National Drugs Rehabilitation Framework: person-centred care in the addiction services

Introduction: The National Drugs Rehabilitation Framework (2010) is a framework through which service providers can ensure that individuals affected by drug use can access a range of integrated options tailored to meet their needs and create for them an individual rehabilitation pathway

An integrated model of rehabilitation means that the Service User’s specific needs are met through interventions which are not necessarily confined to drug-specific interventions. Each Service User will have a complexity of needs which will require support in some or all of the following areas:

Drug specific interventions

Housing and tenancy support and independent living

Mental/physical/intellectual disability

General health services and  health promotion

Employment (incl. community employment), work placements

Community integration, social and recreational activities

Education and training, personal development

Justice, law and criminal issues support

Family support and childcare

Budgeting and money management

Transition programmes (eg. structured pre-induction)

Aftercare

No one agency will be able to provide the range of supports that the service user needs. Therefore, through the NDRF process of comprehensive assessment, key working, care planning and case management, the specific need of the service user can be established and the services they require can be coordinated.

Change management process, practice change, targetted population and stakeholders, timeline

Following a pilot roll-out in ten sites, the NDRF was evaluated in 2013 and is now being implemented nationally in services who work with drug-using individuals. The change management process has included the following:

Nomination of local rehabilitation drivers through the Drug and Alcohol Task Forces

Inclusion in the National Drug Treatment Reporting System

Inclusion in the HSE Operation Plan as a national key performance indicator

Inclusion in service level agreements between the HSE and section 39 funded projects

Inclusion as sample evidence in the National Standards for Safer Better Healthcare workbooks for the Addiction Services

Highlights: Achievements to date include:

Development and sharing of protocols and resources online and through the rehabilitation drivers network

Development of shared assessment criteria and referral pathways in a number of Drug and Alcohol Task Force areas

Local memorandum of understanding between services in Drug and Alcohol Task Forces on referral processes

Planned development of a competency framework for staff who work with drug-using clients, in collaboration with the Dublin Region Homeless Executive and HSE Mental Health

Development of competency based training resources

Under the NDRF, the Service User can expect person-centred care, consistency of care, integrated care based on assessed need, individualised care plan and quality service provision.

Sustainability and transferability: The NDRF is supported at a local level by the Drug and Alcohol Task Force through the nominated rehabilitation driver, and by sectors at a national level through representation on National Drug Rehabilitation Implementation Committee (NDRIC). The NDRF is supported by a national Coordinator within HSE Social Inclusion and by the National Oversight Forum on Drugs. The MOUs on referral processes in many areas and the successful implementation of shared assessments and referrals in the South are supported by the sharing of information, tools, policies, resources and training by the rehabilitation drivers through the national Coordinator.