOP NDTMS Data Section 2: Injecting Risk Behaviour IV Drug Use: 0
Sharing: N
Information sought:
Number of days out of last 28 client has injected non-prescribed drugs.
Permissible values:
Number in range “0-28”
“NA” if client is unable to or refuses to answer question
Information sought:
Has client shared needles or paraphernalia in last 28 days.
Permissible values:
Y or N
“NA” if client is unable to or refuses to answer question

36. TOP NDTMS Data Section 3: Crime
No details of specific crimes should be shared by client with keyworker.
General information about type of crimes funding drug or alcohol habit should be shared and recorded to address all client needs and evidence improvement in lifestyle.
The information shared with NDTMS is subject to the same confidentiality as all client information currently / previously received.
Data is used for performance / outcome monitoring only.

37. TOP NDTMS Data Section 3: Crime Shop Theft: 18 Drug Selling: 6
Other theft: Y
Assault / Violence: N
Information sought:
Number of days out of last 28 client has been involved in each crime.
Permissible values:
Number in range “0-28”
“NA” if client is unable to or refuses to answer question
Information sought:
Has client been involved in each crime in last 28 days.
Permissible values:
Y or N
“NA” if client is unable to or refuses to answer question

38. TOP NDTMS Data Section 4: Health & Social Functioning
Psychological Health Status: 9
Paid work: 3
Education: 1
Information sought:
Self reported score from scale.
Permissible values:
Number in range “0-20”
“NA” if client is unable to or refuses to answer question
Information sought:
Number of days out of last 28 client has had paid work or been in education.
Permissible values:
Number in range “0-28”
“NA” if client is unable to or refuses to answer question
Client focused.
Any queries on scales, refer to Keyworker Guidance – help on extracting accurate info from client.

39. TOP NDTMS Data Section 4: Health & Social Functioning
Physical Health Status: 5
Quality of Life: 4
Acute Housing Problem: N
Housing Risk: Y
Information sought:
Self reported score from scales.
Permissible values:
Number in range “0-20”
“NA” if client is unable to or refuses to answer question
Information sought:
Client has been homeless / risk of eviction in last 28 days.
Permissible values:
“Y” or “N”
“NA” if client is unable to or refuses to answer question

40. Modality End / Discharge Data
Modality End Date
Modality Exit Status
Can be entered as modalities are completed, client episode remains open
MUST be entered for all modalities on discharge from agency
Discharge Date
Discharge Reason
If a Discharge Date is entered, then a Discharge Reason must be given and vice versa.
Discharge information must be reported accurately and in a timely fashion as it is used to monitor successful completions.
If agencies want other discharge reasons added, we can put them forward to the NTA on their behalf. Can’t guarantee that it will be added, but we can try.

41. Complete TOP at discharge from treatment system.
Discharge Data and TOP
Complete TOP at discharge from treatment system.
This should be done face-to-face between keyworker and client where possible
May be done over telephone where no other option available (i.e in unplanned discharges).
NOT acceptable to complete on clients’ behalf without client present.

42. LUNCH

43. Data Collection Purpose
Enables national, regional and local-level reporting on alcohol treatment.
Supports the National Alcohol Strategy and needs analysis
Facilitate policy formulation
Supports development of efficient commissioning systems at local level

44. Planned Performance Monitoring
Performance measures for Alcohol Services are being developed now that there is one year of baseline data.
Numbers in Treatment
Waiting Times
Successful completions of treatment

45. Reporting and Monitoring
Monthly
Quarterly
Proposed “Purple Reports”

46.
GO THROUGH QUARTERLY PERFORMANCE REPORTS – provide each delegate with their agencies Q3 report.

48. Quarterly “Purple Reports”
For Consultation

49. Potential Reports What would Commissioners find useful?
What would Agency staff find useful?
Suggestions???

50. What should you expect from DTMU?
Agency Training and Support: Dedicated Liaison Officers and Database Administrator providing telephone and in-house training on CDS-F dataset.
Guidance Documentation: ‘A Rough Guide to the NATMS’ (in development)
Monthly Validation and Data Quality Reports: Reporting erroneous client records, requiring correction.
Newsletter
Access to DTMU documents online

51. DTMU Data Quality Standards
All monthly agency submissions must contain at least 100% valid records.
All monthly agency submissions must reach 99.9% data quality
All fields of CDS-F populated.
Files must be in a CSV format.
All agencies must submit via the Drug and Alcohol Monitoring System (DAMS):

52. SE DTMU Team Based in Oxford with SEPHO Team consists of:
Kellie Peters: Head of Data Management
Regina Lally: Manager
Michael Wallington: Technical Liaison
Sue Dales: Database Administrator
Caroline Ridler: Information Analyst
Rachel Johnson: Information Analyst
Laura Kesseboom: DIR Administrator
Lucy Nicholson: DIR Administrator
Jo Frank: Project Administrator

53. ANY QUESTIONS

54. Kellie.Peters@sepho.nhs.uk Regina.Lally@sepho.nhs.uk