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DRUG TREATMENT & TESTING ORDERS 2004/5:

TARGETS, PERFORMANCE MEASURES AND


POOLED BUDGET ADVICE Probation
PURPOSE
To inform areas about:
Circular
• their 2004/5 DTTO targets and new performance measures
REFERENCE NO:
• the revised DTTO monitoring requirements
06/2004
• the Pooled Budget arrangements for 2004/5
guidance issued by the NTA to Drug Action Teams (DATs) regarding the
ISSUE DATE:
commissioning of DTTOs
22 January 2004
ACTION
Chief Officers are asked to: IMPLEMENTATION DATE:
• Note the contents of this circular and distribute it to relevant staff Immediate
Ensure that the revised DTTO monitoring requirements are put in place by 1
April 2004 EXPIRY DATE:
31 March 2005
SUMMARY
DTTO commencement targets for 2004/5 will increase to 12,000 orders with a TO:
higher intensity treatment plan and 1,000 of the new lower intensity variant. Chairs of Probation Boards
£76m funding has been made available for this, of which £42m will be Chief Officers of Probation
transferred to the Department of Health Pooled Treatment Budget to fund the Secretaries of Probation Boards
treatment and testing components of the order in England. Funding for DTTO
Lead ACOs – Substance Misuse
treatment and testing in Wales will be included in the 2004/5 Main Resource
Allocation to the four Welsh areas.
CC:
Additional DTTO performance measure targets, agreed with the NTA, will be
Board Treasurers
introduced from April 2004 for completion and National Standard first
appointments arranged to take place with probation and the treatment provider. Regional Managers
NTA guidance for DATs on the commissioning of DTTOs is attached to this DTTO SPOs/Managers
circular.
AUTHORISED BY:
RELEVANT PREVIOUS PROBATION CIRCULARS Claire Wiggins, Head of Intensive
PC 116/2001, PC 19/2002, PC 06/03, PC 68/03 Interventions Team

CONTACT FOR ENQUIRIES ATTACHED:


Anne Williams, Drug & Alcohol Performance/Interventions Manager Annex A - B
Tel: 020 7217 0768 Email: anne.williams@homeoffice.gsi.gov.uk
Robert Stanbury, Drug & Alcohol Policy Developer
Tel: 020 7217 0767 Email: robert.stanbury@homeoffice.gsi.gov.uk

National Probation Directorate


Horseferry House, Dean Ryle Street, London, SW1P 2AW General Enquiries: 020 7217 0659 Fax: 020 7217 0660

Enforcement, rehabilitation and public protection


1. BACKGROUND

The Government’s Updated Drug Strategy 2002 set out a range of targets to drive delivery of it’s main aims. A
key target is to increase the participation of problem drug users in treatment programmes by 100% by 2008 and
a significant increase in funding has been made available to achieve this. Various initiatives are being
introduced through the NTA and the Criminal Justice Interventions Programme (CJIP) to expand treatment
availability and increase pathways into treatment.

As part of the expansion of treatment places, funding is available to increase the 2004/05 DTTO
commencement target to 13,000 - 12,000 orders with a higher intensity treatment plan and 1,000 of the new
lower intensity variant.

Since 2001/2 arrangements have been in place to transfer the treatment and testing element of DTTO funding
for England to the Department of Health who, through the NTA, distribute this funding as part of the Pooled
Treatment Budget to DATs. The funding to deliver DTTO treatment and testing provision in Wales continues to
be included in the Main Resource Allocation to the four Welsh areas.

2. 2004/5 DTTO TARGETS

The targets shown below are the indicative DTTO 2004/5 targets. These are awaiting final approval but are not
expected to change.

Commencement Targets:
The DTTO commencement target for 2004/5 has been distributed to areas using the same percentage share
(based on an area’s share of the Main Resource Allocation) as for the other Performance Bonus Scheme
linked targets. Areas have been allocated their percentage share of both higher and lower intensity orders
(shown at Annex A).

