The healthmatters blog; commentary, observation and review
NHS Confederation response to CQC report emphasises the need for a fundamental shift in the way we regulate care
In response to the CQC State of Care report released today, Rob Webster, chief executive of the NHS Confederation, said:
“This is an important report that shows the majority of services across health and care are rated as good, with some outstanding. The report shows the pressure our members are under during the toughest times of a generation and that variation still exists in care quality and delivery. This alone is important – but there are other significant conclusions that must be drawn.
“No organisation is an island so we need a fundamental shift in the way we regulate care. We’ve seen some progress but more is needed. A&E performance, for example is a function of community support, social care and the local people as much as hospital staffing. Regulators should look at health and care systems not just individual organisations.
“Leaders must be supported to deliver safe patient care and to transform the way we deliver care. This must be accompanied by an end to the ‘toxic’ environment that is creating a revolving door of NHS leadership, which is bad for the health service, and bad for patients. The CQC have a role to play here, as do NHS England and NHS Improvement.”
Those rejected include abused and neglected children. Charity warns of a ‘time bomb’ of serious mental health conditions if vulnerable victims don’t get early help
More than a fifth of all children referred to local specialist NHS mental health services, including children whose problems stem from abuse, are rejected for treatment, the NSPCC reveals today.
New statistics from 35 Mental Health Trusts across England show that of a total of 186,453 cases referred by GPs and other professionals, 39,652 children did not receive help.1
A worrying picture also emerged from six Trusts who provided a breakdown of outcomes for children referred to Child and Adolescent Mental Health Services (CAMHS) who had problems associated with abuse or neglect. In these Trusts 305 of the 1,843 – one in six – cases were rejected.2
Children who have been abused or neglected could face serious long-term mental health problems because of a lack of support, the NSPCC says. The charity says a ‘time bomb’ of serious conditions is being created by children not getting appropriate early help. The findings come as reported abuse across the UK soars.
Where reasons were given for not offering a service to children affected by abuse or neglect it was often because did not meet the high clinical threshold to qualify for treatment at a CAMHS. Not all abused children will have a diagnosable mental health problem but many will still need therapeutic support to help them deal with their trauma.
Some evidence has raised concerns around access to this kind of support for children and young people following abuse. Strict access criteria, both for assessment and treatment, have been identified as significant issues in some areas.3
NSPCC Chief Executive, Peter Wanless said: “There’s been a huge increase in awareness about all forms of abuse in recent years. If children don’t receive the right kind of help and support following a disclosure, the damage can last a lifetime and include post-traumatic stress disorder, depression or suicidal thoughts in adulthood. Not addressing their needs early on is just creating a time bomb of mental health problems. Sadly, the availability of specialist services that meet the needs of abused children, when they need it, do not appear to have kept pace with this growth in understanding of the crime. There is a vacuum that needs to be filled and it needs to be a national and local priority.
“Children and Adolescent Mental Health Services are just one part of the jigsaw and it’s clear the current range of support available does not meet the needs of many abused and neglected children. Often children who are suffering with the consequences of what’s been done to them won’t necessarily meet a medical threshold but the emotional and psychological fallout of their abuse can snowball and get more severe in years to come. Desperate and frightened about their feelings, but unable to access services, some of these children call ChildLine. More and more victims of abuse are speaking out and we need to match their bravery with more specialist therapeutic support that is age-appropriate and there for children and young people, for as long as they need it.”
The NSPCC’s ChildLine service recently revealed it had received nearly 100 contacts a week last year from children who have been abused and whose mental health and wellbeing are suffering as a consequence. Previous research by the charity has found huge gaps between the estimated need for services by victims of sexual abuse for example and service availability.4
The NSPCC’s state of the nation How Safe 2015 report, revealed the number of sexual offences against children recorded by police in England and Wales soared by more than a third last year (2013-14), with the number of children referred to social services also soaring.5
1 12 Trusts approached did not provide data for a variety of reasons including commercial sensitivity
2 Of the Trusts who provided data on referrals for children who had abuse or neglect as a primary concern it was not clear in some cases whether children rejected for a service went on to receive support elsewhere.
