Decision details

Ms Karon Brown, Head of Integrated Services, Delphi Medical Consultants Limited presented an update on the first year of the integrated Drug and Alcohol Treatment Service to support adults. Also in attendance were Ms Nina Carter, Commissioning Manager; Ms Judith Mills, Public Health Consultant; and Dr Arif Rajpura, Director of Public Health.

Ms Brown explained that the Service provider was Horizon (part of Delphi). She outlined the background to the current service.

The Care Quality Commission had been critical that all support was provided in one building. Horizon recognised that it was important for clients to see a clear pathway of treatment progress to enable them to see their lives were moving forward.

It was report that first-line support (including outreach services to hostels and other places) was provided at the Dixon Road building and focused on community detox models involving key workers supporting clients. Most clients then moved on to Winston House where specialist support was offered, e.g. with mental health workers. Clients were often struggling with alcohol, drug, mental health and other problems such as smoking. They were initially supported with the first condition that they presented but most did have emotional and mental health issues. Staff included a psychologist and family worker to recognise that people were part of families suffering pain and loss. GPs were involved with meetings too. Ms Mills added that people presented with complex conditions but the services were well embedded to support them.

Ms Brown added that death rates were high with particular risks associated following the period immediately after finishing detox so support needed to be wide, including managing drug withdrawal, peer networks, art groups. It was a challenge supporting people with serious addictions to fully recover. She referred to a YouTube link within the report which featured examples of success stories.

Members accepted that the first year involved transitional change but were concerned that the recovery rates at the end of January 2018 were well short of end-year targets (end March 2018). The number of people recovering from opiate use was at 104 with a target of 200, non-opiates at 44 (target 200) and alcohol recoveries at 226, with a target of 500. They queried if the targets would be met or if they were unrealistic and how many people were waiting for treatment.

Members also queried the percentage of people entering treatment against those successfully completing treatment and it was agreed that a written answer would be provided following the meeting.

Ms Nina Carter explained in-depth analysis had been undertaken and the figures did not show the complexities involved, e.g. people often had a primary substance which they had recovered from but used other secondary substances. People also used drugs and alcohol making recovery challenging.

Ms Brown added that the previous service had been clinically focused, i.e. if people were identified as ‘drug-free’ then that counted as a successful completion. However, people were now supported for much longer periods, e.g. over six months to ensure that they achieved sustained recovery.  She added that they had a 100% target that all new clients were seen within two weeks and that most were seen within one week. She reported that there had been 170 new clients in December 2017 and a further 130 in January 2018, all of whom had been seen in good time.

Ms Brown explained that national targets were being met and a meeting was to be held with the national body (National Reporting System for Drug and Alcohol) to agree targets which were more relevant to Blackpool. Dr Rajpura agreed that the original targets were not realistic and added that there had been data recording issues. Members acknowledged the national system but recommended that there should still be relevant local data and targets.

Dr Rajpura acknowledged that it had taken time for the new service model to become embedded but it was a much better approach which was far more focused on sustaining recovery and better futures for people, i.e. becoming genuinely drug-free and integrated back into society with prospects such as employment, housing and socially finding friends. 

Members noted that 35 people had secured employment and enquired how many of those had sustained employment. Ms Mills would provide a written answer. Ms Brown added that as part of a new national research pilot, which Horizon was involved with, employment workers would be used to support people. Dr Rajpura added that this had been a successful funding bid and more funding opportunities were being pursued.

Members noted the high numbers of people facing difficulties and the impact on them and society.  The impact of drugs and other substances was high including on limited resources but the profile was low. They acknowledged the work of staff. Members were concerned that whilst good outcomes were being achieved, the numbers were growing and they queried how many people might be missed.  A representative from Streetlife explained that they did refer people into services but only if they were looking for support. Streetlife accepted people as they were and aimed to support them to recover. Councillor Amy Cross, Cabinet Member for Adult Social Care and Health agreed that people needed to want to recover.

Members suggested that cost savings could be used to increase treatment spend and that the public perception of Blackpool needed to be improved as well as getting across the message that people with problems were ill so needed support.

Dr Rajpura agreed that these were real people with real issues whose stories needed to be listened to. Councillor Cross added that a new Drug Strategy was being developed which would provide a more effective way forward.

The Committee agreed:

1.      That Ms Mills would provide written details of sustained employment.

2.      That Ms Mills would provide written details of the percentage of people entering treatment against those successfully completing treatment.