It is recognised that service users may present with diverse needs, including treatment, education, vocational training, employment support and accommodation, and that no single agency can cater for all possible needs. An individual care plan will be developed for each service user, and will be delivered by a multi-disciplinary team comprising the necessary range of disciplines and skills drawn from a variety of service providers. Where a service user has complex and multi-faceted needs, a more intensive case management approach may be used.

 

According to the authors of the Framework,

The provision of rehabilitation pathways is a shared responsibility of the education, training and employment sectors alongside the health, welfare and housing sector, non-governmental organizations, communities, families and the individual themselves. (p. 7)

 

The ICP will comprise four steps, which will be linked to the four-tier model of service provision:

1.     Initial contact (Tier 1 services):Screening and referral, using a brief intervention screening instrument.

2.     Initial assessment and identification of appropriate service (Tier 2 services upwards): Matching person to service – the aim is to determine the seriousness and urgency of the drug/alcohol problem.

3.     Comprehensive assessment – key working and care planning (Tier 3 services upwards): Matching services to the person, i.e. identifying appropriate services for service users with more complex needs. Following the comprehensive assessment, a case manager will be identified, who will support the individual on their rehabilitation pathway.

4.     Implementation of the care plan to support an individual rehabilitation pathway.

Services drawn from the four-tier model of service provision will be characterised by the following attributes:

·         Settings may include general healthcare, structured drug treatment, community-based specialist addiction services, and residential detoxification and treatment followed by supported step-down accommodation as part of aftercare.

·         Services may include information and advice, brief interventions, methadone, harm reduction and therapeutic interventions.

·         Target groups may range from those experimenting with drugs to those with drug-related problems and dependence.

 

The development of a competent workforce in the addiction services will be supported and maintained through the development of a quality standard framework. The national standards for drug and alcohol treatment services that have been agreed by the Health Service Executive are the Quality in Alcohol and Drug Services (QuADS) organisational standards.

 

The NDRIC has responsibility for developing national protocols and service-level agreements (SLAs) to facilitate the implementation of the National Drugs Rehabilitation Framework. The NDRIC is currently piloting the integrated care pathway model at regional and local levels, with a view to informing the development of the protocols.3 Three drugs task force sites have been selected to participate in phase 1 of the pilot process: North Inner City LDTF, Blanchardstown LDTF and North East RDTF.The objectives of the pilot projects are to:

·         support the implementation of the National Drugs Rehabilitation Framework and integrated care pathways model in line with the recommendations of the report of the working group on drugs rehabilitation,

·         build awareness and knowledge of the National Drugs Rehabilitation Framework among key stakeholders,

·         identify progress in implementation,

·         identify gaps in services and drivers/obstacles in respect of implementation,

·         assess the initial impact of the Framework, and

·         help to clarify roles and inform implementation of the Framework. 

 

1. Working group on drugs rehabilitation (2007) National Drugs Strategy 2001–2008: rehabilitation. Report of the working group on drugs rehabilitation. Dublin: Department of Community, Rural and Gaeltacht Affairs. Available at https://www.drugsandalcohol.ie/13502/

2. Doyle J, Ivanovic J (2010) National Drugs Rehabilitation Framework Document. Dublin: Health Service Executive. Available at www.drugsandalcohol.ie/13502

3. National Drugs Rehabilitation Implementation Committee (2010) Terms of reference for pilot projects to inform the implementation of the National Drugs Rehabilitation Framework. Dublin: HSE. Available at www.drugsandalcohol.ie/13502