Provision of Rrecovery Orientated Alcohol & Drugs Service.
The Early Engagement and Intervention service will operate across Bristol in order to engage with active substance users, including those who are not in contact with ROADS services. As well as alcohol, opiates and crack cocaine, this will include engaging with people who use non-opiates, Novel Psychoactive Substances, and performance and image enhancing drugs.
Interventions to improve health and reduce the harms associated with drug and alcohol use will be delivered as well as supporting those furthest away from services to access treatment in a timely manner.
Key elements of the service include; Outreach: Needle and Syringe Provision, Naloxone supply to individuals at risk of overdose, Interventions and pathways for key health needs: Clinical support for will be available for clients experiencing harms associated with drug and alcohol use.
The SML service will operate out of GP practices and/or other agreed locations participating in the Alcohol Detox and/or OST primary care local enhanced contracts. The SML will care coordinate primary alcohol and opiate clients attending their GP practice for pharmacological interventions, deliver appropriate psychosocial interventions commensurate to need and facilitate pathways with the Community Recovery Service.
Key elements of the service include:
Community Alcohol Detox: capacity for 1,488 primary alcohol clients to undertake community alcohol detoxes per year. The SML service will prepare clients for detox, support them through the withdrawal process and offer brief post-detox support to facilitate access to the Community Recovery Service for ongoing psychosocial interventions, relapse prevention and aftercare.
Opioid Substitution Treatment: capacity to case manage approximately 1,800 opiate clients accessing opioid substitution treatment at any given time. Care coordination, strategic reviews and packages of psychosocial interventions will be delivered by the SML service to all clients accessing primary care for OST.
Effective working with colleagues in Primary Care and the Early Engagement and Intervention service will be vital to ensure there is access to priority interventions including hepatitis B vaccinations and testing for hepatitis B, hepatitis C and HIV. Supporting clients to access healthcare to ensure early identification and treatment of conditions, such COPD and other respiratory illness, to minimise the impact of ill-health will be a key deliverable of the SML service.
After undertaking a period of assessment and stabilisation commensurate with their level of need clients receiving OST will have access to maintenance and detox pathways.
The CRS will deliver a range of one-to-one and group-work psychosocial interventions in line with best practice to support individuals in their recovery. Interventions will include those suitable for service users referred from criminal justice e.g. Drug Rehabilitation Requirements (DRR). The use of digital interventions should also be utilised where appropriate at all stages of an individual's recovery journey.
The Community Recovery Service will play an essential role in ensuring there is enough capacity to deliver relapse prevention support for all individuals who undertake detoxes (both opiates and alcohol) within ROADS. Facilitating access to mutual aid and linking in with wider recovery support across the local community will also be key in delivering this element successfully.
We recognise the importance of individuals accessing support around their substance misuse at locations that are easily accessible to them. We will commission a flexible service that works in partnership with existing community resources to provide a locality based Service situated across various sites in Bristol.
The Community Recovery Service will be required to comprehensively assess an individual's needs to support them in their recovery. An individually tailored package of treatment and support will need to be offered to reflect their levels of need and stage of recovery. Recovery care plans will need to be collaboratively developed with individuals and reviewed periodically to ensure that they are continuing to benefit from treatment and support.
The peer support component of the will facilitate peer support workers with lived experience of substance misuse/homelessness to offer peer support through substance misuse services and the commissioned homelessness prevention accommodation pathways.
The Service will provide a specific workforce development role to co-ordinate activity and maximise the training, development and equality good practice that is embedded within ROADS and other services. Other ROADS Providers are required to work in partnership to support this function.
In order to reflect the increasing levels of complexity for substance misusers at both a local and national perspective, this complex needs provision will identify and case hold the most vulnerable and chaotic clients across the city who are affected by substance misuse (this is estimated to be 10 % of the overall treatment population).
People with complex needs are understood as having multiple issues in their lives which can include physical or mental health and/or addictions, involvement in the Criminal Justice system, and problems finding and maintaining housing. Because of the number and complexity of these, individuals with complex needs require access to multiple services and support systems from a wide variety of systems and community organisations.
This service will provide an enhanced offer to those most severely affected by physical and mental health needs that are unable to engage in mainstream substance misuse provision and have multiple barriers to working towards recovery. Specialist prescribing is a core element of this service.
Key to this success will be how the service proactively links in with local physical and mental health services to collaborate and optimise the treatment offer for complex clients. This service will need to meet the needs of ‘dual diagnosis’ clients, particularly around trauma and post-traumatic stress disorder in relation to their substance misuse.
It will deliver high level consultant led treatment for these clients whilst also providing clinical leadership and advice through a liaison style approach to support partners in the substance misuse system as well as primary and secondary care support across Bristol.
The Families and Carers Service is jointly commissioned by the neighbouring local authorities of Bristol City Council, South Gloucestershire Council, and Bath & North East Somerset Council with Bristol Council leading the commissioning on behalf of the three partnerships. This Service requires delivery over a wider geographical area than the other Bristol only ROADS components.
This service will work with adults who are affected by someone else's substance use, including significant others and close friends as well as family and carers.
The Family and Carers Service will help affected others learn more about substance misuse and treatment, and give them new skills to better cope with problems as they arise. The service will also offer opportunities for peer support, and promote affected others' involvement in treatment services where appropriate.