An individual Probation Area’s DTTO ‘commencement target’ is made up by combining the targets of both
higher and lower intensity orders. Where an area exceeds its target of higher intensity DTTOs, these will count
towards the overall DTTO target, and can effectively be used to substitute the number of lower intensity orders
made. However, the reverse situation does not apply i.e lower intensity orders made above the lower intensity
DTTO target at the expense of making higher intensity DTTOs will not be counted against the DTTO
‘commencement target’.

New targets:
The following new targets, applicable to each area, will be introduced from April 2004 and will be jointly
applicable to both higher and lower intensity orders:

1. 35% of DTTO terminations between April 04 and March 05 to be satisfactorily completed orders (normal
termination at end of order and early revocation for good progress)
2. 90% of first appointments with probation arranged to take place within one working day of the order
being made (E6 of National Standards refers)
3. 90% of first appointments with the treatment provider arranged to take place within two working days (E6
of National Standards refers).

An order will be deemed to be “completed” and count for the purpose of meeting the target when the order has
either reached it’s expiry date with the offender still on the treatment programme and under active supervision,
or, where the order has been terminated early for good progress. An order that expires with outstanding
breach proceedings/warrants (ie where the order is not active and the offender is not responding) will not
count as a completed order.

Performance Bonus Scheme indicators


Next year the DTTO completion target will also be included in the Performance Bonus Scheme. The scheme
target is to achieve 90% across all the indicators, which are weighted as shown below:

PC06/2004 - Drug Treatment & Testing Orders 2004/05: Targets, Performance Measures and Pooled Budget Advice 2
The number of DTTO commencements against the area target - weighting 7%
The proportion of DTTO completions against the target of 35% - weighting 7%

3. DTTO PERFORMANCE MEASURES AND MONITORING

In addition to the above targets, performance monitoring of first appointments kept with probation and treatment
providers and retention on orders at three, six and twelve months will be introduced from April 2004. This data
will be used to collect some baseline information about retention on DTTOs at critical points to establish if drop
out of the order is more likely at any specific point. The data will enable comparison by area and support the
development of practice to improve engagement and retention.

NPD are aware of the many monitoring demands made on areas, particularly in respect of DTTOs and have
given particular attention to ensuring no additional DTTO returns would be required. The target and
performance measurement will therefore be collected by NPD as follows:

• commencements are measured through the monthly DTTO returns submitted by areas to NPD and these
returns will continue to be required
• Performance measured against the completion target which will be introduced for England and Wales in
2004-05 will also be taken directly from the monthly DTTO returns. However, areas are asked NOT to
include any order that is not active at the point of termination (ie in breach and no contact/warrant
outstanding). Such cases must be included in the ‘OTHER’ section of the monthly monitoring form with the
reason clearly given in the text box. The number of orders that terminate in this way will be closely monitored
but will not be counted in calculations for completion. The reason for this is that the order cannot be viewed
as a “successful” completion, but it would also be inequitable to penalise a probation area for performance
by agencies responsible for executing warrants (the areas responsibility to undertake breach promptly is
already assessed by other performance measures).
• first probation and treatment provider appointments arranged and achieved are monitored via the monthly
National Standard monitoring. Currently this is required on all cases commenced and terminated but in
recognition of the heavy demand this makes on areas, monitoring will become consistent with other orders
and be monitored on a sampling basis (20% of commencements and 7% of terminations) with immediate
effect.
retention at 3, 6 and 12 months will be monitored through the Quarterly Probation Lists (old Form 20s). From
this data we will be able to extrapolate data relating to the age, gender, ethnicity, offence and length of order
and cross reference this to retention

4. DTTOs WITH A LOWER INTENSITY TREATMENT PLAN

PC 68/03 advised that the DTTO with a lower intensity treatment plan, introduced this year in nine probation
areas, where the 30 BCUs with the highest levels of acquisitive crime are located, would be rolled-out across
the NPS from 2004/05. Areas will need to agree with their DATs/JCGs what treatment provision will be
appropriate for the lower intensity variant, as the indicative funding for treatment and testing is about half that
provided for a higher intensity order.

