ITEM 7 Alcohol & Drugs
North Lanarkshire Council · 27 March 2024
Back to Health and Social Care Integration Joint Board — 27 March 2024 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 REPORT Item No: 7 SUBJECT: Alcohol & Drugs TO: Integration Joint Board Committee Lead Officer for Report: Morag Dendy Head of Planning, Performance and Quality Assurance Author(s) of Report John Holleran – Strategic Lead, North Lanarkshire ADP DATE: 27 March 2023 1. PURPOSE OF REPORT This report sets out the progress of the Alcohol and Drug Partnership for 2023. This report reflects a sample of the ongoing work being undertaken across North Lanarkshire to reduce harms from substances and improve access to support. This report also sets out the range and scope of investments through the ADP to target support across our communities in 2023/24. This paper is coming to the IJB for: For approval ☐ For endorsement ☐ To note ☒ 2. ROUTE TO THE BOARD This paper has been: Prepared By: ☒ Reviewed By: ☐ Endorsed By: ☐
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2 3. RECOMMENDATIONS (1) Note the content of the report. (2) Acknowledge the progress made towards delivering the ADP strategic objectives and National Drug Mission priorities. (3) Recognise the broad range of supports in place and the programme of work being delivered to reduce harms and prevent deaths from alcohol and other drugs (4) Note the key developments in targeting resources in line with budgets for each priority area. (5) The MAT Standards is not covered in this report as a separate paper has been drafted and submitted for consideration. 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 North Lanarkshire Alcohol and Drug Partnership (NLADP) is a multi-agency strategic partnership focused on understanding and mitigating the impact of problematic alcohol and drug use in the local area. 5.2 The purpose of the ADP is to co-ordinate and lead a collective response to tackle harms and improve the lives of people who used alcohol and drugs and those around them. 5.3 The ADP is made up of key agencies and stakeholders with an interest in tackling harms and improving lives. This includes the wider community and those who have lived experience (including families). 5.4 Much of our work involves bringing people together to plan and improve services whilst setting out what needs to be put in place to support change and keep people safe and well. Yes ☐ No ☒ N/A ☐
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3 5.5 We do this by reviewing, monitoring and evaluating the impact of investments targeted towards reducing substance-related harm and improving health and wellbeing. 5.6 NLADP Structure All sub-groups above meet quarterly and report to the ADP Partnership Board. Each sub-group held a planning session in the first quarter of 2024 to map out areas of focus and further development for the next 12 months. 5.7 ADP Priorities o Priority area 1 - Fewer people develop problem alcohol & drug use. o Priority area 2 - People access and benefit from effective, integrated person- centred support to achieve their recovery. o Priority area 3 - Children and families affected by alcohol and drug use will be safe, healthy, included and supported. o Priority area 4 - Vulnerable people are diverted from the justice system wherever possible, and those in the system are fully supported. o Priority area 5 – Less harm is caused by alcohol North Lanarkshire. 5.8 NLADP support team continues to be active within the following networks and forums. Child protection committee Family Support development group Adult protection committee Harm Reduction - Naloxone/BBV/WAND VAW partnership Operational Group Residential Rehab Oversight Group Community Justice Partnership Buvidal Steering Group Reducing Alcohol Harms Groups Improving Child Services Group MAT Standards oversight group Drug Death Prevention Groups MAT Experiential/ MAT Numerical Trauma Informed Network Youth Diversionary Activities Group Experiential Data Collection Group ADP Board Prevention & Early Intervention Treatment Care & Recovery Whole Family Approach Public Health Approach to justice Reducing Alcohol Harms Finance Group
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4 5.9 All thirty of Scotland ADPs are responsible for delivering on the National Mission Priorities. The aim of the National Mission is to improve and save the lives of people who use drugs and their loved ones. It will do this by: providing fast and appropriate access to treatment and support through all services improving frontline drugs services (including the third sector) ensuring services are in place and working together to react immediately for people who need support and maintain that support for as long as is needed. increasing capacity in and use of residential rehabilitation implementing a more joined-up approach across policy and practice to address underlying issues. 