Thurrock Alcohol Misuse Strategy

Transcription

1 Thurrock Alcohol Misuse Strategy Version Control Date Version no Recipients Updates 2/8/11 V3 Leads Agreed with amendments 28/8/11 V4 stakeholders 31/08/11 V5 updated LM comments 23/9/11 V5.1 01/11/11 V5.2 updated Stakeholder comments 28/11/11 V5.3 Lead stakeholders Childrens 30/11/11 V6.0 Lead stakeholders Final draft for sign off 30/12/11 V6.1 Lucy Magill Updated for sign off Jan V6.2 Childrens board, CSP Exec PFH comments 12/1/12 V6.2 TCSP Executive Signed off 8/3/12 V6.3 TCSP Board Sign off V6.4 Shadow Health and Well- Being Board Agreed with amendments

2 Contents 1 Foreword 3 2. Strategic Overview 4 3. Introduction 5 4. Context: National and Local 6 5. Where are we now and recommendations Priority 1 : Promote Responsible Drinking through effective and clear communication 7. Priority 2: To identify people drinking at hazardous and harmful levels and provide advice and support 8. Priority 3: Reduce link between alcohol and violent crime and anti-social behaviour through proactive actions Priority 4: Protection of children from harm caused by alcohol Priority 5: Build capacity to extend access to appropriate and effective treatment at tier 2 services 11. Priority 6: Improve communication links across local NHS partners (ambulance trust, acute trust) to deliver seamless pathways of healthcare provision Risks Monitoring Resources Equality and Diversity Contact Details Acknowledgements Appendices: Glossary of terms 22 2

3 1. Foreword Councillor Barbara Rice, Chair: Thurrock shadow Health and Well-being Board As Chair of Thurrock s Shadow Health and Well-Being Board I recognise the importance of addressing the harm caused by alcohol misuse in the Borough. The cost to society of alcohol misuse is great and we know that in Thurrock alcohol is the drug of choice. Dealing with the impact of alcohol misuse on individuals and the community and promoting sensible drinking is a priority for us and can only be tackled through a multi-agency and partnership approach. I am extremely pleased therefore in the range of partners involved in the development and delivery of this Strategy. I am confident that this approach will both tackle the harm caused by alcohol misuse and also help to prevent its misuse in the first instance. Superintendant Ivor Harvey, Chair: Thurrock community safety partnership I am delighted to be involved with a partnership wide alcohol strategy which embraces partnership working across health, enforcement teams, and children and young people to look at the complexities surrounding alcohol abuse and to take a proactive approach to tackling this. All too often in policing we see the tragedies caused by alcohol. I am confident that the joined up approach to tackling the 6 priorities outlined within this strategy will deliver a significant reduction in the harm caused in our communities and to individuals through alcohol. 3

4 2. Strategic Overview Thurrock s character and personality has formed and evolved over centuries as agriculture, industry and the river have shaped the landscape, the make-up of its people and the quality of life. The enduring characteristics of those who live or have lived and worked in the borough enterprise, resilience, opportunism, adaptability represent strength of spirit. It is this spirit that will drive a new tone and a fresh relationship between the Council and everyone it does business with and is captured in the Council s vision and priorities: We want Thurrock to be the dynamic heart of the Thames Gateway, a place of ambition, enterprise and opportunity, where communities and businesses flourish 1. Improve the education and skills of local people 2. Encourage and promote job creation and economic prosperity 3. Ensure a safe, clean and green environment 4. Provide and commission high quality and accessible services that meet, wherever possible, individual needs 5. Build pride, respect and responsibility in Thurrock s communities and its residents is the 75 th anniversary of Thurrock as a Borough and marks the start of a new phase of opportunity for the next generation the next generation of young people, older people, families, vulnerable people the next generation of people who have an opportunity to benefit from the future prosperity of the borough. The current regeneration programme will once again change the landscape, with the expansion of retail and Lakeside, the creation of the biggest container port in Europe, the Royal Opera House Production Park and performing arts, to name a few. All of these will bring new jobs and fresh opportunities for the future. How people feel about where they live, how they feel about their public services, how they feel about themselves will be central to creating a collective sense of identity and direction. One in which people aspire for themselves and for their families to do well in their education, are equipped to take on the new and different types of jobs available, have the best possible quality of life and are proud of where they live. Thurrock Council will be changing and adapting to help achieve this, enabling and facilitating change, preparing its residents for the new opportunities, engaging and involving, more in tune and in touch with the needs of local residents, partners, businesses and its employees, aligning expectations and aspirations. The current economic downturn provides an opportunity and a catalyst for operating differently and valuing the perspectives of everyone who has a stake in the future of the Borough. Our ambition, to change people s lives for the better captures the very essence of our vision and priorities and this strategy sets out what local partners will do to address alcohol misuse and contribute to priorities 3 - safer, 4 - accessible services and 5 - building responsibility. 4