5. DTTO COMMENCEMENT TARGETS AND FUNDING

NPD recognises that the allocation of DTTO commencement targets to areas, based on the percentage of
funding an area receives under the Main Resource Allocation funding formula, does not necessarily sit well with
the proportion of Pooled Treatment Budget funding allocated to DATs within an area through the York Formula.
However, in retaining DTTO commencement targets in the Performance Bonus Scheme, the NPD needed to
ensure fair distribution of DTTO targets to probation areas.

To determine whether or not this method of apportioning DTTO commencement targets has a significant impact
on probation areas and/or DATs, NPD undertook work with the NTA to assess:

PC06/2004 - Drug Treatment & Testing Orders 2004/05: Targets, Performance Measures and Pooled Budget Advice 3
• the percentage apportionment of area 2003/4 DTTO commencement targets (for England) to DATs
against DATs’ percentage allocation of the Pooled Budget

• the apportionment of the 2003/4 DTTO commencement target (for England) to probation areas against
the problematic drug user (PDU) prevalence figures 1

The outcome showed a close correlation between the 2003/4 distribution of DTTO targets, problematic drug
misuse prevalence and the percentage share of funding received by DATs from the Pooled Budget. In light of
this, it was decided that, set against the need to be consistent with other probation cash linked targets, no
change would be made in the distribution method of DTTO commencement targets to probation areas for
2004/5.

Areas with more than one DAT do have flexibility to negotiate with their DATs about apportioning area DTTO
commencement targets taking various local factors into account, which could include:

1. the number of PDUs who would meet DTTO suitability in a DAT area
2. the distribution of Pooled Budget funding to DATs within a probation area
3. local drug related crime profile
4. whether or not a CJIP area with enhanced funding for drug misuser identification and treatment provision

Where a probation area has more than one DAT, apportioning the area’s DTTO commencement target to the
relevant DATs must be jointly agreed by those DATs. In any area where agreement cannot be reached, it is
important that both the NPD and local NTA Regional Managers are advised as early as possible.

6. POOLED TREATMENT BUDGET

There are no plans to change the arrangements for the transfer of the treatment and testing element of DTTO
funding for England. The baseline for 2004/05 is expected to remain unaltered and accordingly, it is anticipated
that £42m will be transferred in 2004/05. This transfer is included in the Three Year Drug Misuse Treatment
Allocation to DATs.

PC 06/03 sets out the framework within which the NPD and NTA expect that joint commissioning of the
treatment provision for DTTOs will be carried out and includes the expectation that DATs will agree DTTO
targets and commission treatment that enables DTTO National Standards to be met. That circular included
advice that the NPD expects accredited substance misuse or, where appropriate, offending behaviour
programmes to be delivered to address offending behaviour within the DTTO context and that the relevant
costs of delivering these programmes should be met from the Pooled Budget. The principles outlined in PC
06/03 are applicable to DTTOs with the lower intensity treatment plan.

NTA has confirmed that offenders on DTTOs would require high threshold interventions irrespective of their
links with the criminal justice system and that, therefore, the Pooled Budget contribution is to meet the costs of
providing the additional drug treatment and testing provision necessary to comply with National Standards.

The NPD and NTA recognise that not all DATs have readily signed up to DTTO commencement targets or
commissioned adequate treatment provision to meet the National Standard. The lower total uplift of the Pooled
Budget in 2004/5, with variable increases across DATs, could potentially lead to more DATs being resistant to
jointly owning DTTO targets next year. The attached NTA guidance “Commissioning Drug Treatment &
Testing Orders” (Annex B), is being issued simultaneously with this circular to DATs and Joint Commissioning
Managers. This guidance advises that the NTA considers DATs are being funded at a level that reflects local
need and this includes funding to commission adequate DTTO provision.

1
Estimating the Prevalence of Problematic Drug Misusers for Drug Action Team Areas in England and Wales Using the Multiple
Indicator Method – Frischer, Heatlie & Hickman 2003

PC06/2004 - Drug Treatment & Testing Orders 2004/05: Targets, Performance Measures and Pooled Budget Advice 4
7. JOINT COMMISSIONING

Responsibility for meeting DTTO targets at a local level must be jointly owned by probation areas and DATs.
The range of treatment provision that must be delivered as part of a DTTO and the level of contact required is
set out in the National Standard. Commissioning treatment provision to meet the Standard is the role and
responsibility of DATs through their Joint Commissioning Groups (JCGs). The NTA and NPD agree that,
wherever possible, JCGs should be working towards integrating DTTO treatment provision into mainstream
provision.