5.10 Commissioning and perfomance reviews - A programme of extensive and competititve commissiong activities took place via NLADP in 2023, with 5 key services tendered to support the delivery of the National Mission Priorities, including: Early intervention, prevention and education – awarded to Landed Individual Placement Support – awarded to SAMH Adult and Whole Family Support service – awarded to Phoenix Futures Recovery Community Development – awarded to Recovery Scotland Crisis, overdose repsonse and assertive outreach service – awarded to Turning Point Scotland 5.11 Performance monitoring reviews have been carried out in the first quarter of 2024 with all 17 additional services or programmes commissioned via NLAPD. 5.12 All commisioned initiatives are required to report to the ADP on a quarterly basis to evidence impact, highlight challenges, risks and mitigation measures, whilst offering assurances the right supports are in place and operating effectively. 5.13 North Lanarkshire ADP Board made the decision to commit to 3 year funding for all new and continuing services from 2023 onwards. This recognised feedback from stakeholders citing challenges faced with previous year on year funding arrangements that impacted on staff recruitmetnand retention, longer- term planning and service stability. 5.14 This approach will allow services to focus on the quality of support being offered to those who need it most with stronger links being build between services. 5.15 A number of test of change projects have been funded/initiated via NLADP Including; Arrest referral pathways via Police custody centres, Contextual safeguarding for children and young people,
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5 Alcohol and Drug Solutions Courts, and; Extended Youth Work Provision and Diversionary Activities via Community Learning and Development (CL&D). 5.16 Drug Death Prevention - Work to refine drug death prevention efforts in 2023 included a full review of the Drugs Death Drevention Group (DDPG) operational workstreams with a full membership update and draft work plan now in place. The DDPG strategic group will now be Chaired by the Director of Public Health. 5.17 A Pan Lanarkshire post was created for a Drugs Death Information Officer to support the functions and processes of the DDPG. 5.18 A DDPG development session was held in February 2024. This was facilitated by Scottish Drugs Forum, who developed the national drug death prevention guidelines. The content from this session will form the basis of a 5 year drug death prevention plan for the DDPG. 5.19 A Naloxone delivery plan is now in place to target training and widen Naloxone distribution throughout 2024. 5.20 The Lanarkshire Drug Trends Monitoring Group (LDTMG) was reinstated in March 2023, having not met since early 2020 due to the pressures of the COVID-19 pandemic. The group provides an opportunity to strengthen linkages and relationships between services through the sharing of relevant intelligence from different parts of the system. 5.21 Reducing Alcohol Harms - The Reducing Alcohol Harms group has been meeting for the last 18 months and is a multi-agency group with broad representation from the ADP partners. This group is Chaired by Public Health colleagues on behalf of North and South ADPs with broad representation from ADP partners and support staff. This group reports to the ADP Partnership Board. 5.22 Work has been undertaken by NHS Lanarkshire Health Improvement in 2021 to scope national strategies and plans in order to identify key priority themes and actions. From this work four subgroups were initially established to align with the key themes of Rights, Respect and Recovery and to mirror the ADP sub-group structures. 5.23 There is a detailed work-plan linked to the RAHG that cuts across whole population measures and targeted local interventions from Licensing, Alcohol Brief Interventions, Health Needs Assessment, education and training and work to target higher risk groups. 5.24 NLADP, as part of the Reducing Alcohol Harms group conducted a survey to understand the impact of alcohol consumption on individuals and communities in 2023. This information will inform future actions that will be taken forward
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6 with communities and partner agencies in 2024 to tackle any issues relating to alcohol use. In total, 1367 people in Lanarkshire took the survey with over 100 people involved in follow up focus groups from June to September 2023. There is a development session being held on 26th March to share feedback from the consultation and to facilitate discussions that will shape key actions for 2024 for the ADP, Public Health and Heath Improvement. There is broad representation from services, community members and those with lived and living experience for this session. 5.25 Following the ADP stakeholder event in 2023, a commitment was made to NLADP hosting an Alcohol summit in this financial year to re-focus our collective efforts to tackle harms from alcohol across our communities. We have a commitment from national colleagues who spoke at the Stakeholder day to support the event including Alcohol Focus Scotland (AFS), Scottish Health Action Alcohol Problem (SHAAP) and Scottish Families Affected by Alcohol and Drugs (SFAD). There was broad support for such an event with the 127 people in attendance. 