effective treatment. changing lives treatment outcomes profile (top) level 3 top outcomes report...

Effective treatment. Changing lives

Treatment Outcomes Profile (TOP)Level 3 TOP Outcomes ReportImportant notes

November 2009


Contents

Performance management warning How to use these notes Examples of how to use these notes Eligibility criteria Eligible Partnerships Outcomes in Problematic Substances Outcomes in Substances Used Outcomes in Injecting behaviour Outcomes in Crime Outcomes in Health and Social Functioning


This is the first level three outcomes report and it should not be used for delivery assurance

The information contained in the Level 3 Outcomes report should NOT be used for the purpose of delivery assurance. This will begin quarter 1 in 2010/11.

Therefore this data is provided for information purposes only because: There is only one quarters data There are some small numbers, especially at Provider level (this makes

percentage comparisons difficult) The information has not been adjusted for the differential case mix of client

profiles in different partnerships (to ensure like for like comparisons) No performance metrics have yet been established against which

performance could be said to be good or not

All data is RESTRICTED and should not be disseminated beyond the partnership or provider

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How to utilise these notes

We have continued to receive requests from the field for guidance on the TOP reports and what they mean

Dense word documents have not proved to be the best way to communicate information. People either don’t have time to read or find them confusing and difficult to follow

This PowerPoint pack aims to communicate the information in a simple, interactive and effective format.

To keep the number of slides needed to communicate all the information the following slides have been animated. This makes the pack difficult to print and you will need to view it in ‘slide show mode’.

Each slide is linked to the contents page, so you can easily navigate through the different sections – just click the contents button in the top right hand corner of any slide and it will take you back

We suggest several ways that this information can be used – these are shown in the slides to follow

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This format can be used in a variety of different ways. Two of the most common ways are shown here

Print the actual Level 3 Outcomes report not the notes.

Open the PowerPoint notes on your PC

Select slide show mode

Press ‘enter’ to move through the notes

You can then go through your report at your own pace in combination with the PowerPoint notes

The Level 3 Outcome report notes can be used in the ‘traditional format’ as an aid to a verbal presentation.

Or, several reports can be printed and all persons can run through the reports & explanatory notes in a group

This might be useful if the information needs to be communicated to a group of people.

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Contents


There are five key eligibility criteria used to define the clients included in the level 3 outcomes

They started a treatment journey in Quarter 4 2008/09

They were in treatment for at least 6 months

They were to be aged 18 and over at triage

They had a TOP reported within +/- two weeks of starting treatment

They had a TOP reported between 5 and 26 weeks after starting treatment

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There are currently 46 Partnerships who have met the eligibility criteria and can access the Level 3 Outcomes Report (all providers in the partnership area also have access)

Eligible Partnerships

Barnet Dudley Lincolnshire Stockton-on-Tees

Bath and North East Somerset

Ealing Medway towns Telford and Wrekin

Bedfordshire Enfield Middlesbrough Torbay

Birmingham Essex Milton Keynes Tower Hamlets

Blackburn with Darwen Hackney Newham Trafford

Bradford Hammersmith and Fulham

North East Lincolnshire Wakefield

City of London Hartlepool North Lincolnshire Waltham Forest

Coventry Havering Nottinghamshire Warrington

Derby Hertfordshire Plymouth Westminster

Devon Isle of Wight Salford York

Doncaster Kent Solihull

Dorset Kingston Upon Hull Staffordshire

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These figures show the average number of days using a drug – in those who were using it at the Start of treatment – in the 28 days preceding their Review in the 5-26 weeks

after treatment started

These figures provide a summary of the difference between the average level of use at the Start of treatment compared to the average level of use at Review

The first section of the Outcomes report only considers clients who cited a particular drug as problematic at triage

These drugs were cited by the client as problematic (Drug 1, 2 or 3) when they started treatment

These figures document the number (%) of people who were not using the drug when theyentered treatment but who subsequently report using it by the time of the Review

‘Number of valid TOP pairs’ is the number of clients (who said they had a problem with a particular substance) who gave a response on TOP at Start and Review that was between 0 & 28

‘Number using at baseline’ is the number of people who returned a valid TOP pair who were using 1 to 28 days in the month preceding the Start of treatment

‘% Using at baseline’ is the number of people using a substance divided by the number of valid TOP pairs. It may be prudent to question why this percentage is not 100%

These figures represent the average number of days the users of a drug were consuming that drug in the 28 days prior to the Start of treatment. Comparisons with regional and

national figures give an estimate of the relative problem in the Partnership

Of those who were using a substance at the Start of treatment, this percentage shows the proportion of the group who were not using the drug in the 28 days prior to their Review

Are these as expected?Are there large

differences here?

