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IN PRACTICE 2000 PDF file 665Kb
Oiling the wheels
From the south west of England, a frank account what it takes to get treatment services to accept the judgements of their peers and to make this an engine for improvement rather than a source of conflict.
OFFCUT 2002 PDF file 237Kb
Audit Commission paints a stark picture of drug treatment in England and Wales
In 2002 an Audit Commission investigation of drug services and GP involvement in 11 drug action team areas in England and Wales found weak commissioning practices and the absence of management information and effective performance monitoring.
Using advanced methods, this US study asked what makes for an effective treatment agency. Being constrained by funders in terms of services and ability to individualise treatments was the clearest negative factor, quality accreditation the clearest positive.
Instead of telling addiction treatment providers what to do to qualify for funding, the US state of Delaware set recruitment and engagement targets and largely left the methods up to the services. Result: more and more engaging treatment without stifling innovation.
Improving performance of substance use disorder treatment systems is no easy matter and one prone to unintended consequences. All the more welcome then is guidance from leading US experts with top-level experience in the UK and the USA; their favourite tactic, rewarding services for patient progress during treatment, is featured in UK payment-by-results schemes.
In the US homeland of competition and private health care, it was cooperation and coordination which led to the introduction of new medications and innovations to promote continuing care – plus the exercise of regulatory and financial muscle and the salutary experience of senior staff who placed themselves in the patient's shoes.
MATRIX CELL 2018 HTM file
Drug Treatment Matrix cell D4: Organisational functioning; Psychosocial therapies
Key studies on how treatment organisations affect the implementation and effectiveness of psychosocial therapies for drug dependence. See if you agree that “organizational climate underlies the entire process of innovation adoption”, appreciate the obstructive effect of high staff turnover and how to reduce it, ask yourself, “Is my service even ready for change?” – and explore whether change driven by money is just as good for patients as that motivated by a desire to improve their lives.
DOCUMENT 2012 HTM file
Quality standard for drug use disorders
Official UK quality standards on the treatment of adults for problems related to the use of illegal drugs, intended be used to plan and deliver services to provide the best possible care.
STUDY 2009 HTM file
Relating counselor attributes to client engagement in England
The most wide-ranging investigation of the organisational health of British treatment services found clients engaged best when services fostered communication, participation and trust among staff, had a clear mission, but were open to new ideas and practices.
Is regular counselling really essential to the effectiveness of methadone maintenance treatment, or are treatment entry and the power of high-dose methadone enough in themselves for many patients? At least in the first four months, this US study suggests the latter.
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