3 Goddard, Harewood, Brennan. (March 2015). Review of pathway following sexual assault for children and young people in London. The Havens, King’s College Hospital NHS Foundation Trust on behalf of NHS England.
4 Allnock, D. et al (2009) Sexual abuse and therapeutic services for children and young people: the gap between provision and need. London: NSPCC.
5 It’s not clear why the number of offences has risen so dramatically. Greater awareness may be giving more victims the courage to come forward, including those reporting non-recent abuse, or the police forces have improved their recording methods. However it does mean that more children are speaking out, only to find little support to help them recover from abuse.
Responding to Q1 NHS financial data published by Monitor and the NHS Trust Development Agency today (9 October), Paul Healy, Senior Economics Advisor, NHS Confederation said:
“The billion pound NHS deficit now forecasted for Foundation Trusts is a symptom of problems across the entire health and social care system and we agree with Monitor that radical change must happen.
“Unfortunately financial planning in the NHS leaves the health service navigating in the dark without knowledge of how much funding will be available in six month’s time. Eighty-seven percent of our members want to see a long-term financial commitment from the Government on health and social care so that we can plan changes and become more sustainable. We also want to see £4 billion of Government’s £8 billion funding commitment available to the NHS within the next two years.
“Hospitals and other frontline NHS organisations have all-but exhausted their options for becoming more efficient. They are also increasingly affected by cuts in social care, local GP shortfall and a host of other challenges.
“We need an end to the short-term approach to finances which is causing financial instability in the NHS and acting as a hindrance to transforming patient care.”
North East has biggest drop in smoking in the country “Model for the rest of the country” says Public Health England
NEW official figures show the North East has had the biggest drop in smokers nationwide –with fewer people smoking than ever before.
The proportion of North East smokers fell from 22.3% of people smoking in 2013 down to 19.9% in 2014. The figures are from the Integrated Household Survey published by the Office for National Statistics.
There are now 165,000 fewer smokers in the North East than there were in 2005, when 29% of people smoked. The figures have also resulted in the North East approach being praised by Public Health England.
Professor Kevin Fenton, National Director of Health and Wellbeing, Public Health England: said:
“This significant drop in North East smoking rates is a credit to the hard work and commitment of local organisations who have come together to reduce the devastating harm caused by smoking. Our ultimate goal is a smokefree nation and the North East provides a model for the rest of the country in how working in partnership and focusing on this shared goal can make a difference to real lives.”
Lisa Surtees, Acting Director of Fresh Smoke Free North East, which was set up in 2005 to tackle the worst rates of smoking in the country, said: “We are thrilled to see such a significant fall in smoking. It is the first time our smoking rates have ever dropped under 20% and shows the North East has had the biggest fall of any English region since 2005.
“We have seen a massive culture shift in the last decade with regards to smoking, with smokefree laws coming into force and massive public opinion in favour of reducing smoking and protecting children from tobacco.
“But around 417,000 people still smoke in our region and one in two will die from a smoking related disease unless they quit.”
Councillor Paul Watson, chair of the Association of North East Councils, said: “I’m proud of the way other regions look to the North East for our work in tackling smoking, despite the challenges we still have.
“Smoking affects the life chances of every child who grows up to smoke, especially in some of our poorest wards. Councils have agreed that tackling smoking locally and working even more closely together to do this as a region is an ongoing priority and we have played a key part in raising our voices to demand action from the government.”
Cllr Nick Forbes, Chair of the Making Smoking History in the North East Partnership, said:
“The North East is no longer the region with the highest smoking prevalence and I am incredibly proud of the progress we have made. We have set a vision of reducing smoking rates to 5% which is a clear statement from councils, the NHS and CCGs that the North East wants to end the burden caused by smoking, which still affects poorer families and people with mental health issues the most.
“But getting down even further will mean embracing more harm reduction approaches and demanding more action nationally. It is good also to see the NHS Five Year Forward View stating the future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health.”
Anna Lynch, Director of Public Health for County Durham and chair of the North East Directors of Public Health Network said: “Smoking is still our biggest cause of ill health and since public health transferred to local authorities, councils have prioritised efforts to reduce smoking locally and work together to collaborate even more closely through the Fresh approach.