Are reductions better or worse than regional and

national levels?

How do abstinence levels compare to regional and national levels?

Are these levels as expected?

Cannabis use is lower in this Partnership than Regional /

National Levels

Average reduction in use is less in this Partnership.

Is there a reason? What about the other drugs?

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These figures show the average number of days using a drug – in those who were using it at the Start of treatment – in the 28 days preceding their Review in the 5-26 weeks

after treatment started

These figures provide a summary of the difference between the average level of use at the Start of treatment compared to the average level of use at Review

These drugs are not dependent on being cited as problematic at TriageThese figures document the number (%) of people who were not using the drug when they

entered treatment but who subsequently report using it by the time of the Review ‘Number of valid TOP pairs’ is the number of clients (regardless of whether they had a problem

with a particular substance) who gave a response on TOP at Start and Review that was between 0 & 28

Of those who were using a substance at the Start of treatment, this percentage shows the proportion of the group who were not using the drug in the 28 days prior to their Review

‘Number using at baseline’ is the number of people who returned a valid TOP pair who were using 1 to 28 days in the month preceding the Start of treatment

‘% Using at baseline’ is the number of people using a substance divided by the number of valid TOP pairs.

These figures represent the average number of days the users of a drug were consuming that drug in the 28 days prior to the Start of treatment. Comparisons with regional and

national figures give an estimate of the relative problem in the Partnership

Section 1 considers all drug use, reported using the TOP. This is not dependent on it being cited as problematic at triage

These proportions give information about the prevalence of substances in clients accessing treatment in the

Partnership or Provider.

One might want to compare these figuresagainst the numbers reported when a drug

is cited as problematic e.g. crack

Cited as problematic

Reported as used

Why the large difference?Could some of the 157 be extra ‘crack

PDUs’ in this Partnership?

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Section 2 reports on injecting risk behaviour and receptive sharing of injecting paraphernalia as reported on the TOP

The report on injecting risk behaviour follows the same format as Section 1.

The number of pairs that can be analysed

The number reporting the behaviour

% of injectors is the number reporting injecting over the number of valid pairs

% who share is obtained by dividing the numbers of sharers by baseline injectors

These two sections give the Partnership (or Provider)Regional and National comparison figures

Frequency of injecting

Proportion of injectors sharing

This section provides a summary of the amountof reduction in the frequency (above) and proportion (below) of injecting and sharing

This section shows the proportionof injectors who were no longerinjecting by the 6 month review

The final section reports thenumber and % of those who

have started to inject

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Section 3 reports on the crime information that has been reported using the TOP.

Are these levels of reported crime as expectedfor this Partnership or Provider?

How do the frequencies or proportions compareto Regional and National figures?

How do reductions compare to Regional andNational reductions?

Are the levels of those no longer reportingshoplifting or drug selling in line

with comparators?

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Section 4 reports on the health and social functioning that was reported by clients on the TOP

•Consider PAID WORK

•11.1% of those entering this Partnership were working at the start of treatment

•They were working just over 21 days on average in the previous 28

•At Review, ¼ were no longer working (~¼ of 35 workers is 9)

•This REDUCED average working by about 6 days

•BUT 29 individuals started work in the same period

•This translates into a net gain of 20 workers in this Partnership in 6 months – nearly a 60% increase

•NB: these figures must be digested slowly

•Same pattern applies – in this example – to education

Acute housing problems andhousing risk decrease

Health and social functioning alsoincrease by 6 months

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Remember this information should not be used for delivery assurance Contents

The information contained in the Level 3 Outcomes report should NOT be used for the purpose of delivery assurance. This will begin quarter 2010/11.

Therefore this data is provided for information purposes only because: There is only one quarters data There are some small numbers, especially at Provider level (this makes

percentage comparisons difficult) The information has not been adjusted for the differential case mix of client

profiles in different partnerships (to ensure like for like comparisons) No performance metrics have yet been established against which

performance could be said to be good or not

All data is RESTRICTED and should not be disseminated beyond the partnership or provider

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