You may or may not have heard about WCC-the latest development from the DoH since it invented commissioning in 1996!
It does feel abit vague but one of the very tangible, useful bits is a list of 11 organisational competencies for commissioning-sort of an organic development of the DANOS standards for commissioners from several years ago.
We are about to start a 3 year treatment system redesign program, built on these competencies (as we move towards being World Class!!).
One of the competencies is :

"Lead continuous and meaningful engagement with clinicians to inform strategy, and drive quality, service design and resource utilisation"

This forum is a brilliant way of doing this-but 3 specific questions:

1-does anyone have any good experiences of being engaged by commissioners that go beyond the usual powerpoint presentations and buffet lunches type of thing which they could share as examples of good practice?

2-When planning events with clinicians should we have seperate events for different clinicians-eg. GPs, GPwSIs, pharmacists etc-or will the "inter-clinician" dynamics get in the way? (the forthcoming West Mids SMMGP conference may partly answer this--should someone put a note about it in the events section?)

3-Do clinicians feel that one of their core competencies should be engaging with commissioners? (I'm aware that many GPs were prescribing for drugs treatment long before national drugs strategies and will carry on regardless of future funding arrangements)

I did want to ask some Addiction Psyciatrists the same questions but the forum on the SCAN website is only accessible to Add Psychiatrists-which probably answers question no. 3

Hi Tony - how did your meeting go ?
Was it the one run jointly by Smmgp, NTA and RCGP at the NTA in Birmingham on Feb 27th ? I found that meeting really useful if only because it brought various clinicans together with the aim of looking at the way forward. There were service managers, service users, drugs workers, doctors, nurses, addictions psychiatrists, pharmacists, you name it, all looking at how best to deliver " joined up " services, and they all had something to bring to the table.
Where do Commissioners fit in ? Clearly with a strategic head, thinking of partnership working, but I think what also helps is a good understanding of the nuts and bolts of dealing with clients, and supporting those who are at the front line dealing with people who live often very fraught, risky lives and may need guidance as well as client-centred care planning.
Maybe that reflects our local scenario, and in some areas the opposite will apply, but a key message was of local panels of specialists overseeing the development of drugs treatment services and each making their own, sometimes unique, contribution.
An excellent conference, hats off to all those involved.
Gill

Hi Gill-I think your right that its about making sure that local specialists from different professions can contribute to developing services-maybe commissioners need to ensure that can happen locally and be less concerned about other professions understanding what we do? certainly its about leadership, but without commissioners thinking that they "know everything"-a valid criticism another poster made some time ago. Also lately I seem to have spent a good proportion of time "selling" what drugs treatment does to professionals outside the field.
Yes the conference was a good day and a good mix of people (but a bit low on commissioners!)-and I really enjoyed the workshops on recovery and clinical audits-looking forward to the next one!
Tony

In addition to the reward circuit, it is hypothesized that stress mechanisms also play a role in addiction. Koob and Kreek have hypothesized that during drug use corticotropin-releasing factor (CRF) activates the hypothalamic-pituitary-adrenal axis (HPA) and other stress systems in the extended amygdala. This activation influences the dysregulated emotional state associated with drug addiction. They have found that as drug use escalates, so does the presence of CRF in human cerebrospinal fluid (CSF). In rat models, the separate use of CRF antagonists and CRF receptor antagonists both decreased self-administration of the drug of study. Other studies in this review showed a dysregulation in other hormones associated with the HPA axis, including enkephalin which is an endogenous opioid peptides that regulates pain. It also appears that the µ-opioid receptor system, which enkephalin acts on, is influential in the reward system and can regulate the expression of stress hormones.

Drug Treatment Centers

eh?

quote:

Originally posted by Simon Morton:
eh?

Don't you understand commissioning better now?

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quote:

Originally posted by jimjones:
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Grasser.