“Our aim for children growing up in the North East is that they can grow up in smokefree homes, free of tobacco addiction, and don’t see the diseases smoking causes as a normal part of life. We owe it to them to make it happen.”
Ambitious plans to cut smoking rates to 5% across the North East by 2025 were backed by health and local government leaders and young people in the North East earlier in the year. It was estimated getting down to 5% would save thousands of lives and an estimated £100 million a year, freeing up around £50 million for the NHS, significantly easing the strain on hospitals and GP surgeries, as well as significantly cutting the cost of smoking related sickness on local businesses. 
A survey by YouGov found 89% of North East adults would like smoking to become a thing of the past for children. 
1: The calculations were made using the National Institute of Health and Care Excellence’s Tobacco Return on Investment Tool based on 5% of people smoking within the predicted North East population in 2025 compared to the figure of 22.3% of people smoking in 2013. The NICE tobacco return on investment tool was developed to help decision making in tobacco control at local and sub-national levels. http://www.nice.org.uk/About/What-we-do/Into-practice/Return-on-investment-tools/Tobacco-return-on-investment-tool
2: YouGov Smokefree Survey, co-ordinated by Action on Smoking and Health
The Nursing and Midwifery Council (NMC) has today made the decision to introduce a process of revalidation for all nurses and midwives in the UK, fulfilling a key recommendation from the Francis report into the failings at Mid–Staffordshire Hospital NHS Foundation Trust.
The introduction of revalidation is the most significant change to the regulation of nurses and midwives in a generation and will mean that everyone on the NMC’s register will have to demonstrate on a regular basis that they are able to deliver care in a safe, effective and professional way.
To remain on the register, nurses and midwives will have to show that are staying up to date in their professional practice and living the values of their professional Code by seeking feedback from patients and colleagues and engaging in a regular process of reflection, learning and improvement. For the first time, they will also have to obtain confirmation from another professional that they have met all the requirements before they apply to renew their place on the register every three years.
NMC Chief Executive and Registrar, Jackie Smith, said:
“The NMC holds one of the largest registers of healthcare professionals in the world, and the introduction of revalidation is the most significant regulatory change in our history.
“We believe that revalidation will give the public confidence that the people who care for them are continuously striving to improve their practice. Indeed, nurses and midwives who piloted the new model told us that they too believe it will deliver real benefits in raising standards and protecting the public.”
After piloting revalidation in 19 sites across the UK, the NMC is confident that it is achievable, effective and realistic and that it is a proportionate way to make sure that nurses and midwives keep their knowledge and skills up to date throughout their career.
Following the NMC’s decision today and confirmation that all four UK countries are ready to implement the new system, revalidation will be introduced from April 2016. All 685,000 nurses and midwives on the NMC’s register will go through the new process as their registration becomes due for renewal over the course of the next three years.
The junior doctors’ dispute caught many of us by surprise, but it should not have done. The British Medical Association’s (BMA) withdrawal from negotiations about a new contract last year was a warning, but perhaps even the BMA did not anticipate the anger of junior staff about a contract that has been neither presented in detail nor costed. Tory MP Dan Poulter – a member of the Coalition health team until 2015 – told The Guardian that the government tore up an agreement that would have sorted out the contract problem. It looks as if both parties are looking for a fight.
Other people’s contracts are boring to most, yet the devil really is in the detail. The proposals from NHS Employers aim to increase the basic rate of pay for junior doctors but also to redefine ‘normal working hours’, whilst being cost-neutral. There is no extra cash on the table. The basic rate will go up for all, but annual increments will stop, being replaced by rewards for new levels of responsibility or skill. The redefinition of normal working hours means that the ‘7am to 7pm weekdays’ package will change to ‘7am to 10pm, weekdays and Saturdays’. Money saved from these two changes will allow funds to be used for ‘premia’ payments to hard-to recruit disciplines. NHS Employers reckon that actual hours worked will decrease further. Because no economic modelling has been done, it is not clear who will benefit and who will loose from this sketchy contract, which the Secretary of State for Health says he will impose (despite the lack of detail) if negotiations do not resume.