5.26 NLADP has given its full support to a joint statement to the Health, Social Care & Sport Committee on MUP, advocating for an increase to 65p as part of our links to national alcohol forums. This recognises: • The extensive and robust evaluation by Public Health Scotland which estimates that it has reduced deaths caused solely by alcohol by 13.4%. • That’s an estimated 156 families each year who have been spared the loss of a loved one. • Hospital admissions are down by an estimated 4.1%, reducing the pressure on our NHS. • MUP has also narrowed alcohol health inequalities. 5.27 Failure to raise MUP to 65p will result in an estimated 800 more deaths, and almost 10,000 additional hospital admissions at an estimated cost of £11 million to our hospitals. 5.28 NLALP submitted a joint response with NHSL Public Health colleague to the alcohol licensing policy statement consultation led by NLC in 2023. This led to a commitment to re-establish the local licensing forums with calls being made via NLADP for volunteers and members to support his work across our communities in 2024. From the consultation NLC acknowledged this needs a full overhaul and will refresh the alcohol licensing policy statement in 2024, this will be published later this year. 5.29 Residential Rehab - An extensive programme of work was led by the ADP support team and the Scottish Recovery Consortium to offer training and support to staff to ensure residential rehab is available to anyone who wishes to be assessed.
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7 5.30 Residential rehab is now offered more consistently as part of the treatment and care offer in North Lanarkshire There’s been an increase in the number of referrals, assessments and placements to a range of rehab settings across Scotland. NLADP support team have embedded appropriate reporting and monitoring systems to reflect this submitting returns to the Scottish Government on a quartleryl basis. The North annual budget is £318,728. As of month 9, £294,391 was spent on rehab placements. Since tracking started, 41 referrals for assesment have been made to the multi– disciplinary team and of those, 38 individuals have gone to residential rehab placement. Alcohol is the most common factor for those attending residential rehab (55% of all referrals) Placements have been allocated on the following basis 76% Male and 24% female placements. 5.31 The residential rehab operational and oversight groups will reconvene in February 2024 to review placements, data and lived experience feedback and will report back to the ADP partnership board in March 2024. 5.32 Whole Family support – NLADP continues to invest in family support linked to the decisions reached via the Whole Family Approach sub-group, led by the national holistic framework, local evidence of need and linked to ADP strategic objectives. 5.33 The funding allocated to family support from SG is now committed to the stand- alone adult family support service launched in December 2023 (delivered by Phoenix Futures). Additional support is funded via by Barnardo’s, North Lanarkshire Council family programmes and Test of Change match funding for early learning centres provision from 2023 – 2026. 5.34 Workforce Development - The ADP support team continues to support local services to improve their offer targeted relevant training and learning opportunities. In 2023, 516 people attended training over 20 different courses and learning events. 5.35 Website Development - The ADP launched a new website that acts as a central source of information, advice and support relating to alcohol and drug use and details services currently operating locally and nationally. 5.36 The site was developed based on feedback from people with lived and living experience of substance use, and key services, to ensure that the content available is suitable and relevant. www.northlanadp.org 5.37 ADP stakeholder event - The ADP hosted an annual stakeholder event in December 2023 bringing partners together to connect with the services being
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8 offered locally, to hear from national organisations shaping the policy landscape and to engage in discussions on ADP priorities for the next 12 months. 5.38 In total, 127 people attended the event including people with lived experience, families and young people engaging with support services. 5.39 Health and Wellbeing events - Throughout 2023, NLADP co-hosted 4 health and wellbeing events across North Lanarkshire, as part of a series of 6, aiming to bring local partners, people and communities together to connect with each other and learn about our work. 5.40 Each events had a different feel having been led locally by key services and people from in the area. Over 100 organisations have been involved with 289 people attending across all 4 events below: Cumbernauld 24th May Wishaw/Newmains 19th July Coatbridge 14th September Motherwell 26th October 5.41 NLADP will host two more health and wellbeing events in 2024. A full evaluation report will be published in April 2024. 