Report of the Director of Public Health to the meeting of Corporate Overview and Scrutiny Committee to be held on Wednesday 16th June 2015. A Subject: Scrutiny Review into the treatment and perceptions of Drugs and Alcohol Use 12 months progress report Summary statement: This report provides an update position on progress made against recommendations arising from the Scrutiny Review into the treatment and perceptions of Drugs and Alcohol Use Bradford, May 2014. Dr Anita Parkin Portfolio: Corporate. Community Safety. Report Contact: Liz Barry, Head of Commissioning, Public health Phone: 01274 431565 E-mail: liz.barry@bradford.gov.uk Overview & Scrutiny Area: Corporate. 1
1. SUMMARY 1.1 This report provides an update position on progress made against recommendations arising from the Scrutiny Review into the treatment and perceptions of Drugs and Alcohol Use Bradford, May 2014. 1.2 The report is provided as part of the overall recommendations to give assurance to the Corporate Overview and Scrutiny Committee. 2. BACKGROUND 2.1 At its meeting on Thursday 16 May 2013, the Corporate Overview and Scrutiny Committee considered the Bradford District Partnership report and, as part of the discussions, Members of the Committee raised concerns about the areas of underperformance in the key priority area of Drugs and Alcohol. 2.2 Subsequently the Corporate Overview and Scrutiny Committee decided to undertake a detailed scrutiny review into the underperforming areas, to further explore the effectiveness of measures used by the Council and its partners relating to drugs and alcohol. 2.3 In May 2014, the scrutiny report was considered by the Corporate Overview and Scrutiny Committee and six recommendations were agreed. The original report is attached as background information under item 12. 2.4 An update on progress against each of these recommendations is contained within this report, listed as Appendix 1 under item 11. 2.5 The Scrutiny Process 2.5.1 Members received and gathered a range of information from a number of different sources, including: Bradford Council Officers; West Yorkshire Police; Drugs and Alcohol Recovery Centres. 2.6 Overall Aims 2.6.1 The key lines of enquiry for the scrutiny review: Engagement and retention of all substance misusers into recovery focused treatment (drugs); Successful exits from recovery treatment for alcohol; Perceptions of drug use and drug dealing as a problem in the local area. 2
2.7 Recommendations of the Scrutiny Review Recommendation 1 The Committee recommends that drug treatment providers, the criminal justice sector, Public Health and West Yorkshire Police specifically target disruptive and hard to reach individuals through the treatment and enforcement routes and expect to see an increase in this group being engaged in treatment, by September 2014. Recommendation 2 This Committee recommends that officers in Public Health continue to work with commissioned services to: increase numbers into alcohol treatment in 2014/15 by a further 10%; improve successful completions as a proportion of all in treatment from the established baseline figure of 32.5% by 5%, by March 2015; improve re-presentation rates back into treatment from the established baseline of 12.5% to 10%, by March 2015. Recommendation 3 This Committee recommends the removal of the perception indicator and requests that a more suitable measure of perception be developed by the Bradford Community Safety Partnership Board by July 2014. Recommendation 4 This Committee recommends that officers from Public Health and Local Authority Commissioning explore the viability, of extending contracts for treatment and recovery providers, using the correct guidance and regulations from 12 months to 3 years by September 2014. Recommendation 5 This Committee recommends that the Safer and Stronger Communities Partnerships engage with these communities to build their confidence and skills to represent themselves in different ways, this should also be a measure of performance in all Neighbourhood Area Team Plans. Recommendation 6 Bradford Council s Corporate Overview and Scrutiny Committee to receive a report back in12 months which monitors progress against all the recommendations contained within this Scrutiny Review. 3. OTHER CONSIDERATIONS Whilst progress against the OSC recommendations has mainly been positive, the evidence from examining performance and demographic data indicates that the local substance misuse system still has on-going issues and underperformance. 3
In order to address these issues, the Local Authority, along with local Clinical Commissioning Groups (CCG`s) have begun a full review of the Substance Misuse Recovery System with regards to both Drug & Alcohol use. The review will look at substance misuse as a system rather than specifically on individual components or discrete services. 4. FINANCIAL & RESOURCE APPRAISAL 5. RISK MANAGEMENT AND GOVERNANCE ISSUES 6. LEGAL APPRAISAL 7. OTHER IMPLICATIONS 7.1 EQUALITY & DIVERSITY 7.1 SUSTAINABILITY IMPLICATIONS 7.2 GREENHOUSE GAS EMISSIONS IMPACTS 7.4 COMMUNITY SAFETY IMPLICATIONS Implementation of the Community Safety Plan and performance against the targets set therein has implications for community safety across the District. Targets linked drug and alcohol remain key indicators within the plan. 7.5 HUMAN RIGHTS ACT 7.6 TRADE UNION 4
7.7 WARD IMPLICATIONS 7.1 The implementation of the Community Safety Plan has implications for all Wards in Bradford District. 8. NOT FOR PUBLICATION DOCUMENTS 9. OPTIONS 10. RECOMMENDATIONS 10.1 The Corporate Overview and Scrutiny Committee considers and comments on the Scrutiny Review into the treatment and perceptions of Drugs and Alcohol use, 12 month progress report, as set out in this report. 11. APPENDICES 11.1 Appendix 1 The Treatment and Perceptions of Drugs and Alcohol use across the Bradford District 12 month progress report. 12. BACKGROUND DOCUMENTS 12.1 Report of the Corporate Overview and Scrutiny Committee, Scrutiny Review into the treatment and perceptions of Drugs and Alcohol use 5