Some junior doctors currently working a lot of unsocial hours think they will lose a lot of income, since the uplift in basic pay is unlikely to compensate for lost hours of ‘overtime’. Others fear that their income will fluctuate unpredictably as they move from one training post to another (because of the complexity of the funding formulae). Lost and variable income matters most amongst those trying to live in the South East’s inflated housing bubble, or seeking to move into the golden triangle of Cambridge, Oxford and London. Others fear that hours they did not want to work – late evenings and Saturdays – will become part of their contract, and a slip along the slope towards seven day working. These seem to be the main objections to the new contract. Talk of rejecting it because it threatens patient safety is not plausible.
If the BMA breaches the ‘no new money’ rule imposed by the Government, other unions with members in the NHS will take it as a precedent and campaign for similar pay increases for other professions. The Government will oppose this, so the junior doctors’ industrial action (if it comes about) will have great significance.
As currently discussed, the new contract could aid workforce planning, because some of those doctors who do not emigrate or become bankers (most can’t) will reduce their income risks by moving to the low cost areas where doctors are most needed anyway.
Abolishing incremental increases in pay will affect more than salary bills. Awarding increases to some might send a signal to those who are perhaps performing less well, and dent the sense of entitlement that is so strong in medicine. It could be an expansion of management powers into clinical performance.
What would a Labour government do? Hopefully it would agree with NHS Employers and the Doctors and Dentists Remuneration Board that the junior doctors’ contract needs reforming. It would surely agree with the BMA that the government has handled the negotiations about reform badly. Most probably it would avoid seeing the problem as nothing but an attempt to drive down salaries and increase NHS productivity, although there are siren voices singing this reductionist song.
It is easy enough to see how, in the big picture, this government offers reactionary modernisation of junior doctor work patterns, but what would progressive modernisation look like? Pledging no loss of pay and restoring annual increments might be tempting. This would reduce doctors’ anxieties about income but maintain long hours for some, weaken workforce planning and lose the disciplinary and incentivising effects of selective increments. Perhaps the best outcome would be to keep the substance of the reforms but negotiate around stabilising doctors’ incomes in high cost areas. This could be done by offering benefits like key worker status for housing, by emphasising local flexibilities in salaries to mitigate losses to some individuals, and by providing funding for educational courses, specialist examinations and membership of professional organisations. The overarching aim would be to take the drama out of the crisis.
New online Smart Map shows progress in UK lung cancer care, though continued improvement needed to address regional variations
Roy Castle Lung Cancer Foundation (RCLCF) today launches a new online Smart Map that shows how standards of lung cancer care vary throughout the UK.1 The resource, available at http://www.roycastle.org/how-we-help/our-campaigns/improving-treatment-and-care/interactive-map, is based on the latest research by the National Lung Cancer Audit (NLCA), published in December 2014. This shows encouraging improvements have been made in standards of lung cancer care across multiple UK regions.
The figures show that nursing has been a key area of improvement: 83.9% of patients in England and Wales were able to benefit from care by a specialist cancer nurse in 2013*, compared with only 79.9% in 2011.3 Lung Cancer Nurse Specialists can assist patients navigating through complex treatment regimens and provide support to assist daily living following the impact of diagnosis.4
Despite these improvements, significant challenges and variations in care still exist across the country. For example, while surgical treatment represents the best chance to cure the disease, only 15.1% of patients with lung cancer (at any disease stage) are receiving surgery.1,2 For patients with early stage lung cancer – when surgery is most likely to cure the disease – the number of patients receiving surgical treatment ranges from 33.3% to 62.9% across England.1,2
Lorraine Dallas, Director of Patient Information and Support at RCLCF said: “Since RCLCF was founded 25 years ago, we have seen great improvements to patient care in local cancer services across the UK. While these successes should be recognised, more needs to be done. This Smart Map shows that, in some areas, too few people are able to receive surgery, which offers the best chance of curing their disease. We call for further improvements to lung cancer services to ensure that all patients enjoy the best treatment and care available, no matter where they live in the UK”.