5 3. Introduction Increasingly, excessive alcohol consumption can be shown to be closely correlated to a variety of social, health, and psychological disorders including attendance at accident and emergency (A&E) departments, and the relationship with certain types of offending for example violent crime (South East and South West Essex Primary Care Trusts Alcohol Needs Assessment 2010). Alcohol is a complex issue. While it can bring both social and economic benefits, its misuse can also cause social, physical and mental health problems. A coordinated and multi-agency approach is needed to address issues raised, as problems caused by alcohol cross into many spheres of people s lives and can bring them into contact with many different agencies, for example health, police, social services, probation and housing. Thurrock s Alcohol Misuse Strategy has been developed in partnership and aims to both identify and find solutions to the issues created by Alcohol Misuse. It identifies Thurrock s Alcohol Misuse priorities over the next three years within the realms of Prevention, Enforcement, and Treatment and is supported by a multi-agency action plan. Key issues identified within the Alcohol and Substance Misuse chapter of Thurrock s recently refreshed Joint Strategic Needs Assessment and Thurrock s Local Alcohol Profile (North West Public Health Observatory) are: Harmful and Binge drinking rates are higher in Thurrock than the East of England average Hazardous drinking levels are lower in Thurrock than the East of England and National averages The pattern of consumption varies across the Borough Alcohol specific mortality rates are higher in Thurrock than the East of England average for men, but lower than the East of England average for women Alcohol related liver conditions, including mortality from chronic liver disease are higher in Thurrock than the East of England average Alcohol related crime is higher in Thurrock than the East of England average Land traffic accidents are higher in Thurrock than the East of England average The Strategy s priorities are as follows: Prevention 1. Promote responsible drinking through effective and clear communication 2. Early identification of those at risk of alcohol misuse Enforcement 3. Proactive action to reduce alcohol-related violent crime and anti-social behaviour 4. Protection of children from harm caused by alcohol (for the purposes of this strategy, in line with the Licensing Act, Children are those aged under 18 years of age.) Treatment 5. Provide appropriate and effective treatment 6. Deliver seamless pathways of healthcare provision The Strategy is jointly owned by Thurrock s shadow Health and Well-Being Board and Community Safety Partnership and contributes to Thurrock s Community Strategy priorities as follows: Priority 3 - Ensure a safe, clean and green environment Priority 4 Provide and commission high quality and accessible services that meet, wherever possible, individual needs Priority 5 Build pride, respect and responsibility in Thurrock s communities and its residents Unless otherwise identified, this strategy will be delivered within existing budgets and will focus clearly on delivery of the identified priorities. 5

6 4. Context There are a number of reasons, both nationally and locally, why dealing with alcohol misuse is a priority. The key reasons have been divided under national and local headings, although many overlap across the two areas. The reasons below provide the context and drivers for developing a Thurrock Alcohol Misuse Strategy. 4.1 National Context The cost to society of alcohol misuse is great. The following diagram 1 puts in to context the cost to society of excessive alcohol misuse and makes a compelling case for having a strategy. Figure 1 Institute of Alcohol Studies Cost of Alcohol Misuse The above diagram was based on 2004 figures. Recently, the quoted cost of excess alcohol consumption to the NHS was 2.7 billion per year with 1 billion of this being the cost to Accident and Emergency alone. The wider cost to society was estimated to be between 17 billion and 22 billion per annum. Legislative backdrop Legislatively the Council will be responsible for Public Health locally as of April This means improving the health of the population and reducing health inequalities. The Department of Health published its Public Health White Paper to outline the approach to tackling health improvement and health inequalities. This Strategy responds to the principles contained within the White Paper. Economic downturn The global economic situation has resulted in a reduction in funding available to the Public Sector. Public Sector organisations are faced with delivering significant savings. Tackling alcohol misuse and ensuring the services that are offered are targeted and efficient will help contribute to both the national and local economic position. 1 Taken from Institute of Alcohol Studies 6

