Agenda item

This report presents the update requested by Overview and Scrutiny on 22 August 2023. It contains data that outlines the impact of the new adult substance misuse treatment service. It also details the work taking place to develop a collaborative approach with criminal justice partners, and work to improve the continuity of care between prison and community for people who use substances.

Discussion:

The Head of Public Health Programmes introduced the report which provided an update on the substance misuse treatment service.  He explained that progress was being made with good outcomes and the services had settled well since the contract commenced a year ago. There were risks relating to the uncertainty of future funding but that collaborative partnership working would help to safeguard the service.

Members then raised a number of questions and comments, which included:

·        Alcohol – concern was raised that despite being the substance that causes the most significant harm, there was not enough emphasis on alcohol. Officers confirmed that alcohol was the reason for more deaths in Medway than drugs and reassured the Committee that substance misuse encompassed alcohol too. There was also a specific alcohol pathway, treatment which was continuing to improve.

·        Individual Payments Scheme – the representative from Forward Trust (the service provider) explained that the project, which aimed to achieve sustainable employment for people in substance treatment, was due to commence in July and was already running successfully in other areas.

·        Staffing and vacancy rates – reference was made to the 13 vacancies quoted in the report. Officers undertook to provide exact staffing figures to Members but confirmed that the vacancy rate had reduced.  Recruitment had been a challenge due to a lack of trained substance workers and staff being deterred by fixed term contracts. The vacancy rate was impacting most on service’s outreach work. Following a further query, it was added that an opportunity escalator was in place where individuals that had completed treatment could work as peer support.  There were further traineeship opportunities once someone had abstained from substance misuse for 3 years. The Forward Trust representative undertook to provide the fall-out rate from the scheme.

·        Support for ex-prisoners – in response to a question about how ex-prisoners were supported by the service, officers explained there was a Continuity of Care Toolkit which enabled the service to work as a system, with the prison and probation services, to assess an individual’s pathway and identifying particular areas for that person that required support and solutions.

·        Young people services – officers explained that research was currently being undertaken to explore the reasons behind young people’s use of substances and that the service was looking to develop an all age service for young people, with an age appropriate response to service users.

·        Mental health support – a question was raised about how the service supported its clients to also access mental health services, as being a person who used substances could often be a barrier to accessing mental health services.  In response officers confirmed that there was a Co-occurring Condition Protocol in place. A survey was currently underway with frontline workers to gain their views and knowledge about the protocol and why they might not be using it. This would then lead into the development of pathways and through the mental health transformation, ensuring co-occurring conditions was recognised across the system. The Forward Trust representative added that she had seen improved linkage between mental health and substance misuse support.

·        Foetal Alcohol Syndrome Disorder (FASD) – reference was made to FASD and whether potential FASD was a factor for service users.  Officers explained that women of child-bearing age were advised and supported in relation to FASD risks but undertook to take the suggestion back, as it could be something explored with all service users to further understand a patient’s needs.

·        Interventions through schools – a question was raised about whether as a preventative measure, collaboration took place with schools.  In response officers confirmed that they did collaborate with the education sector, youth service and the youth offending team but always welcomed further opportunities to engage with young people about the risks of substance misuse.

Decision:

The Committee noted the report and requested a briefing note providing more information in relation to vacancy and staffing levels, fall-out figures from the opportunity escalator scheme and the Co-occurring Conditions Protocol survey results.