5.42 Alcohol (and other the drugs) local support fund - A new fund was made available through North Lanarkshire ADP to support organisations to build capacity and support local people through prevention efforts, reducing crisis and promoting recovery across all six localities. Organisations could apply for up to £10,000. 5.43 NLADP is keen to reinforce the rights-based approach and build a better understanding of the health and social needs and experiences of individuals, families and marginalised populations through this fund. 5.44 The fund was initially supported via VANL early in 2023 however, due to a number of challenges in delivering this fund, VANL and NLADP both agreed the ADP would take this back in house. All awards from the fund will be made by the end of March 2024 with each successful bidder having 12 months to deliver. 6. CONCLUSIONS NLADP continues to deliver on the National Drugs Mission objectives and ADP strategic priorities targeting resources appropriately and measuring impact. The ADP has appropriate structures and governance arrangements in place to support decision making around spend and offering best value. The right mechanisms in place to offer assurances that as much as possible is being done to tackle harms from substances and reduce deaths.
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9 Each sub-group is accountable to the ADP finance group and Partnership Board, and each have clear priorities to take forward in 2024. There is a wide variety of supports in place for individuals and families who are impacted by substance use. The current commissioning approach will support efforts to improve the quality and availability of support across statutory and community/voluntary services. There is a strong focus on learning and development across the ADP linked to listening to stakeholder views and involving those with lived and living experience across each area of work and sub-groups. 7. IMPLICATIONS 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☒ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 7.2 ASSOCIATED MEASURE(S) 7.3 FINANCIAL In the budget statement on 19th December there was acknowledgement that the system is under significant pressure as a result of the ongoing impacts cited as Covid, Brexit, high inflation and other factors. There was some acknowledgment this may mean taking difficult budgetary decisions to ensure we are investing in the right approaches that will have the biggest impact.
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10 Work was carried out by the ADP Strategic Lead and finance colleagues to review ADP budgets and to set out a financial forecast until the end of the National Mission (2026/27) offering assurances that budgets were in place to meet our financial commitments. This was reviewed and scrutinised by the North ADP Partnership Board and finance groups in January 2024 as follows: Annual spend plans. 23/24 £2,888,785 24/25 £2,105,503 25/26 £1,912,123 Programme for Government (PfG) funding has been awarded since 2018 to ADPs, the PfG budget in 2023 was £1,083,675. Due to the short-term nature and no guarantees this would be protected as a recurring budget, this has been used to support Test of Change initiatives. It has been confirmed PfG will be protected in 2025 as part of Board Baseline budgets. This paper has been reviewed by Finance: 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. 7.5 ENGAGEMENT & PARTICPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details ☒ Involve stakeholders in the development work aimed at achieving the national Regular stakeholder engagement takes place through the ADP. Yes ☐ No ☒ N/A ☐
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11 outcomes subgroup structures with people with lived and living experience (including families) involved in shaping the decisions around tackling alcohol. and drug related harms. ☒ Provide stakeholders with information on how to get involved ☒ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☒ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ADP sub-groups/Stakeholder event and ongoing engagement in communities across North Lanarkshire. ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ADP sub-groups/Stakeholder event and ongoing engagement in communities across North Lanarkshire. ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership ADP sub-groups/Stakeholder event and ongoing engagement in communities across North Lanarkshire. 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: Yes ☐ No ☒ N/A ☐
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12 8. BACKGROUND PAPERS None. 9. APPENDICES Please include a glossary of terms if not already included. None. CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following. Yes / Date added ☐ No ☐ N/A ☐
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13 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed