EXTRAORDINARIO DE LA MISERICORDIA

This section provides an overview of National Drug Treatment Monitoring System (NDTMS) data for Greater Manchester for 2009/10. It shows the number of individuals in contact with structured alcohol treatment services (tiers three and four)^m with details of change in presentation since 2008/09, gender, age, referral type, and discharge reason by Primary Care Trust (PCT) of residence (individuals are only counted once in a PCT area but may have been resident in more than one PCT during the financial year). Latest data for the year to date (April to December 2010) are also included.^[9] In this section, 95% confidence intervals (95%CI) have not been provided in the tables due to space restrictions but have been supplied in the text where relevant.

m The Department of Health classifies alcohol interventions and treatment (and associated services) into four tiers according to need.^[41] Tier one services provide alcohol-related advice and interventions, brief interventions referrals and screening. Tier two services provide alcohol-specific, brief interventions, open access outreach, non-care planned interventions and referral. Tier three provides alcohol-specific community-based, care-planned assessment and

11.2 Alcohol treatment: numbers in treatment (UPDATED DATA)

In 2009/10, there were 8,932 people in contact with structured treatment in Greater Manchester, an 11%

increase compared with 2008/09 (n=8,012).^[9] Sixty-three per cent of these individuals were male, although the proportion varied between PCT (Table 27). Individually, the numbers of both males and females in contact with treatment have increased since 2008/09 (Figure 26). Seven of the ten PCTs in Greater Manchester experienced an increase in numbers for males. The highest increase was seen in Heywood, Middleton and Rochdale (by 31%). For females, seven PCTs reported an increase in numbers. The highest increases were reported in Heywood, Middleton and Rochdale PCT (by 29%) and in Salford (by 25%). For both males and females, Trafford experienced the largest decrease in Greater Manchester (29% and 18%

respectively). In 2009/10, Manchester PCT had the highest numbers of both males and females in treatment (1,560 and 778 respectively), more than five times the number of those recorded in Trafford PCT (which had the lowest numbers). In the financial year to date (April to December 2010), 8,111 people have been in contact with structured treatment (64% male). Again, the highest proportions were reported in Manchester PCT for both males and females.

Figure 26: Numbers in structured treatment in Greater Manchester from 2008/09 to 2009/10, by gender^[9]

Table 27: Numbers in structured treatment in Greater Manchester Primary Care Trusts, by gender^[9]

Males Females

11.3 Alcohol treatment: characteristics of individuals in treatment (UPDATED DATA)

In 2009/10 in Greater Manchester, the most common age group for individuals in contact with structured alcohol treatment services was 30 to 44 year olds (41%; 95% CI:40-42%) followed by 45-59 year olds (32%;

95% CI: 31-33%; Table 28). Five per cent were aged under 18 years (95% CI: 4.4-5.3%), 16% were aged 18 to 29 years (95% CI: 15-16%) and 6.3% were aged 60 or over (95%CI: 5.8-6.8%). However, the age of those in treatment varied significantly by PCT. For example, in Manchester PCT only 2.3% (95% CI: 1.7-3.0%) of those in structured treatment were aged under 18 (half of that observed for Greater Manchester overall) compared with 10% in Bolton (95% CI: 8.1-13%) and Bury (95% CI: 7.4-14%). Overall, age groupings have remained similar in the latest data for April to December 2010. The most common route into structured alcohol treatment in Greater Manchester in 2009/10 was through a self-referral (33%; 95%CI: 32-34%; Table 29). Routes of referral varied significantly by PCT. Whilst in Bolton, 3.9% of referrals were self-referrals (95%

CI: 2.6-5.6%), this increased to 65% in Stockport (95% CI: 61-69%). Conversely, whilst in Stockport, 4.4% of referrals were received through substance misuse services (95% CI: 2.9-6.4%), in Bolton, 66% were referred in this way (95% CI: 63-69%; 16% for Greater Manchester overall; 95% CI: 15-17%). Overall, referral pathways have remained similar in the updated data for April to December 2010.

