Home > Evaluation report of the National Drugs Rehabilitation Framework pilot.

Barry, Joseph and Ivers, Jo-Hanna H (2014) Evaluation report of the National Drugs Rehabilitation Framework pilot. Dublin: Health Service Executive.

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This is the first external examination of the pilot of the National Drug Rehabilitation Framework (NDRF). A selection of service providers, service users and key informants were interviewed across ten volunteer pilot sites. Of the ten pilot sites six had begun implementing the framework and four had not. There were qualitative and quantitative components to the evaluation.
The quantitative findings come from questionnaires filled out by 81 individuals, all from pilot sites implementing the framework. There were 14 service users, 48 key workers/case managers and 19 service managers. All service users had completed an assessment and all had a key worker. Two thirds had a case manager. Overall, service users were satisfied with the service they were receiving. Three quarters of key workers/case managers always engaged in care planning, and the remainder sometimes, with similar ratios for engaging in interagency meetings. Service managers were more likely to experience difficulty implementing comprehensive assessments than initial assessments.
All bar one manager said care planning was being implemented but of those doing so all except three reported difficulties. Implementation of confidentiality protocols was in some way difficult for over three quarters of service managers. Service managers reported varying levels of access to support services such as addiction, education and employment, housing, justice and law reform services. All service managers were engaged in interagency working but all reported at least some difficulty implementing service level agreements. Both service managers and frontline staff reported an improvement in communication, sharing of information and referrals following implementation of the framework.
The qualitative findings come from interviews with 74 individuals. Interviews took place with 14 service users from the pilot sites that were implementing the framework. In addition, there were interviews with 12 key workers, 8 case managers and 12 service managers from the pilot sites. Ten coordinators from the pilot sites were interviewed. In addition 18 key informants were also interviewed. Fourteen of these were from pilot sites that were not implementing the framework. There was near universal enthusiasm for the framework and optimism that its aims could be achieved if commitments to the framework were re-iterated by all agencies. Better inter-agency working was seen as key. One of the fears expressed by many was that the momentum gained could be lost if all agencies who have an input decided to pull back from the implementation. There is already some evidence of 'missing partners'. When asked about their experience with their key workers and case managers, service users were generally very positive and felt supported in the process. Service users spoke about the benefits of connecting with a service and the direct effect that this had on their lives.
In terms of the benefits that were more directly attributable to the framework, care planning was the most recognisable practice for service users; the majority of service users had a clear idea of their goals and aspired to build on the current success. Four sites were not implementing the framework when this evaluation fieldwork was being carried out. While parallel work to the framework was most likely taking place in these sites there were no service users who could be interviewed as possible beneficiaries of the framework. The two most commonly cited reasons for non-implementation were politics and lengthy pre-implementation planning. Some interviewees saw this as a lost opportunity and there was a sense that if people had their time back they would have begun implementing sooner.
Notwithstanding the findings and some of the challenges uncovered in the roll-out of the framework there was near universal support and enthusiasm for the framework, even where it was not being implemented yet. The purpose of the evaluation was to provide learning on what was, and was not, working. All findings, both positive and negative, provide a stimulus for increased learning and can be used to advance the implementation of the framework nationally.

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