Data challenges & opportunities: offenders in custody and the community

1. Data challenges & opportunities: offenders in custody and the community Caroline Bonds (Head of Strategic Drug & Alcohol Treatment Team) & Robert Stanbury (Alcohol Operational Policy & Delivery Manager)

2. Why does NOMS collect data? • As a strategic tool that can be closely linked to planning processes • Review the effectiveness of existing provision • Identify problems and devise appropriate remedial action • Measure performance against agreed targets and indicators • Inform decisions about the commissioning and delivery of services

3. What are the principal data sources? • Community • Offender Assessment System (OASys) • Case management systems e.g. CRAMS, ICMS • Offender Caseload Management Statistics • NOMS Performance Hub • Interim Accredited Programme Software (IAPS) • National Standards Monitoring and Reporting Tool (NSMART) • Research and evaluation • Police National Computer

5. The nature and extent of the alcohol problem - community • 44% of offenders had a current problem with alcohol use • 48% with binge drinking • 57% had misused alcohol in the past • 41% had violent behaviour related to their alcohol use • 47% were found to have a criminogenic need relating to alcohol misuse

6. What Causes Their Offending? Over half of the offenders had ‘needs’ with regard to criminal history, education, training and employment and thinking and behaviour. Additionally, over half of offenders in custody were also assessed as having a ‘need’ with regard to lifestyle and associates, which encourage criminal activity. A much larger proportion of offenders in custody was assessed as having accommodation, drug misuse and attitudes problems than offenders on community sentences. As some factors, e.g. criminal history, cannot be altered, it is through factors like education, employment and substance misuse, that offending can be reduced.

7. What are the principal data sources? • Prisons • AUDIT • DIR (DIRWEB) • facilitate and improve standards of • continuity of care • support the monitoring and research • functions around DIP • act as the SMTA in prisons • CARATs Research Data • Research and Evaluation

8. Alcohol Use Questions on DIR

9. Alcohol and prisons (1) • Office of National Statistics (ONS) research found that:- • 63% sentenced males and 39% females were hazardous drinkers in the year before prison • 70% of young adults • Around 8% have intensive treatment need • CARAT research data found that: • 36% used alcohol in the 30 days before custody • 14% reported alcohol as the main problem drug

10. Alcohol and prisons (2) • Data from a 2004/05 study showed that up to 1 in 5 CARATs clients regarded alcohol as their main problem drug/substance • A study of problem drinking among minority prisoner groups showed that: • A third of women had increasing risk or higher risk patterns of drinking alcohol • Harmful levels of alcohol use featured prominently amongst 18-21 adult male prisoners • Half of males from minority ethnic groups were drinking at increasing and higher risk levels of alcohol, with just over a third classified as both harmful drinkers and dependent on drugs • Data from SPCR showed that: • 36% reported heavy drinking prior to custody; • Heavy drinking was significantly more likely among prisoners sentenced to less than a year (39% vs. 31%) • 16% of sample self-reported a requirement for support for an alcohol problem

11. Assessing Need - Prisons • All prisoners receive an Initial Healthcare screen • Drug Clinical Assessment (initial SMTA – DIR) • CARATs (SMTA) • AUDIT – optional tool • CSMA – for those whose alcohol misuse is part of poly-drug misuse • Psychometric testing for intensive rehabilitation programmes • OASys - Two thirds of prisoners will not be given an OASys Assessment

12. Assessing need - community • Areas should undertake a comprehensive assessment of offender need to: • Increase their knowledge and understanding of the offender (drinking) profile • Increase the correlation between identified alcohol need and service provision • Influence externally commissioned alcohol services to reflect offender need • Should comprise analysis of data from OASys and alcohol screening tool/specialist assessment data • PCTs and Local Authorities should include the needs of offenders in their area (both in the community and prisons) within their assessments for the alcohol component of the Joint Strategic Needs Assessment (JSNA)

13. Performance Monitoring - Community • From April 2008 an alcohol treatment requirement (ATR) completion target was introduced into the NOMS performance metrics to drive up commencements and completions nationally • From 09/10 the main ATR metric is the completion rate with a supporting volume completions diagnostic measure:- • Completion rate – Minimum of 40% in each area • Volume – Minimum 100% increase on aggregated 08/9 target (1876) • The Sentence Plan Outcomes Shadow Measure uses data from OASys to focus on the requirement for sentence plans to ‘deliver against needs’ by addressing the needs which are most likely to reduce re-offending

14. Monitoring outcomes: Measuring impact on offender health and behaviour change • Retention rates and compliance with order • Satisfactory completion of the intervention and any associated community order/suspended sentence order/licence requirement(s) • Changes in the level of alcohol use (measured by AUDIT/Offender Assessment System (OASys) Sentence Plan review/outcome data) • Improvements in health and social wellbeing e.g. family life, accommodation, employment status, etc. • Changes to alcohol related risk of re-offending (measured by OASys data)

15. Target Setting and Performance Monitoring - Prisons • With no central funding few targets have been set • Performance monitoring of Alcohol 12-Step programme and Alcohol Violence Reduction Programme • Measure starts and completions targets

16. Challenges: What are the main limitations of existing data sources? • Lack of routine, systematic and integrated data that is collected on alcohol - NATMS • NOMS does not have nationally collated data from a validated alcohol screening tool (AUDIT still an optional tool) • Over reliance on OASys as a tool to assess need • Missing data/Invalid assessments • Replication of data collected (Healthcare – CARATs) • No single unified case management system • Operational burden of data collection • Issues around sensitivity of data/data sharing • Not in a position to provide a detailed epidemiology and provision/gap analysis from existing data sources • No direct and routine monitoring of treatment need across prisons and probation • Spending by PCTs on alcohol treatment not reported routinely • No central record being kept of which prisons offer locally funded alcohol treatment

17. Opportunities: A brighter future? • Drug Treatment Demand Model • DIRWEB • National Alcohol Treatment Monitoring System (NATMS) • Research studies • ICPR research to assess the effectiveness of probation work with alcohol misusing offenders and CARATs Research • Offender Management Cohort Study • Revised alcohol interventions guidance • Alcohol Learning Centre - http://www.alcohollearningcentre.org.uk/