Table 28: Age of those in structured treatment in Greater Manchester Primary Care Trusts

% of those in treatment in 2009/10 (year to date, Apr to Dec 2010)

Under 18 years 18-29 years 30-44 years 45-59 years 60 years and Table 29: Referral route of those in structured treatment in Greater Manchester Primary Care Trusts

% of those in treatment in 2009/10 (year to date, April to December 2010) Substance

misuse service

Criminal Justice

Service Self General

practitioner Other Other is undefined. * Proportions have been suppressed as numbers are less than five.

In 2009/10, there were 4,781 discharges from care in Greater Manchester. Forty-seven per cent of these were care planned discharges (95% CI: 46-48%) whilst 48% were unplanned discharges (95% CI: 47-50%;

Table 30). Another 4.6% were referred on to other services (95% CI: 4.1-5.3%). Care planned discharges were

significantly more common in trusts such as Trafford PCT (67%; 95% CI: 60-74%) and Bury PCT (59%; 95% CI%:

52-66%), than Greater Manchester overall. In comparison, unplanned discharges were significantly more common in trusts such as Manchester PCT (59%; 95% CI: 56-62%) and Salford PCT (58%; 95% CI: 54-62%).

Between April and December 2010, there were 3,789 discharges in Greater Manchester. Over half of these were care planned (53%; 95% CI: 52-55%), a significantly higher proportion than in 2009/10. Whilst changes are evident between the data available for 2009/10 and those for April to December 2010, without data for the full financial year of 2010/11, it is not possible to ascertain whether these are due to an actual change in discharge patterns or are due to seasonal variations.

Table 30: Discharge reason for those exiting structured treatment in Greater Manchester Primary Care Trusts

% of those in treatment in 2009/10 (year to date, April to December 2010) Care planned discharge Unplanned discharge Referred on

Ashton, Leigh and Wigan 54.7% (65.7%) 32.4% (26.1%) 12.9% (8.2%)

Bolton 53.0% (52.0%) 45.1% (46.1%) 1.8% (1.9%)

Bury 58.9% (71.4%) 39.3% (28.0%) * (*)

Heywood, Middleton and Rochdale 48.5% (50.1%) 49.0% (47.1%) 2.5% (2.8%)

Manchester 36.6% (44.2%) 59.1% (52.8%) 4.2% (3.1%)

Oldham 53.6% (55.4%) 37.7% (35.8%) 8.7% (8.8%)

Salford 41.4% (55.6%) 58.1% (42.3%) * (2.1%)

Stockport 52.9% (53.6%) 43.9% (43.2%) 3.2% (3.2%)

Tameside and Glossop 42.2% (54.6%) 51.0% (41.0%) 6.8% (4.4%)

Trafford 66.8% (65.7%) 23.7% (21.0%) 9.5% (13.3%)

Greater Manchester 46.9% (53.3%) 48.4% (42.6%) 4.6% (4.1%)

* Proportions have been suppressed as numbers are less than five.

11.4 Alcohol treatment: summary

In 2009/10, there were 8,932 people in contact with structured treatment in Greater Manchester, an 11%

increase compared with 2008/09. In general, these increases have been witnessed in the majority of PCTs in Greater Manchester. In 2009/10, Manchester PCT had the highest numbers of both males and females in treatment (1,560 and 778 respectively), more than five times the number of those recorded in Trafford PCT.

Analysis of the characteristics of those in treatment in Greater Manchester in 2009/10 shows that: 63% were male; the most common age group was 30 to 44 year olds (41%); and the most common route of referral was through a self-referral (33%). In 2009/10, there were 4,781 discharges from care in Greater Manchester (with another 3,789 discharges in Greater Manchester between April and December 2010). However, characteristics and experiences of those in treatment varied significantly between PCT.