7 4.2 Local Context Drinkers are categorised as hazardous, harmful and binge drinkers. Where a hazardous drinker will have a pattern of drinking alcohol that increases the risk of harmful consequences for the person, harmful drinking will result in physical, social, or psychological harm resulting from excessive alcohol and a binge drinker is defined as someone who drinks at least twice the maximum recommended units of alcohol per day in one session. The picture in Thurrock compared to regional and national averages is as follows: Figure 2: Estimated rates of Hazardous, Harmful and Binge Drinking of Thurrock residents compared to the England and East of England rates, 2010 Estimated levels of drinking 25 Percentage of population over 16 years of age Hazardous Harmful Binge Thurrock East of England National Category Young People in Thurrock and Alcohol By the year 2002, hazardous drinking was most prevalent in teenagers and young adults. 2 accompanied by a decline in age of regular drinking. This is Nationally: The Institute of Alcohol Studies factsheet on Adolescents and Alcohol 2010 stated that: Most 12 to 17-year olds (84%) have drunk at some point in their lives with one in ten reporting that they drank at least once a week on average; Latest survey data suggests that girls have caught up with, and in some measures, overtaken boys in relation to binge drinking; Ethnic minority teenagers are less likely to drink alcohol one in twenty non-white 12 to 17-year olds are frequent drinkers compared to 1 in 4 white; Under-18 year olds cannot legally buy alcohol themselves, but 63% of those aged and 10% aged who have drunk in the last year say that they usually buy their alcohol themselves; and A higher proportion of offenders aged are frequent drinkers (36%) than nonoffenders (20%). 2 Psychiatric Morbidity among Adults living in Private Households Office for National Statistics Taken from public health observatory 4 as recorded by the probation OASys assessment 7

8 In Thurrock: For the year 2010/11 there were 44 new presentations of young people for cannabis and alcohol and 9 new presentations for alcohol only. Areas with the highest teenage pregnancies and substance misuse in under 18s are correlated to areas of multiple deprivation. Nearly all violent crime committed by young offenders is linked to alcohol misuse 57% of people referred for cannabis and alcohol misuse and 61% for alcohol misuse only were in treatment for 0-3 months. Of the treatment provided (7 of which received multiple treatment) 68% received psychosocial interventions, 40% harm reduction and 58% family work. 29% completed their treatment as either drug free or occasional users. For 2010/11 the number of higher risk drinkers was 3% in Thurrock (3) which is less than national at 8%. Alcohol and Crime For all crime attributable to alcohol and for violent offences 3 Thurrock residents reported higher rates than regional average. For the year 2010/ crimes were recorded as alcohol related. 44% of adult offenders in Thurrock have a current problem with alcohol use this is compared to a national average of 37%. 4 Area breakdown The pattern of alcohol consumption varies across the Borough. Being aware of the variation in consumption of alcohol within the Borough helps to target the right activity and activity tailored to meeting need. The East of England Lifestyle Survey conducted in 2008 provides an understanding of where the greatest levels of hazardous and harmful drinkers are in Thurrock the information is provided at Middle Layer Super Output Area (MSOA). 8

9 Map 1: East of England Lifestyle Survey 2008: Hazardous Drinking Map 2: East of England Lifestyle Survey 2008: Harmful Drinking Although alcohol misuse can occur regardless of wealth, the death, disease and injury caused by alcohol can, on the whole, be linked to economic status. People who are employed are more likely to drink more often than those who are unemployed, and men and women in high income jobs are more likely to have a higher weekly consumption of alcohol. Yet those living in the most deprived areas are two to three times more likely to die of alcohol-related causes, three to five times more likely to die from alcohol specific causes, and two to five times more likely to be admitted to hospital due to alcohol than the most affluent. 5 9

10 The following map illustrates deprivation across Thurrock. Map 3: Indices of Multiple Deprivation 2010 by Lower Super Output Area 4.3 Links to other strategies and plans This Strategy has links to a number of other strategies and plans. Which strategies and plans this Strategy links to and how they link is detailed below. Knowing how they link will help to ensure that the Strategy is delivered, co-dependencies are recognised, and that gaps are closed. Strategy/Plan Thurrock Community Strategy, refreshed 2011 Link The Alcohol Strategy in particular links to priority 4 of the Community Strategy Provide and commission high quality and accessible services that meet, wherever possible, individual needs, and the outcome reduce inequalities in health and well-being. There are strong links to a number of the other priorities reflecting that alcohol misuse is a cross-cutting issue. Thurrock Community Safety Partnership Strategy Thurrock Joint Health and Well- Being Plan (to be developed following JSNA) Drug Strategy, refreshed 2011 Priority 1 to reduce anti-social behaviour, priority 3 to reduce re-offending and priority 4 to reduce serious and violent crime Although still in development, the Health and Well-Being Plan will ensure that the right services are commissioned according to need, and that the determinants of poor health are being addressed. Alcohol misuse is a determinant of poor health and will therefore link to Thurrock s Health and Well-Being Plan. The drug strategy seeks to link and coordinate commissioning of joint drug and alcohol services and maximise service provision 10