Regional variations included the Thames Valley region, in which 85.4% of patients were tested to determine their lung cancer type, compared with the national average of 75.1%.1,2 Furthermore, 65.7% of patients gained access to anti-cancer treatment compared with the national average of 60.2%.1,2 Elsewhere, 99.6% of patients in Wales received treatment by an expert multidisciplinary team compared with the English average of 95.4%.1,2
In comparison, only 69.4% of patients were tested to determine their lung cancer type in the Cheshire and Merseyside region, and only 53.0% of patients gained access to anti-cancer treatment in the South East.1,2 Furthermore, only 88.8% of patients in Cheshire and Merseyside received treatment by an expert multidisciplinary team.1,2
To address these differences, RCLCF calls for variations in service provision to be investigated locally and for appropriate strategies for improvement to be implemented to ensure patients receive the best treatment and care wherever they live.
The lung cancer Smart Map has been developed to allow people affected by lung cancer to review standards of lung cancer services in their region and to compare local standards with national averages. The resource includes the option to directly compare one region with another to determine where the best outcomes have been achieved. It is hoped that this information will further support lung cancer patients in their discussions with healthcare professionals and will enable them to make informed decisions to ensure that they receive the best care available. Understanding diagnosis and treatment available and why they are being offered can make a difference to patients’ wellbeing.
Commenting on the launch of the Smart Map, Dr Ian Woolhouse, Senior Clinical Lead, National Lung Cancer Audit, said: “The launch of the new Smart Map is a valuable expansion of the data the National Lung Cancer Audit has collected. By highlighting best practice and enabling the public to better understand the performance of services, this new resource can support further improvements to the quality of lung cancer care in the UK.”
The burden of lung cancer in the UK is significant; the disease remains the biggest cancer killer of men and women with around 44,000 new cases diagnosed every year.5 While survival rates are increasing, the UK is still among the lowest in Europe and trailing behind some other European countries.6
The Smart Map can be found at: http://www.roycastle.org/how-we-help/our-campaigns/improving-treatment-and-care/interactive-map
1. Roy Castle Lung Cancer Foundation. 2015. Interactive map. Available at: http://www.roycastle.org/how-we-help/our-campaigns/improving-treatment-and-care/interactive-map (Last accessed: October 2015)
2. National Lung Cancer Audit Report 2014. Report for the audit period 2013. Available at: http://www.hqip.org.uk/assets/NCAPOP-Library/NCAPOP-2014-15/HSCICNLCA-2014finalinteractivereport.pdf (Last accessed: October 2015)
3. National Lung Cancer Audit Report 2012. Report for the audit period 2011. Available at: http://www.hqip.org.uk/assets/NCAPOP-Library/NCAPOP-2012-13/Lung-Cancer-National-Audit-Report-pub-2012.pdf (Last accessed: October 2015)
4. White, J. ‘The role of lung cancer nurse specialists’ in Cancer Nursing Practice. November 2013 Volume 12, no. 9. pp. 16-22 Available at: http://journals.rcni.com/doi/pdfplus/10.7748/cnp2013.11.12.9.16.e1000 (Last accessed: August 2015)Cancer Research UK. Lung cancer statistics. Available at: http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer#heading-One (Last accessed: October 2015)
5. Macmillan Cancer Support. UK cancer survival rates “stuck in the 1990s” says charity. March 2015. Available at: http://www.macmillan.org.uk/Aboutus/News/Latest_News/UKCANCERSURVIVALRATESSTUCKINTHE1990SSAYSCHARITY.aspx (Last accessed: October 2015)
6. Cancer Research UK. Mortality statistics for common cancers. Available at: http://www.cancerresearchuk.org/cancer-info/cancerstats/mortality/cancerdeaths/uk-cancer-mortality-statistics-for-common-cancers (Last accessed: October 2015)
* 2013 is the year upon which the latest NLCA figures are based
“Making one person smile can change the world. Maybe not the whole world, but their world.”
Earlier this year Marie Sylvie (7) re-discovered her smile after visiting the Africa Mercy, a floating hospital run by Mercy Ships which sails to some of the poorest countries in the world.
