Drink and Drugs News DDN Feb2018 - Page 10

Commissioning

Commissioning for CHANGE

An independent expert faculty has been set up to consider a vital new approach to commissioning . Mark Gilman , Paul Musgrave , Niamh Cullen , Terry Pearson and Chris Lee explain the context and the plan of action

Important progress in developing services for managing problematic opioid use has transformed the outcomes for people with serious drug problems . This has been achieved through a balance of innovation and careful allocation of resources . Coming together as a group of commissioners with extensive experience , we needed to look at the pathway leading to these successes , to enable us to review the challenges facing us today . Our aim was to define questions that are central to the ongoing development of care .

This pathway to developing opioid dependence treatment may be divided into a series of stages , with defining characteristics :
Initial problems related to heroin
The 1950s saw increasing non-therapeutic opiate use , a trend which continued to grow throughout the 1960s . Early strategies to address dependence focused on prescribing opioid agonist medicines , with methadone a common and effective choice for many . Residential rehabilitation centres were set up following relatively unsuccessful results with outpatient treatment .

Key questions for commissioning

1 . PLANNING BASED ON INDIVIDUAL NEEDS
How can commissioning approaches assist providers in planning high quality support , by skilled staff , for groups with different aims , goals and characteristics ? How can we improve outcomes while focusing resources effectively ? We need to consider introducing case management functions and systematic commissioning for mutual aid .
2 . NEW THINKING AND INNOVATION
Consider how commissioning can build in new thinking to services which may reduce the need for resources directed to managing misuse and diversion risk , and ensure efficiency in medicines delivery – for example , by using innovative product formulations of opioid agonist therapy , which may not require resource intensive use of dispensing services or supervised consumption .
3 . INTEGRATION AND COLLABORATION
Can commissioning ensure that specialist services better align with partner services ( mental health , housing , social services , probation , police , justice , etc ), to avoid duplication , create efficiency and improve continuity of care ? Can we align competencies systematically so that the right skills are used most efficiently ?
4 . USING THE RIGHT MEASURES
How can commissioners ensure a complete holistic assessment of impact , including real world measures of health , wellbeing , crime , safeguarding and resource utilisation ? Commissioners need to make decisions based on insights from a broad set of outcome measures .
10 | drinkanddrugsnews | February 2018 www . drinkanddrugsnews . com
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