Service Level Agreements or Service Specifications that determine contracts with treatment providers need to
be clear about requirements for DTTOs and robust enough to be monitored by JCGs whether a stand-alone
service or part of mainstream provision.

National Standards monitoring shows a low achievement of the required contact with offenders on DTTOs It is
unclear yet if this is due to poor feedback and/or recording processes or whether provision does not meet the
contact requirement level required by the National Standard. Areas need to identify where improvement needs
to be made and, those with more than one DAT determine whether there are differences in performance
between the DATs.

Any probation area that considers insufficient provision has been commissioned to meet the anticipated
treatment needs of offenders on DTTOs should try to resolve this with their JCG/DAT. Where this continues to
prove an issue, and could place an area at risk of not meeting the completion target and/or the National
Standard, NPD and NTA need to be notified.

Probation representatives must play a full role in the process of jointly commissioning treatment provision
within a DAT area. Although their principal role is to ensure that criminal justice needs are identified and met,
they should not restrict their activity to probation or criminal justice provision.

8. DTTO NATIONAL STANDARDS

The National Standard for DTTOs, introduced in February 2001, was primarily based on the limited experience
of the DTTO pilot areas. Various factors including the introduction of the Models of Care framework, over three
years of DTTO delivery and research evidence about treating crack users and retaining drug misusers in
treatment suggest that the current Standard should be reviewed. In particular, the contact and enforcement
requirements are limited in their flexibility and may act against completion of orders.

The new Criminal Justice Act includes legislation which replaces provisions in Section 53 of the Criminal Justice
and Court Services Act 2000 which had not been enacted. This means that the current National Standard
enforcement requirements are governed by legislation and cannot be amended. However, NPD is looking to
issue guidance about the discretion that exists in respect of enforcement of all intensive interventions, including
DTTOs

Consideration is presently being given to revising DTTO contact levels within the National Standard and a
decision is expected early this year. Guidance and any revision to the National Standard will be issued before
April 2004.

9. IMPACT OF CJIP ON DTTOS

The introduction of additional funding this year to DATs in high crime Basic Command Units (BCUs) under the
CJIP initiative has provided more scope to enhance criminal justice based interventions in those areas, including
DTTOs. Twenty five DATs located in nine probation areas received additional funding for 2003/4 and a further
twenty three DATs based in the existing nine or five new probation areas will receive increased funding for
2004/5. Additionally, all DATs will receive extra funding to deliver the CJIP Through and Aftercare initiative next
year.

PC06/2004 - Drug Treatment & Testing Orders 2004/05: Targets, Performance Measures and Pooled Budget Advice 5
The impact of this on DTTOs has been development in three main areas:

1. improved identification, screening and assessment including Tier 2 intervention to motivate and reduce
pre-sentence attrition
2. integrated teams working directly with DTTO teams, treatment providers or alongside them
3. easier access to post-DTTO treatment provision

All areas, whether or not they are designated as a “CJIP” area, should work with their DATs/ JCGs to make
the best possible use of the additional funding to enhance criminal justice drug treatment provision. In some
areas this will mean establishing close working arrangements with the new criminal justice intervention teams
(CJITs) who will be able to make a significant contribution to the achievement of DTTO commencement
targets.

