In 2007, the key documents that continue to underpin the strategies and plans for
our Board are The Health Strategy, Quality and Fairness - A Health System for You,
Making it Home - An action plan for homelessness in Dublin 2004 - 2006 and The
National Drugs Strategy 2001 - 2008. Coupled with our Board’s Strategy 2005 - 2010
we have continued to build on our existing services through programmes of
improved quality whilst leading and informing on best practice. In 2008 the National
Drugs Strategy will be reviewed. We look forward to playing our part in shaping the
future of the next drugs strategy.
In 2007 we continued to develop our working relationships with other statutory and
voluntary agencies. Our joint initiative with Focus Ireland in the delivery of services
to the young homeless continued.
In 2007, we reported through the National Drug Reporting System that we assessed
or treated 1,062 clients. There was no significant change in the age profile of clients
attending our services in 2007. However, we note that our client cohort is ageing
with an increase in the age profiles of those 40 years and older. This increased by
almost 2% in 2007 which is in line with national trends.
In 2007, a total of 551 external psychiatric assessment appointments were made.
The ratio of males to females remains at 2:1. Opiates remain the main problem
substance for cases we assessed or treated in 2007. The number of young people
under the age of 19 who present for treatment is continuing to increase each year
(37 in 2005; 52 in 2006 to 56 in 2007). This represents an increase of 51% over 3
years.
We continued to manage the Central Treatment List (a national service for the
recording and processing of all clients who are prescribed methadone). Since 1998,
the number of clients being processed by this service has increased from 5,403 in
1998 to 9,760 in 2007. In addition we enhanced the functionality of the IT system in
2007 which has significantly improved reporting capabilities.
In 2007 our laboratory continued to maintain its accreditation from the Irish National
Accreditation Board (INAB) to the IS0 17025 standard. Having developed a method to
differentiate 'Crack' from ordinary Cocaine we carried out random 'sweeps' on a
sample number of clients attending our service and a project in West Dublin. This
determined that approximately 10% of positive cocaine results can be attributed
specifically to the smoking of 'Crack Cocaine'.
Further developments planned within our laboratory include developing a method to
differentiate between Methamphetamine (Crystal Meth), Ecstasy or Amphetamines
with regard to Crystal Meth. At present all samples received by our laboratory are
screened once a month for amphetamines as per agreed requirements. This screen
does not differentiate between Methamphetamine (Crystal Meth), Ecstasy or
Amphetamines. Within our agreed screening protocol we have however identified an
increase from 1% in 2006 (Of the circa 66,150 samples tested for amphetamines 660
were positive) to 2% in 2007 (circa 69,000 samples tested for amphetamine of which
1,380 were positive).
Our Hepatitis C service continued to be proactive in 2007 focusing on maximising
attendance at our educational service for all those attending our service. To date 43
clients have been offered treatment, 40 of whom have completed treatment
representing an excellent adherence rate of 93%.
We established an Adult ADHD assessment clinic in February 2007. This pioneering
service under the supervision of our Clinical Director Dr John O’ Connor has
enabled us to provide a comprehensive service in the treatment, care and
management of those who were previously undiagnosed thereby significantly
improving their quality of life.
In 2008 we plan to further develop our counselling services focusing for clients who
test positive for Cocaine. In addition, we plan to develop a Cocaine/Stimulant Service
(CSS) for non-opiate users who are not attending existing treatment centres. The
treatment model that will be utilised will be evidence-based and focus on meeting
the needs of clients and their families.
We will also participate in an international clinical trial designed to demonstrate
that placing Opioid dependent patients, seeking treatment for their addiction,
directly on Suboxone is not inferior to first taking Subutex and then Suboxone.
During 2007 we continued to develop our Electronic Patient System (EPS) which has
automated many of the current manual work-flows and has improved efficiencies
and customer care. In particular we moved from paper based to electronic patient
charts. Statutory returns to the Health Research Board are now reported
electronically. I would like to acknowledge the support and assistance of the staff of
the Health Research Board during our development phase.
We commenced a building programme in 2007 to install a second lift to the rear of
the building and air handling on the first to fourth floors. These enhancements will
improve the environment for clients and staff. We acknowledge the support of the
HSE in providing financial assistance for this project and look forward to its
completion in Autumn 2008.
In 2007 we developed our Risk Management Strategy. This strategy ensures that
clients, staff, services, reputation, and finances of the DTCB are protected through
the process of risk identification, assessment, control, minimisation and elimination.
In addition we established a Clinical Governance Committee. We acknowledge the
support of Ms Debbie Dunne, State Claims Agency during this process. During 2007
we also carried out an external review of our internal financial controls.
On behalf of the Board, management and staff, I would like to thank the Charitable
Infirmary Charitable Trust, the Department of Health and Children, The State Claims
Agency, the HSE and HSE Shared Services for their continued support. We share
their objective to improve the patient/client journey and provide a better working
environment for staff. I would also like to acknowledge Focus Ireland, the Health
Research Board, St. James’ s Hospital, Cuan Dara, Cherry Orchard Hospital and St.
Michael’ s Ward, Beaumont Hospital as well as our many partners in the Voluntary
and Statutory sector, the local community, businesses and other community service
providers. I would also like to thank the Chairman and Board for their continued
support during 2007.
This report is a reflection of the continued hard work and commitment of our Board and
staff who during 2007 worked diligently to ensure we continue to provide a quality
service.