11 Thurrock Children and Young People s Plan Essex Policing Plan Violence Against Women and Girls Strategy 2010 national and local Alcohol misuse can affect children and young people in a number of ways from children and young people misusing alcohol, or through the impact of parents and relatives who abuse alcohol. There are therefore links to Thurrock s Children and Young People s Plan. In particular: raising attainment, young people progressing on to higher level qualifications, under-achieving children, building parental and family resilience, and delivering outstanding services for children who have been or may be abused. To support objective 1 to reduce recorded crime and antisocial behaviour Alcohol use is associated with a four fold risk of violence from a partner and is more common when sexual violence is involved. Alcohol misuse can put children and young people at risk of neglect and physical and sexual abuse 5. Where are we now and recommendations An examination of these two areas in addition to looking at any gaps in evidence will help identify what action needs to be taken. 5.1 Where are we now in relation to prevention, enforcement, and treatment? Prevention The following activity around Prevention is currently in place: There is a GP Directed Enhanced Service in place need to review delivery A PSHE subject network has been established across the secondary schools to share best practice, ensure consistency of provision of information to schools regarding alcohol use and misuse and thus enrich the current curriculum provision Work places have access to alcohol awareness information Annual promotion of alcohol awareness week Information on alcohol treatment services is readily available in GP surgeries Alcohol peer mentor scheme was in place for young people Domestic violence is a key issue in families with multiple problems, including alcohol misuse. A key area of work delivered by Family Intervention services has reduced those families suffering the ill effects of domestic violence and substance misuse For those suffering domestic abuse alcohol is often used as a coping mechanism and our provider services have referral processes in place A family support worker is employed to focus on broader family needs of those requiring treatment Enforcement The following Enforcement actions were recorded in 2010/11 Activity No. No. of alcohol underage sale operations 48 No. of proxy sale operations 4 No. of licensing reviews 1 No. of incidents of PCSOs confiscating alcohol (11 months) 443 Treatment The following Treatments are currently in place in Thurrock Alcohol Brief Interventions (BI s), Alcohol Extended Brief Interventions (EBI), Structured Psychosocial Interventions, Alcohol Specific Group Work, Treatment for Alcohol Dependency, Pre Detox Preparation, Home and Residential Detoxification, Residential Rehabilitation, Aftercare and Reintegration Support. 11

12 Current performance for treatment in Thurrock is: Alcohol Treatment Performance Data YTD June 11 Number of Clients in Treatment 78 - Where alcohol is the primary drug Number of Clients in Treatment 26 - Where alcohol is not the primary drug Percentage of New Presentations of Treatment Population 40% Number of clients exiting the treatment system 30 Thurrock percentage of planned exits 60% National percentage of planned exits 58% CORAM run parenting groups in Thurrock aimed at preventing community violence and building healthy family lifestyles. One of their groups run with Oasis and is for parents with drug and or alcohol issues. Alcoholics Anonymous are not available daily and ideally there should be provision within the borough to access daily. They have supported 2 young offenders through referral from YOS. The mental health team provide brief interventions for dual diagnosis of mental illness where alcohol has an effect on mental health 100% of young people who are assessed as have an alcohol misuse issue are automatically referred to the YOS Substance Misuse Worker 5.2 Needs Assessment Alcohol and substance misuse is a chapter of Thurrock s Joint Strategic Needs Assessment (JSNA). This is a document that assesses need and helps to identify key actions that need to be taken. The JSNA has recently been refreshed. This Strategy responds to the findings contained within that document. In addition, NHS South Essex carried out a needs assessment on alcohol in the South Essex area. This was led by the Public Health department and is helpful in identifying action that needs to be taken and issues that need to be responded to. As a result of the needs assessments that have been carried out, the following needs have been identified: Tackling binge drinking rates that are higher than the East of England and National averages; Alcohol-related mortality levels are higher for men than women, so a different approach is required to address this issue; Difference in harmful, hazardous, and binge drinking depending upon super-output area (as demonstrated in maps figures 3 and 4) and therefore there is a need to approach different geographical areas with different solutions; Looking at action that tackles alcohol-related liver disease and mortality which in Thurrock is higher than the East of England average; Targeting deaths or injuries caused by land transport where alcohol was a contributory factor with alcohol contributing to 11% of killed and seriously injured in What does this mean? Although the use of averages show that Thurrock in a number of areas is not significantly worse than England or the region, spatial distribution will allow the strategy to target and focus on those areas where residents are at highest risk, or where the prevalence of hazardous or harmful drinking is greatest. 12