Appendix 1 Progress against Recommendations Recommendation 1 The Committee recommends that drug treatment providers, the criminal justice sector, Public Health and West Yorkshire Police specifically target disruptive and hard to reach individuals through the treatment and enforcement routes and expect to see an increase in this group being engaged in treatment, by September 2014. Drug Use A key entry point into the treatment system has been through drug testing and assessment within police custody. There have been significant reductions in the number of tests over the years in an effort to reduce the costs of negative tests. West Yorkshire Police established and adopted new criteria for drug testing in 2012/13 which had a dramatic impact upon the numbers of individuals being assessed and referred into structured treatment. Mandatory drug testing allows for individuals to be intensively managed within the community, however with significant numbers no longer being tested any intervention to these individuals will be on a voluntary basis. Additional interventions were established with the Criminal Justice providers working with the Police to target drug misusing offenders who were dealt with by way of out of court disposals. Numbers of individuals accessing the treatment system through this route are low as any referral is voluntary. However, there has been a significant improvement in criminal justice clients being retained in the treatment system due to providers working more effectively together. This has improved from an average of 51% retention in the period April to September 2014 to 93% in the period October 2014 to March 2015. It is important to note that there are limited enforcement routes available to individuals accessing the treatment system voluntarily. Alcohol Use The numbers of individuals accessing Alcohol treatment has increased by 19% from 866 in 13/14 to 1033 in 14/15. Contributing factors to this increase include the new initiatives put into place following this review. In particular, within City Park a number of treatment and housing related services work alongside neighbourhood services and the Police targeting street drinkers and individuals responsible for anti-social behaviour. Problematic alcohol related offenders are now intensively case managed through the Integrated Offender Management (IOM) process where referrals are received from both prisons and the community. 6
Recommendation 2 This Committee recommends that officers in Public Health continue to work with commissioned services to: increase numbers into alcohol treatment in 2014/15 by a further 10%; improve successful completions as a proportion of all in treatment from the established baseline figure of 32.5% by 5%, by March 2015; improve re-presentation rates back into treatment from the established baseline of 12.5% to 10%, by March 2015. In terms of progress against all three areas highlighted in Recommendation 2, the following improvements can be reported: Total numbers in alcohol treatment have increased from 1281 in 2013/14 to 1531 in 2014/15, which is an increase of 19.5%. Successful completions as a proportion of all in treatment for alcohol services have risen to 37.2% over the same period. This is an increase of 4.7% from the baseline figure of 32.5%, just short of the 5% increase included in Recommendation 2. Re-presentation rates back into treatment have reduced to 8.3% (25 individuals representing out of 300 successful completions) compared to the 2013/14 baseline of 12.5%. This is based on a 6 month period of completions as was the original baseline figure. All three of these areas have shown significant improvement from the point that the recommendation was made. Recommendation 3 This Committee recommends the removal of the perception indicator and requests that a more suitable measure of perception be developed by the Bradford Community Safety Partnership Board by July 2014. The original perception indicator has been removed. Bradford Community Safety Partnership does report on resident s perception of whether anti-social behaviour is getting worse. This will include views on drug and alcohol issues. Performance against this 7
indicator remains static at 16% of those asked reporting that they feel ASB has got worse over the last 12 months. This was the data at quarter 3 2014/15. There are no longer any indicators measuring the perception of drug and / or alcohol issues in the district. Recommendation 4 This Committee recommends that officers from Public Health and Local Authority Commissioning explore the viability of extending contracts for treatment and recovery providers, using the correct guidance and regulations from 12 months to 3 years by September 2014. The Authority position is that new contracts or existing contracts should be reviewed on their own individual circumstances which will determine their length. On contract extension this will be influenced by various factors including but not limited to whether there is an option (and the length of this option) to renew in the existing contract and whether the contract was delivering what it was designed to. Given the cuts in place to Authority funding, uncertainty as to the extent of future cuts, and the end of ring fencing of Public Health s budget after a few years it would not be advisable, commercially, to extend for more than 12 months (and even then only after a detailed review of the particular contract). Commercially a 3 year extension would be inconsistent with this approach. However, new contracts awarded through Public Health have been issued for the recommended 3 year period, unless there have been extenuating circumstances. Recommendation 5 This Committee recommends that the Safer and Stronger Communities Partnerships engage with these communities to build their confidence and skills to represent themselves in different ways, this should also be a measure of performance in all Neighbourhood Area Team Plans. Safer & Stronger Communities Partnerships continue to engage with local Central & Eastern Communities to build strong confident resilient communities. This work is captured in the European Communities Plan and engagement work features in the following Ward Plans: Great Horton Tong 8
Keighley Central Bowling & Barkerend Bradford Moor Little Horton Toller City Recommendation 6 Bradford Council s Corporate Overview and Scrutiny Committee to receive a report back in12 months which monitors progress against all the recommendations contained within this Scrutiny Review. The report has been completed which updates progress on all recommendations. 9