PC06/2004 - Drug Treatment & Testing Orders 2004/05: Targets, Performance Measures and Pooled Budget Advice 6
Annex A
(1)
Indicative Area Targets 2004-05

Offending Higher Lower


Behaviour Intensity Intensity Total
% Programme ECP DTTO DTTO DTTO Basic Skills Basic Skills
Share Completions Completions Starts Starts Starts Starts Awards
Avon & Somerset 2.47 370 740 296 25 321 789 197
Bedfordshire 0.94 141 283 113 9 123 302 75
Cambridgeshire 1.08 161 323 129 11 140 344 86
Cheshire 1.73 260 519 208 17 225 554 138
Cumbria 0.90 134 269 108 9 116 287 72
Derbyshire 1.71 257 513 205 17 222 548 137
Devon & Cornwall 2.45 367 735 294 24 318 784 196
Dorset 1.00 150 300 120 10 130 320 80
Durham 1.37 205 411 164 14 178 438 110
Essex 2.36 355 709 284 24 307 757 189
Gloucestershire 0.85 128 256 102 9 111 273 68
Hampshire 2.82 423 845 338 28 366 902 225
Hertfordshire 1.24 186 373 149 12 162 398 99
Humberside 1.94 292 583 233 19 253 622 156
Kent 2.56 384 767 307 26 332 818 205
Lancashire 3.02 452 905 362 30 392 965 241
Leicestershire 1.71 256 513 205 17 222 547 137
Lincolnshire 1.03 154 309 124 10 134 329 82
Norfolk 1.30 194 389 155 13 168 414 104
Northamptonshire 1.03 155 310 124 10 134 331 83
North Yorkshire 1.07 160 320 128 11 139 341 85
Nottinghamshire 2.26 340 679 272 23 294 724 181
Staffordshire 1.89 283 567 227 19 246 604 151
Suffolk 0.96 144 287 115 10 125 307 77
Surrey 1.07 160 320 128 11 139 341 85
Sussex 2.05 307 614 246 20 266 655 164
Teeside 1.57 235 470 188 16 204 501 125
Thames Valley 2.88 432 863 345 29 374 921 230
Warwickshire 0.73 109 218 87 7 95 233 58
West Mercia 1.78 267 534 214 18 232 570 142
Wiltshire 0.89 133 266 106 9 115 283 71
Greater Manchester 6.30 946 1,891 756 63 819 2,017 504
Merseyside 3.73 559 1,119 447 37 485 1,193 298
Northumbria 3.42 514 1,027 411 34 445 1,096 274
South Yorkshire 3.12 468 936 374 31 405 998 250
West Midlands 6.50 974 1,949 779 65 844 2,079 520
West Yorkshire 5.01 751 1,502 601 50 651 1,602 401
London 15.11 2,266 4,532 1,813 151 1,964 4,834 1,209
Dyfed-Powys 0.85 127 254 102 8 110 271 68
Gwent 1.32 198 395 158 13 171 421 105
North Wales 1.23 184 368 147 12 159 392 98
South Wales 2.79 419 837 335 28 363 893 223
Total 100 15,000 30,000 12,000 1,000 13,000 32,000 8,000

(1) Figures have been calculated using the basic funding formula.
Annex B

Commissioning Drug Treatment and


Testing Orders
Guidance for drug action teams and commissioners
January 2004

1. Introduction
National targets for Drug Treatment and Testing Order (DTTO) commencements have increased
from 6,000 in 2002/03 to 9,000 in 2003/04. They will further increase to 12,000 (referred to as
higher intensity orders) plus an additional 1,000 new lower intensity orders in 2004/05. The Home
Office contribution to the pooled treatment budget has been increased to reflect these annual
increases. The new targets are challenging, particularly for the next financial year (2004/05) when
some drug action teams (DATs) will receive little or no uplift in their pooled treatment budget
allocations.

This paper provides guidance to DATs and joint commissioning groups (JCGs) on the
commissioning of DTTOs. Similar guidance is being issued by the Probation Service in their
probation circular.

2. Key principles
The key principles behind the commissioning of DTTOs are outlined below.

• National DTTO commencement targets are determined by the Home Office and apportioned to
probation areas. Responsibility for meeting local targets must be jointly owned by probation
areas and drug action teams.
• Probation service representatives need to be recognised by DATs as full partners in the joint
commissioning process. Their contribution should not be restricted to DTTOs and criminal
justice issues.
• Wherever possible, joint commissioning groups should be working towards integrating DTTO
provision into mainstream treatment rather than commissioning stand-alone services.
• In general, drug users who are assessed as suitable for DTTOs are individuals who would
require high threshold interventions irrespective of their links with the criminal justice system.
The Home Office contribution to pooled treatment funding is provided in acknowledgment of
the additional costs associated with DTTOs. This funding is intended to provide a contribution
to the cost of drug treatment provision for every offender on a DTTO.

DTTO – NTA guidance January 2004 1/5


Annex B

3. Pooled treatment budget (PTB)


Some drug action teams have expressed concern that they are being expected to meet the
increased targets for DTTO commencements for 2004/05 in a year when they are experiencing
little growth in their pooled treatment budgets.

The pooled treatment allocations announced in 2002 were based on a revised funding formula
(known as the York formula). It was widely accepted that the previous formula was heavily
weighted to reflect a number of irrelevant factors and led to an inequitable distribution of funds.
Consequently DATs with higher levels of need were under-funded, in relative terms, whilst other
DATs benefited disproportionately. The new formula was weighted towards populations of 15-44
year olds and included a range of more relevant measurement criteria.

The revised formula led to considerable re-adjustments in PTB allocations and in order to
ameliorate the impact, a decision was made to phase in the changes to ensure that no DAT faced
a budget cut and that the changes were spread over a three year period. DATs were also given
indicative budgets for 2004-2006 to enable them to forward plan.

The net result of these changes is that DATs are now being funded at a level which reflects
local need and this includes the funding to commission adequate DTTO provision.

Probation Circular 06/03 sets out the framework for the joint commissioning of treatment provision
for DTTOs.

4. DTTO targets 2004/05


The Home Office issue national targets for DTTO commencements. Probation areas are then
allocated their own targets, which in line with other targets, are based on the probation funding
formula. The National Probation Directorate (NPD) has confirmed that probation areas can
negotiate with their DATs on the basis of their allocated targets and, if necessary, re-apportion
targets across the DATs in their areas.

The NPD/NTA has undertaken a joint piece of work to assess whether existing DAT targets were
allocated on an equitable basis and whether there was scope for redistributing them more fairly.
The study involved a comparative analysis of DAT DTTO targets (20002/03) against the following
criteria:
• problematic drug user (PDU) prevalence figures based on a recent study by Keele University
• the probation cash formula
• as a percentage of the pooled treatment budget allocation.

The outcome of this analysis showed a very close correlation between existing targets and those
produced if they were based on the above criteria. This study confirmed that the current targets
reflect perceived need and resource allocation.

PC 06/04 confirms DTTO commencement targets per probation area for 2004/05 and also
introduces the following new targets which will apply from April 2004 to both higher and lower
intensity orders:

1. 35% of DTTO terminations to be completed orders (normal termination at end of order and
early revocation for good progress)
2. 90% of first appointments with probation arranged to take place within one working day of
the order being made (E6 of National Standards refers)
3. 90% of first appointments with the treatment provider arranged to take place within two
working days (E6 of National Standards refers).

DTTO – NTA guidance January 2004 2/5


Annex B

Next year the DTTO completion target will also be included in the Performance Bonus Scheme. The
scheme target is to achieve 90% across all the indicators, which are weighted as shown below:

The number of DTTO commencements against the area target - weighting 7%


The proportion of DTTO completions against the target of 35% - weighting 7%

5. DTTO national standards


The National Probation Directorate and the National Treatment Agency have been looking at the
impact of national standards for DTTOs. These standards are primarily based on the limited
experience of the DTTO pilots and have now been in operation for nearly three years. The current
arrangements have the advantage of providing consistency with other community sentences in
relation to breach procedures. However, the approach to contact levels and enforcement does not
reflect the current evidence base in terms of what works in relation to drug treatment.

DTTO national standards need to achieve a balance between developing effective drug treatment
responses and providing clear, consistent and enforceable standards that maintain credibility in
public protection and criminal justice terms. Discussions have focused on two key aspects:

Contact levels: Models of care requires treatment to be based on a clear assessment of the
needs of the drug user, with a care plan individually tailored to meet those needs and flexible
enough to respond to changes over time. The evidence base in relation to the reduction of
offending behaviour also indicates that the intervention should be proportionate to the risk of re-
offending. The current contact level of 20 hours per week for the first thirteen weeks for all
offenders on a DTTO does not always conform to this evidence base.