13 5.3 Gaps in evidence (data), and service provision What gaps do we still need to fill? Some data is only available at South west Essex level, it needs to be at local Thurrock level Admissions data to accident and emergency due to alcohol is currently not provided by Basildon and Thurrock University Hospital (BTUH) Evidence regarding school absences where alcohol is a factor Evidence from fire service where alcohol is a contributing factor Analytical data regarding arrests where alcohol is a contributing factor There is a gap in ability for all agencies to identify vulnerable persons PSHE (personal, social and health education): access to information through education and peer mentors Lack of information for those vulnerable young people not accessing school (hard to reach) Support for children whose parents abuse alcohol Provision of a wet house (safe place for people to congregate and drink) may reduce social impact on community Lack of community alcohol outreach worker, and funding for the arrest referral worker is not sustainable (currently grant funded) Referral pathways are not clear There is a lack of correlation between community issues caused by alcohol and local businesses OASIS currently has a 2 month waiting list for alcohol treatment Substance misusing clients of other agencies are not always engaged with alcohol services 5.4 Recommendations The JSNA and alcohol workshop held with input from all partners highlighted the following areas for priority for this strategy: Hospital data needs to be improved particularly around accident and emergency to provide more detailed analysis on alcohol abuse to develop appropriate responses. To improve links with education around data of alcohol related absences Improve access to information through education and youth peer mentors Need to increase availability as resource allows of screening and brief interventions Review data set to ensure all at a local level and action plan accordingly Proactive engagement with local businesses to tackle problems in their community Need to increase availability as resource allows of extended interventions at tier 2 level Improve clarity of referral pathways for substance misusing clients Social marketing campaign required to address drink driving Analysis of harmful and hazardous drinkers indicates that campaigns need to be aimed at identified risk areas (ward and super output area) These areas in addition to the needs assessment and gaps assessment will identify what action needs to be taken. Priorities All priorities will embrace the principle of taking a multi -agency approach to safeguarding young people and vulnerable adults Prevention 1. Promote responsible drinking through effective and clear communication 2. Early identification of those at risk of alcohol misuse Enforcement 3. Proactive action to reduce alcohol-related violent crime and anti-social behaviour 4. Protection of children from harm caused by alcohol Treatment 5. Provide appropriate and effective treatment 6. Deliver seamless pathways of healthcare provision 13

14 PREVENTION: 6.0 Priority 1 : Promote Responsible Drinking through effective and clear communication Findings: There are adverse health impacts for both genders; the related conditions are different by gender yet a greater proportion of men than women will die from alcohol-related causes. For Thurrock land traffic accidents are high and a drink driving campaign is required. Hazardous and harmful drinking have been mapped by area and campaigns need to be targeted accordingly Objectives: 1.1 Reduce levels of ill-health (physical and mental) related to alcohol abuse 1.2 Reduce impact of alcohol abuse on society 1.3 Promote positive message: enjoying alcohol responsibly Implementation: Develop and deliver multi agency communication strategy to promote responsible drinking Promotion of message that alcohol damages your health (campaign similar to smoking), health risks to be promoted by gender specific campaigns Develop closer links with primary, secondary and tertiary education and provide advice including recovery and rehabilitation Promote responsible drinking through rethink your drink scratch card campaign for GPs / surgeries Target top 20% super output areas highlighted for high levels of hazardous and harmful drinkers Review young people peer mentor scheme and continue to deliver if appropriate Involvement of parents and guardians in understanding responsible drinking in their children Promote alcohol misuse treatment services within those agencies supporting families with multiple problems including domestic abuse Promote messages within specific organisations such as TRUST, EGM, religious establishments and those services working with families and women in particular (SERICC and Women s Aid) Continue to grow referral processes between alcohol provider services and domestic abuse services Communication campaigns to include messages to licensed premises Develop social marketing campaign to reduce drink driving Performance measures: hospital admissions for alcohol related crime alcohol specific hospital admissions >18 alcohol attributable hospital admissions >18 mortality and injury from land transport accidents binge drinking (synthetic estimate) Alcohol specific mortality rates Alcohol attributable mortality rates 14

15 7.0 Priority 2: To identity people drinking at hazardous and harmful levels and provide advice and support Findings: Thurrock has a higher than average level of harmful drinking rates, alcohol specific mortality rates and alcohol related liver conditions. The equality impact assessment (EIA) highlights that those with mental health problems, members of the Lesbian Gay Bisexual and Transgender community and families with multiple problems are at greater risk of being impacted by alcohol Objectives: 2.1 Reduction in hazardous drinking 2.2 Early identification of those at risk of alcohol misuse Implementation: Provide training across agencies to identify those vulnerable to becoming hazardous drinkers and problems arising from substance misusing parents Develop multi agency approach to screening for those at risk of abuse Expand current opportunities for substance misusing parents to access treatments including breadth of treatments available Train agencies to screen and deliver alcohol brief interventions Increase provision of screening and alcohol brief interventions outside of traditional health settings, including those supporting families, BME groups and LGBT residents Develop case management for high impact users Take a joined up approach consider alcohol focus group to share information and ideas Review data set at a local level and use to inform action planning Develop robust referral pathways from multi-agencies, encompassing schools and colleges Develop and increase data recording of alcohol-related submissions Research and identify data recording issues for alcohol-related submissions at hospital(s), and work in partnership with staff to improve data recording, data quality and the referral process Train and develop Accident and Emergency and ambulance staff for appropriate detection and referral of alcohol submissions Performance measures: No of agencies and/or individuals trained to provide screening % of individuals waiting 3 weeks or less to receive initial intervention Alcohol specific mortality rates Alcohol attributable mortality rates Hazardous and harmful drinking levels particularly in areas of greatest concentration 15

16 ENFORCEMENT: 8.0 Priority 3: Proactive action to reduce alcohol related violent crime and anti-social behaviour Findings: Alcohol related crime is higher in Thurrock than regional average Violent crime includes dangerous driving, our land traffic accidents are higher than regional average Objectives: 3.1 Reduction in levels of alcohol related violent crime 3.2 Reduction in levels of alcohol related anti-social behaviour 3.3 Proactively work with licensed premises (on and off sales) Implementation: Establish data sharing with accident and emergency Analytical data regarding arrests where alcohol is a factor to be collated and proactive actions to address developed Gather and map evidence of street drinking through needs assessment and implement recommendations To deliver community action against alcohol, including tackling under age sales & proxy sales Working with retailers and pubs to proactively enforce licensing regulations Continue to roll out and support pub watch Identify fires where alcohol is a contributing factor Look at possibility of developing a Thurrock Alcohol Action group Work with perpetrators at point of arrest though alcohol arrest referral worker Link to relevant business in promoting best practice in ensuring the safety of staff, women in particular, with regard to violence against women and sale of alcohol. Link into British Transport Police and network rail to tackle alcohol related public order on trains Integrated offender management approach to include alcohol interventions, in particular where aware of a prevalence of domestic violence Look at engagement as an alternative to enforcement and encourage courts to dispose of offences by referral to appropriate treatment or behavioural programmes Ensure that licences have conditions sufficient to reduce intoxication and take proactive approach to enforce Put injunctions in place to prevent offenders entering certain areas when intoxicated Performance measures: Alcohol attributable recorded crime Alcohol attributable recorded violent crime Alcohol attributable recorded sexual offences No. of proactive actions taken by Public Protection to deter the irresponsible use of alcohol (Under age sales including proxy, licensing reviews etc.) Alcohol related road traffic accidents (killed and seriously injured) Alcohol related accident and emergency admissions % of offenders under supervision who are alcohol dependant 16

