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Review and re-design of alcohol and other drug withdrawal services in the ACT

In 2015, the ACT AOD sector identified the need for a review and re-design of alcohol and other drug withdrawal services, including the need for a comprehensive service model of care.

This need was in response to increasing harms from methamphetamine and other/poly drugs; the need to strengthen stepped-care and treatment pathways; and the pending opening of the new Aboriginal and Torres Strait Islander AOD Residential Rehabilitation Service at the Ngunnawal Bush Healing Farm.

ATODA advocated, through multiple processes (e.g. ACT Government response to increasing harms from methamphetamine, ACT Budget Submission 2015 – 2016) for ACT Health to support and provide funding for a withdrawal review and re-design project. In June 2016 ACT Health commissioned 360edge (www.360edge.com.au), through ATODA, to conduct an independent review and re-design of the alcohol and other drug withdrawal management services in the ACT.

360edge (formally known as LeeJenn Health Consultants) is an alcohol and other drug specialist consultancy service with an established track record in working with specialist alcohol and other drugs services in the ACT and Australia.

The role of ATODA was to support 360edge to conduct the review including supporting specialist AOD services, consumer and other stakeholder input, and data collection. The review and re-design report was completed and submitted to ACT Health in December 2016.

For more information download the Terms of Reference

Review Objectives

The objectives of the review were to:

  1. Build on the review of the ACT withdrawal management services sector conducted by Dr 
Adam Winstock in 2008, such as examining the extent to which the recommendations 
made were implemented; and the barriers to implementing the recommendations if any.
  2. Determine best practice in withdrawal management, and identify the suite of programs 
necessary to deliver withdrawal management in line with leading practice, including those that are culturally sensitive and culturally safe for Aboriginal and Torres Strait Islander peoples.
  3. Develop a high-level map of the current withdrawal services system including services 
that currently provide withdrawal management; consumer access to the current withdrawal services system; service system activity; and pathways into and out of the service system in the ACT, and compare it with best and leading practice.
  4. Canvas the views and experiences of service agencies’ staff; key informants (including those who refer into the service system, and those who partner with the service system such as general practitioners with expertise in managing withdrawal and other relevant services); and service consumers on the strengths and limitations of the current withdrawal service system in the ACT.
  5. Synthesise the information obtained during the review to make recommendations for enhancing the service system as a whole, and for Aboriginal and Torres Strait Islander peoples in particular, and develop a revised withdrawal service system model to be ratified by the sector as a whole.

Scope of the Review

11 ACT Health funded and delivered specialist alcohol and other drug treatment services were in scope for the Review. Specialist withdrawal care provided by general practitioners in primary care settings was also in scope for the review.
–
Out of scope were other settings outside of the specialist AOD treatment sector in which unplanned withdrawal may occur such as the watch house, Alexander Maconochie Centre, Sobering Up Shelter, Bimberi Youth Detention Centre, etc.
– 
Similarly, incidental or irregular withdrawal management provided by general practitioners in primary care settings (i.e. withdrawal is not a main focus of care) was out of scope for the review.
 – 
The specialist ACT AOD services engaged throughout the review included:
 – 
Specialist AOD withdrawal service providers:
  • Alcohol and Drug Services, ACT Health
  • Directions Health Services
  • Ted Noffs Foundation ACT
Additional specialist AOD services:
  • Canberra Alliance for Harm Minimisation and Advocacy (CAHMA)
  • CatholicCare Canberra and Goulburn – Sobering Up Shelter
  • Gungan Gulwan Youth Aboriginal Corporation – AOD Programs
  • Karralika Programs Inc
  • Ngunnawal Bush Healing Farm Aboriginal and Torres Strait Islander Residential Rehabilitation Service
  • Salvation Army – Canberra Recovery Services
  • Toora Women Inc – AOD Programs
  • Winnunga Nimmityjah Aboriginal Health Services – AOD Programs
Other specialist AOD services:
  • AOD Policy Unit, ACT Health
  • ATODA

Review Consultations and Engagements

The review was undertaken as a consultative approach and services, consumers and key stakeholders were engaged throughout the stages of the project. Consultations and engagement to date included:

Forum 1: Terms of Reference validation: 16 August 2016

360Edge hosted a forum of specialist ACT AOD services to be briefed on the project and review the Terms of Reference. Outcomes included:

  • Positive feedback and validation of the review’s terms of reference including data elements, consumer engagement mechanisms and timelines
  • Agreement of face-to-face visits between specialist AOD services and the reviewer between 29 August and 6 September 2016
  • Clarifying the role and independence of the reviewer with ATODA to provide support to the process

For more information see the Summary of Proceedings.

Meeting with specialist AOD withdrawal services: 16 August 2016 

360Edge met with all specialist AOD withdrawal service providers to obtain their input on the process and data collection elements for the review.
 c
Meeting with AOD Policy Unit, ACT Health and ATODA: 16 August 2016 
– 
360Edge met with the AOD Policy Unit, ACT Health and ATODA to obtain agreement on additional data collection elements.
– 
Face-to-face consultations: weeks of 29 August and 5 September 2016
– 
360Edge undertook face-to-face consultations with 35 individuals (CEOs, managers, staff including medical officers) to determine their views and experiences of the programs available, including their recommendations for service system re-design.
Services / groups engaged included:
– 
  • ACT ATOD Workers Group
  • Alcohol and Drug Services, ACT Health (Building 7)
  • AOD Policy Unit, ACT Health
  • ATODA
  • Canberra Alliance for Harm Minimisation and Advocacy (CAHMA)
  • CatholicCare Canberra and Goulburn – Sobering Up Shelter
  • Directions Health Service (including Althea Wellness Centre and Arcadia House)
  • Karralika Programs Inc
  • Salvation Army – Canberra Recovery Services
  • Ted Noffs Foundation ACT
  • Toora Women Inc – AOD Programs

For more information see the Summary of Consultations.

Consumer focus groups: weeks of 29 August and 5 September 2016 
 – 
360Edge spoke to consumers in small groups about their views of withdrawal services in the ACT, and any changes they’d like to see made in the future. Four consumer focus groups were hosted by:
  • Canberra Alliance for Harm Minimisation and Advocacy (CAHMA)
  • Directions Health Service
  • Karralika Programs
  • Ted Noffs Foundation ACT

Key informant telephone interviews: weeks of 12 September and 19 September

360Edge undertook over the phone consultations with 6 key informants to determine their views and experiences of the programs available, including their recommendations for service system re-design.

Forum 2: Feedback on interim findings: 13 October 2016

360Edge hosted a forum of specialist ACT AOD services to present findings from the information gained through the review and canvas participants’ recommendations for enhancing the service system as a whole.

Forum 3: Final Findings: 8 December 2016

360Edge hosted a forum of specialist ACT AOD services to present and validate the final findings prior to submissions to ACT Health.

Products

A final report that includes the revised withdrawal services system 
model of care and the implementation and evaluation plans was submitted to ACT Health in December 2016.

ATODA will seek to have the report and the revised withdrawal services system model of care disseminated to key stakeholders in the ACT.

For more information contact ATODA on (02) 6249 6358 or carrie@atoda.org.au

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Acknowledgement


We acknowledge the traditional owners and continuing custodians of the lands of the ACT and we pay our respects to the Elders, their families and ancestors.

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Phone: (02) 6249 6358
Email: info@atoda.org.au
Mail: PO Box 7187,
Watson ACT 2602
Visit: 159 Maribyrnong Ave, Kaleen ACT 2617

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