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  • Introduction

  • This digital form is a summary of how your personal information will be used. For more information, please refer to the ‘Further Guidance’ document which is available on request, or alternatively speak to your Forward worker.
     
    We at Forward ask you for information about yourself in order to provide you with treatment to match your needs and continuity of care. 
     
    We only keep your information with details of your care for a period as long as necessary to fulfil the purposes we collected it for.  
     
    You have the right to apply for access, correction, erasure, transfer, object to processing or restrict the information we have recorded about you. You have the right to withdraw your consent at any time.
     
    Any information we keep about you is kept confidentially within the service and stored securely except when we have a duty to share information or if you give us permission to share information. 
     
    You can find out more about your rights by request from your Forward worker or by clicking here.
     
    You will be sent a digital copy of the documents you complete via the email address provided. 

  • Duty To Share Information

  • We have a duty to share information with or without your permission under certain circumstances.  Wherever possible, we will discuss this with you first. We have a duty to share information:
     
    If the safety/security of other service users, staff or the community is compromised by not revealing information.
     
    If your Forward team believes you may be at risk of self-harm or risk of harm to any person.
     
    If your Forward team has concerns for the welfare of any child(ren).

  • Permission To Share Information 

  • We ask for your consent to share information with other services or professionals who are important to your care or who hold important information about you. These may include:
     
    Other drug treatment agencies, GPs and other healthcare services, probation service, housing departments and social care services. 
     
    Shared information may include: care plans, previous treatment episodes, health issues (including current medications), treatment summaries, housing status and offending history.
     
    Please state (in the following section) any agencies you do not give us permission to share information with.
     
    The sharing of sensitive personal information is strictly controlled by law. Anyone who receives information from us is also under a legal duty to 1) Only use the information for the purposes you have agreed to, and 2) Keep the information strictly confidential.
     
    We ask for your consent to share some information about you with the National Drug Treatment Monitoring System (NDTMS). This is the database used to collect information on drug and alcohol treatment provision. It is managed nationally by Public Health England, the body responsible for collecting drug and alcohol data and for overseeing drug and alcohol misuse treatment in England. Further information about NDTMS is provided on the next page.
     
    We also ask for your consent to share the information in this document (and the programmes assessments) with the Forward Research Team in order to monitor the effectiveness of Forward’s services and identify ways in which these may be improved. This may also mean sharing your anonymised information with universities. This information will remain confidential and may be used in published reports but will not identify individuals. The Research Team will keep this information recorded securely. You are not obliged to consent to this and if you do not it will not in any way affect the services you receive. 
     
    If you complete a Forward programme we ask your permission to share relevant information with the Forward Recovery & Resettlement Team to offer you continued support and care. They will keep a secure record of this information (including name and address). You can withdraw consent for this at any time.
     
    We also request your consent to share some information with carers / family members to offer them information about support and to involve them in your care, where possible.

  • Sharing Information

  • We are required to provide Blood-borne Virus interventions as part of our services. In order to do this we have a formal agreement in place with the Hepatitis C Trust. We share basic contact details (i.e. name, address and telephone number) with the Hepatitis C Trust (if you have had a positive Hep C screening test) in order that they can contact you to provide these services. For more information, please see the Hepatitis C Trust Privacy Notice http://hepctrust.org.uk/

  • National Drug Treatment Monitoring System (NDTMS)

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  • We are the Office for Health Improvement and Disparities (OHID) in the Department of Health and Social Care. We have a database called the National Drug Treatment Monitoring System (NDTMS), which we use to collect information about drug and alcohol treatment in England.

    We need your consent

    We need your consent to collect information about you and your treatment. You can choose either to share your information with us, or not to share it. Whatever you choose, it will not affect the treatment you receive or how well you are looked after.

    If you consent, your treatment service will share some of the information they collect from you with NDTMS.

    What information we collect about you

    We collect your service’s reference number for you, which allows us to speak to them about your information without us knowing your name. We also collect information to make sure you are only counted once. This includes:

    •       your initials

    •       your date of birth

    •       your sex

    •       the area where you live (the first bit of your postcode)

    We also collect information on things like the treatment you are receiving, and your nationality, ethnicity and disabilities, so we can see if people are being treated fairly. And we ask for information about your family situation so we can understand families’ needs too.

    Why we collect information about you

    We are responsible for improving the lives of people who are affected by drug and alcohol use in England. We collect data about you to help improve your:

    •       treatment and other support

    •       health and wellbeing

    •       education and job prospects

    •       family life

    We use NDTMS data to monitor alcohol and drug treatment across England. It can help us see what’s not working well, so we can do something about it. It helps to make sure that people are getting the best possible care wherever they live.

    Sharing your information

    By sharing your personal data with OHID, any drug and alcohol treatment provider may become aware of any other treatment providers that you are in contact with.

    If your current treatment provider is replaced or taken over by another treatment provider, they will continue to share your information with OHID.

    We may share your information with other government departments, and other organisations working with us to improve the lives of people affected by drug and alcohol use.

    If we do share information, we take as much of the detail out as possible, and only share what we really need for analysis.

    We will not share information about you with the police or the courts.