17 9. Priority 4: Protection of children from harm caused by alcohol Findings: Nearly a third of young people in Thurrock have misused alcohol. Young people who abuse alcohol are more likely to be at risk of displaying other aspects of risky behaviour. Objective: 4.1 Reduce the opportunity for children and young people under 18 to access alcohol Implementation: Ensure consistency of provision of information to schools regarding alcohol use and misuse via the PSHE subject network Develop closer links with primary schools and colleges Look at how we address the needs of young people not accessing mainstream services i.e. hard to reach group Gather and map evidence of underage street drinking through needs assessment utilising PCSO s and youth workers Work with substance misusing parents and provide support for their children Family Intervention Project (FIP) to continue to provide support to families with multiple problems, including alcohol abuse Test challenge 25 scheme by using volunteers aged between 18 and 25 Stay safe operations to identify children at risk of alcohol abuse and take appropriate actions to safeguard them Link prevention campaigns to associated risky behaviours in children and refer those at risk appropriately Appropriate enforcement action and publicity with regards to under age sales Where appropriate, alcohol being consumed on streets to be confiscated Continue to run Strengthening families, strengthening communities programme between Coram and Oasis aimed at parents with drug and alcohol issues. Mapping and trending of teenage pregnancies and substance misuse data in partnership with agencies and stakeholders to provide detailed assessment and inform planning Performance measures: No. of proactive actions taken by Public Protection to deter under age sales Alcohol related crime (under 18) Alcohol specific hospital admissions (under 18) Alcohol attributable hospital admissions (under 18) No. of substance misusing parents supported No. of FIP families with alcohol related issues. No. of under 18 conceptions in Thurrock 17

18 TREATMENT: 10. Priority 5: Provide appropriate and effective treatment at tier 2 services Findings: Needs analysis identified that the greatest gap in service provision is around tier 2 treatment services. Objective: 5.1 Build capacity to extend quick access to tier 2 services 5.2 Commission flexible services 5.3 Provide range of effective extended interventions Implementation: Extend range of treatment services in line with BRIC (Building Recovery in Communities) Raise awareness of treatment services that can be provided Increase capacity of services in line with demand Promote alcohol misuse treatment services within those agencies supporting families with multiple problems including domestic abuse Look at options for provision of a WET house linked to motivational work Look at options and resource requirements to provide community alcohol outreach worker Increase opportunity for psychological therapies Develop response to anxiety induced drinking / sub dual diagnosis Look at the role of an alcohol champion to drive the agenda Seek private sector funding to support treatment services Foster and develop relations between agencies to implement dual diagnosis referral routes and agreed performance framework to monitor Seek to reinvigorate alcoholics anonymous to provide a regular service Performance Measures Numbers of clients receiving treatment for Alcohol as the primary substance. Numbers of clients receiving treatment for Alcohol as the secondary substance. Numbers of new presentations to treatment for Alcohol. Number of clients Exiting Treatment for Alcohol. Percentage leaving treatment with a planned Exit. Dual diagnosis framework to develop 18

19 11. Priority 6: Deliver seamless pathways of healthcare provision Findings: Referral pathways are not clear and there is a gap in seamless support between agencies, particularly for those being discharged from hospital Objective: 6.1 Improve communication links across local NHS partners (Ambulance Trust, Acute Trust) Implementation: Develop and communicate effective integrated care pathways between agencies Seek to commission a single provider to deliver whole treatment pathway Seek to appoint a care / service coordinator Introduce hospital alcohol liason worker linking across services, not just A & E Raise awareness within paramedics Introduce a screening tool in hospitals Look at discharge planning within hospitals Identify and facilitate engagement of high end users Increase links to mental health services and promote alcohol awareness Increase links to women s services (i.e. SERICC and Women s Aid) and promote alcohol awareness Performance measures: Evidence of posts being filled Evidence of material being disseminated to relevant agencies Production and implementation of a screening tool Numbers of high end users identified and referred into treatment Number of awareness seminars delivered to relevant agencies 19