When Marie Sylvie was 2 years old she fell into a pot of boiling water which left her with severe scarring and, as her wounds healed, her arm became stuck to her body. She could barely move it.
Marie Sylvie was embarrassed to go to parties, she couldn’t wear the same clothes as other little girls. When she initially visited Mercy Ships’ floating hospital she was shy and reserved, she found it difficult to smile.
Marie Sylvie’s mother, Felicie, was desperate for help. She told us, “The problem was always the money. Always the money. It would have been impossible for us to find the money to do surgery.”
Thanks to its hospital ship, Mercy Ships was able to make the impossible a reality by performing a free surgery to release her trapped arm. With a huge smile on her face, Marie Sylvie can now lift her arm about her head and behave like other girls her age.
Marie Sylvie is just one of thousands of patients whose lives have been utterly transformed during Mercy Ships’ 8 month outreach to Madagascar. Mercy Ships is dedicated to helping its patients smile through both large and small acts of kindness. The charity’s team of on-board volunteers know that a smile goes a long way to bring hope and healing to the patients they treat.
Judy Polkinhorn, Executive Director of Mercy Ships UK, said: “Mercy Ships is not just about providing free health care – it’s about improving the lives of the patients we treat and giving them a smile of hope for the future.
“I would like to take this opportunity to thank all of our hard working and dedicated volunteers whose acts of kindness relieve suffering and bring happiness to so many people. Over the years we have visited many countries in Africa, however the ship and its ethos, which resonates with World Smile Day, remains the same. It is wonderful to see lives changed for the better after successful operations – may the tears of joy and the smiles continue.”
Mercy Ships is an international charity which delivers free healthcare services to those living in developing countries, namely in Africa, where the services of professional medical staff are most needed. The Africa Mercy has been converted from a Danish rail ferry to a state-of-the-art hospital ship, with six operating theatres, X-ray facilities and CT scanner, a pharmacy and a laboratory.
The hospital ship is currently docked in Madagascar, which is one of the world’s poorest countries with over 90% of its people living on less than 75p a day. As far as healthcare is concerned, with a population of 22.9 million, Madagascar has only 2 physicians and 3 hospital beds available for every 10,000 people.
British Safety Council steps forward as a supporter of The Work Foundation’s research programme into Health at Work
The British Safety Council has announced its support for the Health at Work Policy Unit at The Work Foundation, part of Lancaster University, a leading provider of evidence-based research and policy advice.
Launched in 2014, the Health at Work Policy Unit is focused on providing an independent, evidence-based voice on the public debate around health and wellbeing at work. The British Safety Council is to support the next two years of its work, which will include developing policy briefs, undertaking new policy research and creating a sustained voice in government and media.
Professor Stephen Bevan, director of the Health and Work Policy Unit, who spoke last week at the British Safety Council’s annual conference, ‘Health and safety – what’s next?’, commented: “We’re delighted that the British Safety Council has joined as a sponsor of the Health at Work Policy Unit and we look forward to working closely together to promote the health at work agenda. After a year of proactively putting our concerns across through evidence-based policy reports and recommendations, we’re now at a point where the government is starting to listen and where we can expect to create positive change for health and well-being in the workplace.”
Mike Robinson, Chief Executive of the British Safety Council, said: “With the HSE reporting that for the period 2013/14, there were 1.2 million people who were suffering from an illness – long-standing as well as new cases – they believed was caused or made worse by their current or past work, the agenda around occupational health is clear. As a result, we’re delighted to have the opportunity to support the research of the Health at Work Policy Unit under the direction of Professor Stephen Bevan.”
Following substance abuse treatment, individuals who live in a collaborative housing setting with community rules and responsibilities have their substance abuse treated more effectively than those not provided supportive housing, according to research led by Leonard Jason, a community psychologist at DePaul University.
Research shows that living in a functional community and engaging in positive social structures enhances the recovery trajectory for alcohol and drug abuse, noted Jason, director of the Center for Community Research at DePaul.
“Our research looks at Oxford House and tests a dynamic systems-based theory that explains how house residents with recovery-related attitudes, behaviors and social relationships co-evolve. It also shows how these emergent individual characteristics and house-level social structures subsequently link to individuals’ recovery endpoints,” said Jason.
