Agenda item

Southwark’s Alcohol Strategy is attached, alongside a map & description of Southwark’s Substance Misuse treatment services.

The item will be presented by Rebecca Walker, DAAT and Interim Commissioning Manager and Dr Emily Finch, Clinical Director, Addictions CAG and Consultant Addiction Psychiatrist, South London and Maudsley NHS Trust.

A background paper is also provided giving information on Marina House.

7.1  The chair invited the speakers to present : Rebecca Walker, DAAT ( Southwark Drug and Alcohol Action Team) & Interim Commissioning Manager and Dr Emily Finch, Clinical Director, Addictions CAG & Consultant Addiction Psychiatrist, South London & Maudsley NHS Trust (SLaM).

7.2  Rebecca Walker referred to the papers, which summarised the substance misuse treatment services. She explained that the intention was to bring the Substance Misuse Needs Assessment to the committee; however this will not now be cleared until April. The needs assessment over all shows good services delivering good outcomes with some reservations. The DAAT is looking at services commissioned in 2014/15.  The budget is a key issue. There is work with Public Health and service user involvement to decide what is needed and the service plans  to use the STAR process. The majority of providers have 6 month grants until 31 September 2014. At the moment the plan is not to do a complete change but there will be minor changes; for example there is less opiate and more alcohol use so there will be a change in the services invested in.

7.3  A member asked what is being done to reduce alcohol and sexual violence. She explained that Southwark recently changed its domestic violence provider. The member said that he was a barrister and he was worried about the quality of care and investigation for sexual violence and also the extent of underage drinking. Rebecca Walker said that there was a recent Mystery Shopping exercise on underage drinking and as a result one place was shut down. She went on to offer to provide more data on the underage drinking and how the Domestic Abuse service tackles alcohol & substance misuse.

7.4  Another member suggested that Sexual Health Clinics could be used to provide counselling for those at risk. He commented that he used this service but had never been offered alcohol or substance misuse advice. Rebecca Walker explained that Sexual Health Clinics do screen for alcohol/substance misuse and refer to treatment,  and suggested that the member probably does not drink enough to trigger a service response.

7.5  A member asked about the differing rates of substance and alcohol misuse. Dr Emily Finch explained that party drugs like GHB are seeing a rise and opiate use is seeing a drop, however users are older and iller.  Rebecca Walker explained that the Evolve service provided by Blenheim and commissioned by DAAT (Drug and Alcohol Action Team)  works with party drug/ club drug users and they are seeing more users requesting treatment; this is a double edged as it could indicate either better use of treatment services or increased consumption – people can self refer at a low threshold. More complex party drug users also access Community Drug and Alcohol Team (based at Blackfriars and provided by SLAM),or one of the inpatient services, if they need a detox. A member asked if there were more gay or straight users of party/club drugs and she responded that the service was seeing more gay users.

7.6  The chair invited Tom White to comment. He began by criticizing the closure of most front facing drug treatment services at Marina House and accused the previous health scrutiny committee of going ‘soft’ on this. He then went on to highlight the increase in alcohol consumption and noted that since 2009 there has been a  54% increase in hospital admissions for alcohol as well as  more emergency admissions for liver problems . Drinking is also often a contributory factor for suicide & violence. 

7.7  Dr Emily Finch referred to the letter from SlaM to the committee which outlined plans for more addictions services to be located in Marina House, including the resumption of face to face treatment service for older people as well as creative & art services.  Gwen Kennedy, Southwark CCG, explained that a needs assessment sets out plans for services, some of which will delivered at Marina House. Rebecca Walker explained that some services are spread throughout the borough, with Blackfriars a site for specialist service. She said that a recent performance report identified that outcomes for treatment are better than ever.

7.8  A member asked about work to prevent misuse of alcohol and commented that the focus seemed to be more on treatment. Dr Emily Finch said that the key issue for prevention  were availability and price, however the government has not responded to policy recommendations on this. She added that early intervention was also important. The Addictions service has a range of treatment professionals and effective interventions depended on the harm profiles, for example some people will consume large amounts and act out in harmful ways, while other will consume at home. Gwen Kennedy explained that whole raft of awareness rising around health & wellbeing.

7.9  A member asked about prevention approach and how the licensing committee consider these issues. Rebecca Walker agreed that the prevention agenda was very important, however it was more the remit of Public Health as her role is more focused on treatment. She agreed that licensing is a key issue and reported that Public Health are now working on this and this might well impact on new premises. The member commented that drug use is generally down nationally. He added that he was very angry that government did not take forward the recommendation for minimum pricing on alcohol. He reported that Richmond Council has a saturation policy which he thought was much more effective than Southwark’s present licensing arrangements. Members indicated that they would like to see more proactive work on licensing and a strong Public Health message on alcohol. Officers agreed.

RESOLVED

More information will be supplied on :

• Underage drinking

• Domestic Abuse , alcohol and substance misuse

• Licensing and reducing alcohol misuse.