20 12. Risks Political Government: - Changes to funding structures and a reduction in funding - Changes to public health with the introduction of the PH white paper - Changes to Licensing Act within Police Reform and Social Responsibility Act Local Government: - Annual elections risk of change in local strategic direction and resources - Pressure on public sector finances and cuts to budgets Environmental - Olympics: drain on Police resources - Significant increase in activities and people who will be using alcohol in public areas around the time of the Olympics coupled with potentially hot weather (dehydration) Social - Austerity measures may lead to significant job losses across the public and private sectors in increased demand on services and considerable pressure on individuals and families. - Changing demographics of the Borough in terms of growth and ethnic mix of population. Changes to housing benefits may see migration from London of more deprived communities seeking affordable housing. - Potentially high number of Young people not in education, training or employment Technological - Lack of data sharing of Accident & Emergency data and ambulance data across agencies - Lack of analytical support across agencies to provide ongoing analysis Economic - Financial pressure placed on all public services and voluntary sector as a result of austerity measures may impact on resources to implement the strategy Legislative - Statutory changes to health and well Being with accountability for public health - Police Reform and Social Responsibility Act - Implementation of Equalities Act Changes in the Licensing Act to give Police and communities greater scope to object Organisation - Restructuring within organisations impacting on capacity to support the Partnership agenda. In particular voluntary and community organisations. 13. Monitoring Monitoring of the implementation and performance will be jointly owned by the Thurrock Community Safety Executive group and shadow Health and Well-Being board with annual reports to the Children s stay-safe sub group. Officers that will ensure this will be: Director of Public Health and Head of Public Protection The Prevention action plan will be owned by NHS South West Essex PCT Director of Public Health and implementation will be overseen by the Head of Health Improvement The Enforcement action plan will be jointly owned by Public Protection Lucy Magill, Head of Public Protection, and Essex Police Richard Baxter, Divisional Commander Thurrock with input required from children s, education and family James Waud, Youth Offending Service Manager. The Treatment action plan will be owned by Jim Nicolson, Drug and Alcohol action team. Deleted: s 20

21 14. Resources 14.1 Funding: This Strategy is required to be delivered within existing budgets. Budgets at the moment are unclear with regards to public health moving to Local Authority and reductions to the community safety partnership grant (which includes drug and alcohol budgets) This Strategy provides an opportunity to make better use of shared resources to deliver key priorities across all agencies. There is a need to ensure that agencies are aware of the long-term reduced costs to agencies if substance misuse is addressed Human resources: Workforce development to provide training for all agencies on screening and brief interventions 15. Equality and Diversity The Equalities Act 2010 extended public services discrimination and the need for policies and strategies to be extended to all equalities groups, including sexual orientation. This strategy has been subject to an equality impact assessment 6 and the key findings from this assessment are highlighted within the findings by priority and seek to be addressed within the implementation plans. The actions identified within this assessment are all within the implementation actions in this strategy. As the action plan develops it will also be assessed and we will review the EIA action plan annually. 16. Contact Details To find out more about the implementation of this strategy contact the community safety partnership via: safer@thurrock.gov.uk Visit us at: Phone us on: Community safety partners Thurrock Council: NHS South West Essex: Essex Police: Acknowledgements With acknowledgement and thanks to all who attended our workshop and in particular to Paul Adams, Thurrock Council Licensing Officer: Thurrock Council Gail Clayton, Drugs and Alcohol Action Team: Thurrock Council Gavin Dennett, Environmental Health & Trading Standards Manager: Thurrock Council Paul Hooks, Inspector: Essex Police Kevin Malone, Children s Services: Thurrock Council Debbie Maynard, Head of Health Improvement: NHS South West Essex Niall McDougall, Public Health Manager: NHS South West Essex Jim Nicolson, Community Protection Manager: Thurrock Council Ian Wake, Consultant in Public Health: NHS South West Essex James Waud, Youth Offending Services Manager: Thurrock Council 21

22 18. Appendices: Alcohol dependency Anti-social behaviour Binge drinking BME BRIC BTUH DPPO EIA EGM FIP Harmful Drinking Hazardous drinking IOM JSNA LGBT OASIS OASys PH PSHE Tier 1 Tier 2 Tier 3 Tier 4 TRUST I. Glossary of terms A cluster of behavioural, cognitive and physiological factors that typically include a strong desire to drink alcohol and difficulties in controlling its use. Anything which causes undue harassment, alarm or distress A heavy drinking session in which someone drinks at least twice the maximum recommended units of alcohol per day in one session Black, Minority, Ethnic Building Recovery in Communities recovery and rehabilitation approach led by the National Treatment Agency (NTA) for people dependant on drugs and alcohol Basildon and Thurrock University Hospitals Foundation Trust Designated Public Place Order Equality Impact Assessment Essex Gay Men Family Intervention Project Physical, social, or psychological harm resulting from excessive alcohol use. This may include manifestations of health problems from alcoholrelated injuries resulting from binge drinking to more chronic conditions following on from long periods of alcohol consumption A pattern of drinking alcohol that increases the risk of harmful consequences for the person Integrated Offender management (linked to prolific offenders) Joint Strategic Needs Assessment Lesbian Gay Bisexual Transgender Open Access Substance Information Service Offender Assessment System completed by probation for all offenders Public health Physical, social and health education Model of service provision Model of service provision Model of service provision Model of service provision Thurrock Racial Unity Support Task group 22