How To Find Out How Much Money Is Spent On Alcohol In Disford

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1 Information Request Please find Devon County Council s response below in bold text I am concerned that Exeter, according to the NHS / DoH Health Profiles for 2011, the worst rates for "Increasing & Higher Risk Drinking" in the country. (see Health profiles 2011: alcohol use New estimates were published on June 28, 2011 which appear to show a large increase in the number of people drinking to hazardous and harmful levels in Devon as a whole. The data, produced by the Public Health Observatories, suggests that between 2005 and 2008 rates of hazardous and harmful drinking have risen from 22 per cent of the adult population to 34 per cent, with similarly large increases in the eight local authority districts within Devon. We would like to offer some context to this so that you are able to better understand the issues underlying the report s findings. Hazardous drinking is defined as when a person drinks over the recommended weekly limit (21 units for men and 14 units for women), whereas harmful drinking is defined as when a person drinks over the recommended weekly amount and has experienced health problems directly related to their alcohol use. In Devon there has been no significant rise in mortality, hospital admissions or deprivation factors linked with higher consumption of alcohol and almost certainly areas that you would expect to see an associated increase. The report findings are an estimate based on the findings of a General Lifestyle Survey (GLF) carried out in The levels of drinking in the survey were broken down by age, sex, ethnicity, deprivation, area and other factors and local rates then estimated according to the distribution of these groups in local populations. This is a survey of approximately 9,000 people in the England and given this it is likely to be derived from a small sample size and when broken into district council areas, this could mean between 10 and 30 people per district council area were surveyed. The report does not take local drinking patterns or alcohol sales into account.

2 Given this, the small sample size, and the estimation methods used, there are wide confidence intervals which mean that accurate conclusion about differences between areas cannot be drawn. For Devon as a whole, the report shows that the rates of the adult population drinking to hazardous or harmful levels lie somewhere between 15 and 64 per cent of the adult population. This is why there is a yellow dot on the graph indicating that it is within the national range. Indeed supporting national data shows that no area of the country is significantly different from any other. Here in Devon we are making a significant impact in tackling alcohol misuse. The response to alcohol misuse is substantially the responsibility of the NHS and recently NHS Devon made an additional 1 million investment in services for people who need help as a result of their drinking. As a result, the number of treatment places for people with alcohol problems has increased fourfold over the last three years. Waiting times have reduced from up to a year in 2009, to an average of just three weeks in NHS Devon s action has already seen admissions to hospitals due to alcohol consumption stabilise with an annual increase of three per cent in compared to 10 per cent nationally. Alcohol-related admission rates in Devon also remain consistently below national and regional averages. The data on increasing and higher risk drinking highlights in particular drinking patterns amongst more affluent drinkers, whose lifestyles may routinely involve drinking at higher levels than are recommended. Whilst we question that validity of Devon s place in the rankings, we do accept that there is more work that could be done to raise awareness of safer drinking levels amongst this population. The refresh of the Devon Partnership Alcohol Strategy, currently taking place will highlight this issue. 1. Please can you tell me how much is currently spent on Alcohol Services in Devon, how they are measured to be performing and when they will next be tendered? Alcohol Services in Devon are funded from a pooled budget with contributions of: 1,300,000 from NHS Devon, 170,000 from Devon County Council (substantially through the Safer Devon Partnership and other commissioning budgets), and 10,000 from Probation. The total budget is 1,493,095.