    Your rights to your information

    You can tell your treatment service if you change your mind about sharing data with us at any time. So, if you consent, you can change your mind about that. Or if you do not consent and later decide you’re OK with us collecting your information, you can do that too.

    You can get more information about your data and rights online in the NDTMS privacy notice by clicking here. If you cannot access the information online, you can ask your keyworker to print it out for you.

    You can also contact us if you have a complaint or if you have any concerns about how we may have used your information. Our contact details are in the privacy notice, or you can ask your keyworker to help you contact us.

    If we have not been able to help you, or you are not happy with how we have handled your information, you can contact the Information Commissioner’s Office (ICO). Details about how to contact the ICO are in the privacy notice.
     
    Consent to share your information with us
     
    Please tick the relevant box and sign the form to complete your consent:
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  • Where We Store Your Information

  • We store your information on our case management system known as Carepathway / Illy. This is a cloud based system provided by ILLY Systems Ltd. Illy stores information in the UK and the EU only. For more information please see www.illycorp.com/privacy.pdf. We may also store your information on our cloud based Microsoft Office 365 system, documents are held on Microsoft SharePoint and the data centres are based in the UK.

  • Complaints

  • We are committed to protecting your personal data but if for some reason you are not happy with any aspect of how we collect and use your data, you have the right to complain to the Information Commissioner’s Office (ICO), the UK supervisory authority for data protection issues (www.ico.org.uk).
     
    We should be grateful if you would contact us first if you do have a complaint so that we can try to resolve it for you.

  • Contact Information

  • If you wish to find out more about how your information is used, please speak to your Forward worker or visit the privacy policy on our website at www.forwardtrust.org.uk.
     
    Please contact us if you have any questions about our privacy policy or the information we hold about you.  By email: dataprotection@forwardtrust.org.uk.
     
    Or write to us at:
     
    The Forward Trust
    Edinburgh House Unit 106
    170 Kennington Lane
    London
    SE11 5DP

  • Consent To Treatment & Information Sharing

  • I have been advised that I can withdraw my consent to information being shared with any of these agencies at any time. I have been told that where I have not agreed to my information being shared with and between these agencies, this will not prevent me getting the support I need, but understand this may delay the process. I am aware of my rights in relation to accessing my data and how to request further information on this process.
  • I give my consent for Forward to share relevant information about me and liaise with other relevant agencies/ professionals on my behalf (please detail exceptions and partial disclosure on the following drop down.
  • I give my consent for Forward to share information about me and my treatment with the Forward Recovery Support Team as relevant.
  • I give my consent for Forward to share information about me and my treatment with Forward’s Research Team (for purposes described on the previous page).
  • I consent to share my data with PHE NDTMS for the purposes set out on the previous page.
  • I give my consent to contact specific carers / family members (on the following page) to offer them information and involve them, where possible, in my care.
  • I give my consent for my medical practice to provide Forward Trust with my medical records to support my treatment programme.
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  • Exceptions and partial disclosure to Information Sharing Agreement.
     
    Please enter the names of individuals/agencies you do not want information shared with:
    • Click to add an individual or agency. 
    • Click to add an individual or agency. 
    • Click to add an individual or agency. 
    • Click to add an individual or agency. 
  • If you have agreed on the previous page for the Forward team to share information with your family, friends, significant others and / or any other support agencies, please use the table below to provide staff with contact details.
     
    This is so that staff can inform these individuals about your progress and offer them support:
    • Click to add a family member, significant other or support agency. 
    • Click to add a family member, significant other or support agency. 
    • Click to add a family member, significant other or support agency. 
    • Click to add a family member, significant other or support agency. 
    • Click to add a family member, significant other or support agency. 

  • Emergency Contact Information 

  • Service User Agreement

  • The Forward Trust supports anyone affected by substance misuse. We promote a friendly, inclusive and supportive environment. In order for us to deliver a safe and effective service to all, we ask that the following is observed:

    • Please give the duty worker your name and reason for visit upon arrival
    • If you require a friend or family member to attend with you, please arrange prior to coming to your appointment as this is a confidential service
    • Please use your mobile with discretion while in the building
    • We operate a service that observes confidentiality so please do not discuss people that are not present
    • Please do not glorify the use of substances in any discussion
    • All service users are expected to show respect and courtesy at all times. There will be zero tolerance to any verbal, discriminatory or physical abuse towards any other service user, volunteer, staff member, or visitor. This includes, but is not limited to, using offensive or inappropriate language and discriminating on the grounds of race, age, religion or belief, disability, gender reassignment, sex, marriage and civil partnerships, pregnancy and maternity, or sexual orientation. Abuse of any nature will result in you being asked to leave the premises. Repeat episodes of abuse may result in you being banned from the service.
    • Please do not attend whilst intoxicated or bring drugs or alcohol on site even if you do not intend on using them
    • Anyone suspected of using or dealing drugs will be asked to leave immediately and the police be contacted
    • Anyone suspected of having or carrying an offensive weapon will be asked to leave indefinitely and police may be called
    • Please be aware of emergency evacuation procedures - these are displayed within the services
    • Dogs and other pets are not permitted in any of our building (exceptions may be agreed following discussion with your key worker)
    • Children are not permitted in the building – if you have childcare responsibilities your worker can arrange to see you at another site
    • Please do not loiter or smoke outside the front of the building
    • Anyone suspected of breaking this agreement, particularly with regards to abuse, violence, drug consumption on premises or aggression to others may be asked to leave and police may be called
    • You will be asked to sign consents to store and share your information. You will be given an information sheet about consent. You are entitled to change this at any time.