Enforcement: The rigorous enforcement standards currently in operation are at odds with the
accepted notion of problem drug use as a relapsing condition. Treatment interventions need to be
flexible and responsive enough to accommodate and re-engage those who are unable to adhere to
their treatment plans consistently.

The NTA considers that treatment for those on DTTOs needs to be consistent with the principles
enshrined in Models of care (NTA 2001) and with the emerging evidence of what is effective in
treating drug users. This approach is supported by the NPD.

The new Criminal Justice Act includes legislation which replaces provisions in Section 53 of the
Criminal Justice and Court Services Act 2000 which had not been enacted. This means that the
current National Standard requirement in respect of enforcement is governed by legislation and
cannot be amended by the NPD.

However, the NPD will shortly be issuing guidance that offers greater clarity about the way that
discretion around the enforcement of National Standards can be exercised to provide greater
flexibility. Changes in relation to the DTTO contact levels are also under consideration

6. DTTO reconviction study


A Home Office study published on 25 September 2003 looked at 2 year reconviction rates for 174
offenders placed on DTTOs in the three pilot areas (Croydon, Liverpool and Gloucestershire)

DTTO – NTA guidance January 2004 3/5


Annex B
1998-2000. Nearly a third of offenders completed their orders, enabling this particularly hard-to-
reach/treat group, with entrenched patterns of drug misuse and offending, to lead more stable and
crime-free lives.

The study concluded the following:

• Two years after the start of the order, offenders who completed DTTOs committed less crime
than in any of the five years prior to sentence.

• There were statistically significant differences in reconviction rates between those whose
orders were revoked (91%) and those who completed their orders (53%).

The study confirms the positive impact that drug treatment can achieve in reducing drug-related
crime but also points to the need to improve retention and completion rates.

7. DTTO costs
Establishing the true cost of DTTO provision can be a barrier to effective commissioning. Ascribing
a fixed cost per order is unhelpful because a significant proportion of orders do not reach their full
term.

The unit cost of a DTTO is likely to vary quite widely from one area to another depending on how
DTTO provision is delivered. There is clearly greater scope for reducing costs and achieving
economies of scale where DTTO provision is integrated and delivered in the context of mainstream
treatment services.

Joint commissioning groups and probation areas should work together to identify the overall cost of
their DTTO provision. This will require an understanding of local retention and completion rates
and an ability to disaggregate the cost of the different components of the order to establish:

• which aspects are delivered within existing service provision


• additional elements that are commissioned specifically to meet DTTO requirements
• what is paid for by the probation service from their retained funding

This information can then be used to produce a detailed breakdown including, staff, treatment,
accommodation, drug testing and travel costs etc. The NTA will shortly be issuing guidance on how
to calculate unti costs which will provide additional assistance with this process.

8. Impact of Criminal Justice Intervention Programme (CJIP)


and throughcare/aftercare funding
The implementation of CJIP in nominated high crime areas and the availability of throughcare/
aftercare funding to all DATs as of 2004, will provide greater scope to augment and enhance
criminal justice based interventions. The new criminal justice intervention teams will be able to
contribute to the delivery of DTTOs at a number of different levels e.g. screening and assessment,
offering relapse prevention and tier two motivational engagement and providing aftercare support.

Joint commissioners and probation areas should work together to make the best possible use of
resources available from both the pooled treatment budget and these new initiatives to add value
and flexibility to existing DTTO provision.

DTTO – NTA guidance January 2004 4/5


Annex B

Further information
For further information visit www.nta.nhs.uk and www.drugs.gov.uk or contact your NTA regional
office, or NTA’s criminal justice team at 020 7972 2215.

Published by the National Treatment Agency


5th Floor, Hannibal House
Elephant and Castle
London SE1 6TE
Tel 020 7972 2214
Fax 020 7972 2248
Email nta.enquiries@nta-nhs.org.uk
www.nta.nhs.uk

This report is available online at www.nta.nhs.uk

DTTO – NTA guidance January 2004 5/5