3 Additionally, DCC spent 96,134 on Alcohol rehabilitation last year through its commissioned mental health services. These were spot contracts to respond to individual need and separate from the alcohol pooled treatment budget described above. Details are not provided here but it is also worth noting that many more people who have alcohol problems are supported through services and programmes that are not specifically designated as alcohol services. This might include mainstream mental health services, supported housing services and a range of interventions to support people who are/or are at risk of homelessness. These are not specifically monitored in terms of drug and alcohol services so is impossible to quantify. Alcohol services continue to perform very well across Devon. Performance measures include, - Numbers of people referred into treatment and entering treatment the treatment system receives over 2500 referrals a year of these 1248 people will go on to receive a structured alcohol intervention, a further 1000 people received extended brief interventions - Waiting times - 75% of referrals are seen within 3 week. Most of these within 2 weeks. The longest wait for treatment was 7 weeks - Number of people successfully leaving treatment - 76% of structured interventions result in a planned closure. That is, the client having completed their treatment plan against their assessed treatment needs. Commissioners hold quarterly performance meetings with providers to monitor and discuss performance issues. Additionally, Commissioners convene monthly meetings with alcohol service managers to ensure that blockages and problems in the system are quickly indentified and resolved and that the system works towards achieving optimum efficiency and effectiveness for clients. It has not yet been agreed if and when alcohol services for Devon will be put to tender. I gather that the drugs services in Devon were tendered through a "restricted tender". 2. Why was this decision taken, and services not tendered openly? The decision to run a restricted tender was the result of consultation with a range of stakeholders including, service users, the National Treatment Agency and

4 Drug And Alcohol Action Team partners (including Devon County Council, Police, Probation and NHS Devon). The decision was based on a careful consideration of the benefits and risks of redesigning drug services with current providers or going to open tender. Providers were performing well against the National Treatment Agencies Key Performance Indicators and Commissioners were confident that changes to the treatment system to further improve performance and service user outcomes could be most effectively achieved with current providers. Whilst the contract is let by the NHS the process was conducted in line with the Devon County Council s commissioning and tendering rules. 3. Why are drugs services and alcohol services tendered separately? Drug and alcohol services have not been tendered separately. In the event of a tender of drug and alcohol services, consideration would be given to the tendering for a substance misuse service or separate drug and alcohol services 4. How much did the authority spend on drugs services under this contract last year, and how does that compare with the full year before the tender? (i.e. is the new service costing us more, or less?) The majority of funding for drug treatment is provided by the Pooled Treatment Budget, administered by the National Treatment Agency. Devon County Council does not contribute any funding to the contract for Devon Drug Services, but does contribute 79,000 to funding residential rehabilitation. This is separate to the contract for drug treatment services. As with Alcohol services, many people will also access other support services that are not designated as drug treatment services. 5. How is the new service performing and how is it measured? How does this year's performance compare with the performance before the re-tender? (i.e. is the new service better?) The service is measured by the National Treatment Agencies performance measures including Number of problem drug users in effective treatment, waiting times and successful competition. Devon is 5% above its baseline in terms of treating problem drug users, defined as primary heroin and crack users, in effective treatment and 1 % below its baseline for all drug users. This indicates that the treatment system has been geared towards working with opiate and crack users but less responsive to the needs of other drug users, such as those with cannabis, cocaine or amphetamine problems.

5 97% of people are seen within the target of 3 weeks. This puts Devon in the best performing quartile nationally, 7.4% of problem drug users and 38% of all other drug users exit the treatment system successfully in a rolling 12 month period. This puts Devon in the 3 rd performance quartile. Work is ongoing with providers to improve performance and support increasing numbers of clients towards sustained recovery. Provision has now stabilised and good progress is being made towards developing services which are more recovery orientated. The treatment system is seeing increasing numbers of people with drug problems other than opiate and crack use. 6. Which elected member takes responsibility for issues of alcohol and drugs in our county? Cllr Andrea Davis 7. Which senior managers are responsible? The Devon Drug and Alcohol Action Team is responsible for managing the drug and alcohol treatment system. The DAAT is located within the Public Health Directorate of NHS Devon. The Joint Executive Director of Public Health, Dr Virginia Pearson, chairs the Devon DAAT Board and is employed by both Devon County Council and the National Health Service. The Board of the DAAT is multiagency and includes a senior officer of the Council as well as a range of other partners If you wish to speak with someone regarding the above request, please contact the Freedom of Information team on or xxxxxxxxx@xxxxx.xxx.xx