I went to this yesterday. I didn't know what to expect and part of me was fearing the worst. However I thought the new tool was excellent! Its only 1 side of A4, its simple easy to fill in. Its been rigourously validated and only field where they could achieve meaningful results have been included (hence no specific questions on benzo's- because during testing reporting of benzo use was found to be too unreliable i.e scored less than 60 on their scale and would not provide meaningul data). Its very scientifically produced basically. It should be easy to integrate into routine activity as it asks questions that we would be asking anyway. It will be linked to NDTMS and should eventually be put onto all GP systems.

My only concerns are that there may be incentives for both patients and staff to produce overly positive outcomes. This is because it will be linked to performance management and depending on the service may be linked to take home privilages or even keeping ones script. Also on the other hand it may effect forthcoming contingency management rewards.

Alright, so what does TOP stand for please ? It's not the pleasantest name.

Hi Judith. I'djust thought I'd better come back on here and explain what it was (before anyone asked) but you beat me to it. Its Treatment Outcomes Profile. Its basically an outcome monitoring tool that is to be implemented throughout the system.

To me it seems like a superior version of the Christo inventory (sorry Christo) which keeps the important element of simplicity.

Hello Jim, I've used Cchristo before and found it quite good so if this is a simpler version its worth a look at. How does one get ones grubby mits on it?

Yes, Jim do tell.

Come on then Jim.. one page of A4, even I can cope with. Is this the thing Susi was talking about at the conference, or was that something completely different? Point us towards it.. must be posted somewhere?

Try this:
http://www.nta.nhs.uk/areas/outcomes_monitoring/

My only concern is that the NTA appear to be making a bid for world domination: "Once embedded, the TOP will be the most widely used psychometric monitoring tool of any kind, not just in the drug treatment field, in the world."

But in a nice Mike Myers sort of way.

Simon

hmmm. so how many days in the last month did you steal from a car?
The rest of it looks fine, but the crime bit?

Are people likely to say " In the last 4 weeks, i stole from 4 cars, 3 houses and marks and spencers , committed fraud once, and assaulted my partner 3 times. Who did you say you were going to give this information to? The government? Oh that's ok then."

So I'm not quite sure the crime bit is likely to come up with any accurate sums. The rest of it looks OK though I think. If you like that kind of thing. I quite liked the Christo score though.

Couldn't we please have something that ties in with EMIS ?
So many things are happening in isolation.

Yes , I like Christo too Judith.

I guess there's a problem with self-report of crime: will it be under, over, or spot-on?

But self-report of crime was built into NTORS, so it's always been about the self-report of crime.

The rightful authority of NTORS - and I am a very big fan - augered the legitimate investment in UK treatment services over the last 6 years plus which this government has been prepared to countenance.

So we have to be pleased.
Don't we...?

Simon

Cool i was going to put the NTA link on but couldn't get into the site from work and someone's already done it!
Simon G I think I have good news for you. The TOP will be reported via NDTMS. NDTDMS is being taken over by CFH and EMIS will be compatible with that
I am purposefully giving you a hard time with the acronyms! CFH stands for Connecting for Health (there is another thread somewhere which explains what this is). Wonder what EMIS stands for?
Judith I think it is the thing I was talking about at the conference by the way - I hope it hasn't ben too much of a surprise...

Personally I prefer this to Christo as it is almost all objective scoring. I realise its hard to quantify things sometimes but at least we all know what twice a week means - what does 'often' mean?

Simon M you are right about the link with crime and funding - there is one whether we like it or not.

Thanks for the suggestion - with the drugs strategy coming to an end in 2008 we are going to need a new slogan - we can replace 'More, Better, Fairer' with 'Towards World Domination'

Susi wearing NTA hat

Susi,
That may well be good news, but I'd like to see us all reporting and making assesments the same way. I've seen some assesments that would make me lose the will to live. We need a national agreed structure that we can all fill out quickly and easily on EMIS or other systems.

Hi Judith

the theft from vehicle question is just yes or no over the last month, this was apparently because it could not be validated in a more detailed form.

NDTMS: My favorite subject (not!). Carrying on from the thread of the TOP reporting via NDTMS, WHEN will this be made compatable with CFH? I have heard it all before...We are just about to do our audit round for NES practices and I'd like to give them some indication.

Hi all,
Just some comments on TOP. In section A it asks for amount per day (of drugs used) in g's.. and I don't know many who use in gram's per day, especially heroin as they vary from .2 or .3 of a gram aound here and this is a guess really.. so as I would be in treatment to complete this form, would that be a good unit of measure? Assuming the client is trying to reduce the amount used by having treatment.. as for the crime section? I'd self report 'nil' in every box.
Section 2 B: I think it would be difficult to rate with this personally as it only offers Good or Bad and the scale in the middle, so what would say, 6 be, or 12?
I know I probably sound picky and I don't mean to be, or am I completely missing something? My first impression was " Oh no, another form to complete" as we tend to do lots and lots..

AS for the new motto,
'Towards World Domination' YEAH BABY!!

Joe,
I've always asked people in pounds as it's a unit I understand well. EMIS though won't let us have a read code for pounds per day. We were given substance misuse increased or decreased. We did try.
Yes I also thought another form.
could we rate how much we like filling forms on a scale of 0-20
Zero being I hate filling forms, twenty being I live to fill them it, it is my ambition in life to fill more and more everyday, please give me more forms it makes my life feel of value. Patients value being asked by me to fill in forms they feel great and it increases our street cred. etc.

The TOP form clarifies the NTA priorities in drug treatment. There are six individual categories for crimes committed but assessments of both psychological and physical health use a twenty-point scale from poor to good.

Hi Jane

apparrently NDTMS has been sent off for read coding but TOPS data is going to have to waut for a bit (according to Malcolm Roxborough at the NTA and he's definitley your man when it comes to this sort of thing)

Hi all

Simon/Jane et al lots of people thought . . yet another peice of paper to fill in but this is different.
A key worker from the Blackpool pilot was one of the presenters & she admitted that she went into the pilot thinking 'bad' thoughts but came out having exceeded the number of sevice users entering the pilot. We were also a pilot site & my team also found the tool easy/friendly to use and motivational (+ive) to both service user & key worker. Filling the form in is a short training session. Just looking at it from Jims link doesnt do it justice.

D5 has never opted into NDTMS (& we never got chased) but we will opt into this. The crime questions btw... the pilot used a 2nd interview process to re-check answers to questions (as Jim said this is science and statistice not just lies more lies & dammend lies) were validated hence staying in where as some questions e.g benzo's were booted out of question sheet as the validity of answers on follow up questions were below the 60% cut off

I agree with Jim's points that it's an easy to use brief tool. I don't see it as an either or with christo as TOP is a treatment outcome monitoring tool. A lot of the other tools in the field are tools quantifying the severity of dependence.