Oxford House is a concept in recovery from drug and alcohol addiction. It is a democratically run, self-supporting and drug free home. According to Jason, the number of residents in a house can range from six to 15. There are houses for men or women and also houses that accept women with children. Over the past year, more than 25,000 people have lived in these recovery homes, making them the largest self-help residential recovery program in the country.
Since 1991, Jason and co-researchers have published more than 100 articles involving more than 2,000 Oxford House residents who are trying to overcome substance abuse in Illinois, other parts of the U.S. and internationally. In one of the studies, some patients were assigned to an Oxford House, while others were in a usual-care condition area such as an outpatient treatment center or self-help group.
According to Jason, at the 24-month follow-up, those in an Oxford House setting had significantly lower substance use, higher monthly income and lower incarceration rates, compared with the usual-care condition.
Jason recently was awarded a five-year grant of a nearly $3 million from the National Institutes of Health’s National Institute on Alcohol Abuse and Alcoholism to continue this research. The aim is to study why individuals relapse when suffering from alcoholism and analyze the social and collaborative atmosphere of Oxford Houses to see what makes those residents thrive.
The findings of this research may contribute to reducing unnecessary health care costs by improving the effectiveness of the residential recovery home system in the United States. The research team, which includes Ed Stevens, project director and former graduate of the community psychology doctoral program at DePaul, and John Light, a sociologist from the Oregon Research Institute who is one of the nation’s top authorities on social networks. At the present time there are four DePaul graduate students in clinical and community psychology who are working on their dissertations with Oxford House residents.
“This research on Oxford House and community behavior will provide significant insight on house structure and predictors of an individual’s likelihood of maintaining a positive recovery trajectory,” he said.
The findings also can provide data to help others restructure and improve similar community based recovery settings, said Jason.
“Treating substance abuse disorders is costly and time consuming for the current health care system. Our reports are looked at very closely by government leaders who are trying to decide how to allocate resources to help treat substance abuse,” said Jason.
Different types of peer support
Similar to those who participate in Alcoholics Anonymous, members of an Oxford House receive abstinence support from peers. However, unlike AA, there is no single, set course for recovery that all members must follow, according to Jason. Residents of Oxford Houses decide personally whether to seek outside of the home either psychological or substance abuse treatment by professionals or a 12-step organization.
“These studies really have influence and a great impact on getting people to understand how effective collaborative housing can be to treat drug and alcohol abuse,” said project director Ed Stevens. “We are studying collaborative housing to understand what works and what doesn’t work to help this type of treatment become more effective.”
“Oxford House offers residents the freedom to decide which treatment they desire while receiving constant support and guidance within an abstinent communal setting,” said Jason. “It is a low-cost, safe and effective way to treat substance abuse in a collaborative housing setting.”
Community support is important element for success
According to Jason, in order for the Oxford Houses to be the most effective in treating its residents, it is best if they are located in safe neighborhoods or strong communities.
“Based on our research, the houses work best when they are close to public transportation, have job opportunities, and have other supports such as AA self-help groups We also have data showing that Oxford House residents do contribute and strengthen their neighborhoods,” Jason said. “Our research shows that it is a win-win situation, with communities benefiting from these Oxford Houses, and the support the Oxford House residents receive from their communities help these former substance abusers live more productive and healthier lives.”
“Since residents pay all expenses, and there are no professional staff, these types of self-governed settings have important public policy implications for inexpensive approaches for stabilizing individuals with substance abuse histories, especially in an era of cutbacks in funding for a variety of social service programs,” said Jason. “Because there is no maximum stay, residents may have a greater opportunity to develop a sense of competence toward maintaining abstinence.”
There are more than 1,900 Oxford Houses in the United States, and its residents operate each home independently, without help from professional staff.
“Oxford Houses are located in in almost every state, and are now spreading to other countries and their allure is that they represent an effective and low cost method of providing community support to prevent relapse,” Jason added.
More about Oxford House at http://bit.ly/oxfordhs.
More about the Oxford House research team at DePaul is athttp://bit.ly/oxfordtm.