    Buvidal ONLY Clients - Your Buvidal will be prescribed and administered by Forward Trust clinicians in the HUB. Where possible, this appointment will be conducted jointly with your recovery worker. If you miss your joint appointment, you will need to book an appointment with your recovery worker before your next injection is due. The expectation for Buvidal is that all clients engage with their recovery worker on a monthly basis. Failure to attend an appointment with your recovery worker may result in us withholding your prescription and reviewing your medication to consider the best treatment options for you.


    Confidentiality – we may have to breach confidentiality under certain circumstances. These include ensuring the safeguarding of adults and children, if it is deemed you are of risk to yourself or others, or in line with our legal obligations if you are wanted on warrant.

    Our aim is to ensure that we provide a safe and secure space for all of our service users, visitors, and staff.

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  • Client Information: Alcohol, Drugs & Driving

  • Alcohol clients: Continued alcohol misuse may lead to your driving licence being revoked.
     
    Drug clients: Being stable on prescribed methadone or buprenorphine will not normally lead to your driving licence being revoked unless you continue to use drugs (including benzos or alcohol) on top of your prescription.
     
    As a driver you have a legal responsibility to inform the DVLA of any condition (including substance misuse) that might affect your ability to drive. Contact the Drivers medical unit, Swansea, SA99 1TU.
     
    You are also required to inform your car insurance company.
     
    If we are aware that you are continuing to drive under the influence of drugs or alcohol, we may be obliged to inform the statutory authorities if you insist on driving.
     
    Please speak to us if you have any queries.
     
    Current Medical Standards of fitness to Drive (DVLA March 2001)
     
    Alcohol:
     
    “Persistent alcohol misuse confirmed by medical enquiry and/or evidence of otherwise unexplained abnormal blood markers. Requires licence revocation or refusal until a minimum six month period of abstinence.”
     
    Other drugs including cannabis, amphetamines, Ecstasy, LSD, Heroin, Cocaine, benzodiazepines etc:
     
    “Persistent use of or dependency on these substances, confirmed by medical enquiry, will lead to licence refusal or revocation for a minimum period of one year free of such use, independent medical assessment and urine screens arranged by DVLA may be required.”
     
    “Applicants complying fully with a specialist supervised oral opiate replacement programme (ie. Methadone or buprenorphine) may be licensed subject to annual medical review.”
     

  • Confirmation Of Information

  • I confirm that I have been given The Forward Trust Service information on alcohol, drugs and driving, specifically regarding my fitness to drive in respect to drug and/or alcohol use.
     
    This information tells me of my legal responsibility to inform DVLA Swansea, and my car insurance company, of any condition such as drug and/or alcohol use, which might affect my ability to drive.
     
    I am also aware that The Forward Trust staff are legally obliged to notify the DVLA and/or the police if I continue to drive against this advice.
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  • Service User Responsibilities For Medication

  • As a user of our service you are responsible for:-
     
    Your prescription
     
    We will endeavour to send your prescription to the chemist of your choice so that it is at the chemist in enough time for the chemist to prepare your dosage.
     
    If you collect your prescription from us and then lose this prescription then it is highly unlikely that another prescription can be written to replace the missing one.
     
    Your medication
     
    When starting a new prescription you will receive the substitute medication on a daily supervised consumption basis. We need to see evidence of your engagement in treatment to change from a daily supervised consumption basis – this could involve providing opiate free urine samples.
     
    Once you have received your medication from your chemist and then the medication is lost or stolen we will be unable to re-issue you with any more medication.
     
    You are responsible for ensuring that your medication is kept in a safe place so that others cannot access it, particularly children.
     
    Late collection of your medication
     
    You will be required to collect your medication either on a daily or a weekly basis. If you are unable to collect your medication then contact The Forward Trust immediately. If you do not pick up your medication for three days then your prescription will be suspended. You will then need to be seen by a Forward Trust worker for a reassessment before your medication is released to you. There are no guarantees it will be re-started on that day or at the same dose.
     
    Informing us if a holiday prescription is required.
     
    A minimum of two weeks in advance is required if you are going away. If two weeks are not given then The Forward Trust may not be able to issue you with a prescription for you to take away.
     
    Three Monthly Medical Reviews
     
    You will be required to attend three monthly prescribing reviews with The Forward Trust specialist doctor. If you do not attend this review then your prescription could be held at the The Forward Trust service for you to attend and collect.
     
    Drug screens
     
    You will be requested to provide a drug screen, usually a urine test at the beginning of your treatment. You will then be required to provide urine screens at various times within your treatment journey with The Forward Trust.
     
    You are asked to sign to confirm you have received and understand the above information. This will be kept on record.
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