Delivery Plan Co-ordinating action on Alcohol and Drug problems for individuals, families and communities in Lanarkshire.

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1 Delivery Plan Co-ordinating action on Alcohol and Drug problems for individuals, families and communities in.

2 Contents Summary 3 Governance & Financial Framework 5 Priorities Areas for Funding 6 Alcohol Brief Interventions Improving Access to Treatment Services Providing Support for Young People, Children & Familes affected by Substance Misuse Alcohol & Offenders Delivering Recovery Orientated Systems of Care National Outcomes, & 9 Appendix 1: Alcohol & Drug Partnership Budget Delivery Plan

3 Summary Alcohol & Drug Partnerships (ADPs) are the key delivery agents for the Alcohol Framework and the Road to Recovery. ADPs are responsible for developing local strategies to deliver improved outcomes on the basis of local need, and for making investment decisions regarding both earmarked funding from Scottish Government (via NHS Boards) and from partners core funding (e.g. North and South Councils, NHS, Strathclyde Police). Our Strategy ( ) set out the ADP s approach to tackling alcohol and drug related problems and identified some of the challenges we face in improving these outcomes for individuals, families and communities. Our Delivery Plan reinforces this outcomes based approach to measuring success whilst supporting organisations to improve accountability to both North and South Community Planning Partnerships and our contribution to our local Single Outcomes Agreements by building on good practice. For the first time in 2011/12 the Scottish Government s allocation letters for earmarked alcohol and drugs funding identified agreed core outcomes which all Alcohol and Drug Partnerships are expected to deliver against. These seven core outcomes form the basis of our Delivery Plan. 1. People are healthier and experience fewer risks as a result of alcohol and drug use 2. Fewer adults and children are drinking or using drugs at levels or patterns that are damaging to themselves or others 3. Individuals are improving their health, well-being and life-chances by recovering from problematic drug and alcohol use 4. Children and family members of people misusing alcohol and drugs are safe, wellsupported and have improved life-chances 5. Communities and individuals are safe from alcohol and drug related offending and anti-social behaviour 6. People live in positive, health-promoting local environments where alcohol and drugs are less readily available 7. Alcohol and drugs services are high quality, continually improving, efficient, evidencebased and responsive, ensuring people move through treatment into sustained recovery 3 Delivery Plan

4 Our Delivery Plan defines what we would like to achieve over the next three years and the actions that are required to bring this about. This includes increasing the emphasis on preventative spend as well as on ensuring treatment and support services are person-centred and recovery orientated and have a greater focus on service user engagement and peer support. Our Plan also outlines the essential support and services that we will invest in over the next three years to ensure that children, young people and families affected by alcohol and/or drug problems are offered the right kind of help at the right time. In ensuring we are Getting It Right For Every Child, we have therefore prioritised early intervention and prevention, including diversionary activities which will encourage children and young people away from intergenerational social, economic, educational, health and substance misuse problems. We have also outlined the support and treatment options available to those children and young people who are affected by parental alcohol or drug problems and those who may have developed a problem themselves. Community-wide, our Strategy ( ) and this Delivery Plan emphasises the importance of reducing the negative impact on alcohol and drugs both in our communities and prison environments. We have therefore funded a number of new criminal justice initiatives to ensure that we improve outcomes for offenders with substance misuse problems in line with the Reducing Reoffending Programme and our Recovery Strategy ( ). 4 Delivery Plan

5 Governance & Financial Framework The funding envelope available within has increased significantly over the past five years. Current allocations to the ADP (including those from Greater Glasgow & Clyde ADP) are summarised in Table 1. Table 1 (million) Funding Available to the ADP 2007/ /12 Financial Year Alcohol Drugs Total NHS s allocation (including Greater Glasgow & Clyde ADP funding) from the Scottish Government to tackle problem drug use was 2,319,866 for 11/12 - an increase of 4,365 in 10/11. The alcohol allocation for 2011/12 was 4,032,242 an increase of 91,810 in 10/11. This includes 50,672 to support enhanced screening and treatment for people in prison with alcohol problems and to reflect the transfer of responsibility for prisoner healthcare from the Scottish Prison Service (SPS) to the NHS. This funding ( 6,352,108) is conditional on demonstrating progress towards both national and locally relevant drug and alcohol outcomes, It is also augmented by core funding from NHS, North and South Councils. Service Level Agreements with all providers have now been signed off until The financial framework for 2011/12 and projected budget for 2012/13 and 2013/14 maybe found in Appendix 1. 5 Delivery Plan

6 Priority Areas For Funding Alcohol Brief Interventions A total investment of 751,924 in 2011/12 delivered 18,970 Alcohol Brief Interventions (ABIs) which ensured that NHSL exceeded its HEAT target of 16,057 by March The new target for 2011/12 was 6,127 and early indications are that we have already exceeded this. However a greater challenge is to embed the routine screening and delivery of ABIs into routine clinical practice. To this end we will continue to invest 414,515 into our Community Nursing Service, while maintaining current levels of funding for our Substance Misuse Liaison Nurses ( 249,289) and Specialist Midwives ( 87,490). Improving Access to Treatment Services (HEAT 11) In preparation to meet the HEAT Target for 2013 (90% of clients will receive treatment that supports recovery within 3 weeks of referral) we have developed Local Improvement Targets which will be monitored quarterly by all services. This Local Improvement Target has also been built into our Service Level Agreements with local treatment providers including the North Integrated Addiction Service, Alcohol & Drug Services, South Council s Substance Misuse Team and our newly commissioned Meridian Service. We have also developed a manualised approach to delivering psychosocial interventions which will support the implementation of this HEAT Target. Table 2 summarises the level of investment by the ADP in Tier 3 treatment and support services that support delivery in 2012/13:- Table: 2 Provider ( ) Addiewell Throughcare Service 64,323 HMP Shotts Prison Addiction Services 56,050 Meridian (Counselling & Support for Individuals & families) 750,000 South Council (SLC) Substance Misuse Team 232,590 SLC Housing Project (NEST) 35,018 Eva Services (NHSL) 68,888 North Council Integrated Addiction Service 308,907 Phoenix Futures Peer Support Service 113,000 Methadone Programme (Pharmacy) 309,000 NHS Alcohol & Drug Services 2,298,846 Total 4,172,299 Table 2: List of Services that support people with alcohol & drug problems in. 6 Delivery Plan

7 Providing Support for Young People, Children & Families Affected by Substance Misuse The Youth Counselling Service ( 471,882k per annum) supported over 685 young people throughout all 41 secondary schools in in 10/11 with 85% of young people reporting an improvement in their psychological functioning. 86,784 was further invested in supporting young people within our sexual health services who had identified issues regarding alcohol and/or drug misuse. In addition we commissioned a Tier 3 young people s service (Bernardo s - 250k per annum) to provide care and co-ordination to vulnerable young people (aged yrs). We have further invested in a Tier 2 service (Meridian) which will provide a range of support options to individuals and their families affected by alcohol or drugs ( 750k per annum in 2012/13) across. Alcohol and Offenders Alcohol and Drug Partnerships have been asked to consider how they can identify and support the needs of offenders engaged in problematic alcohol use within community settings and within prison. An additional investment of 63k in the prison throughcare team will ensure that we are able to achieve this, while a pilot project in 2012/13 will evaluate the impact of a service which will address the needs of people who are deemed drunk and incapable and/or in police custody ( 200k). We will also invest an additional 54k into the health care needs of prisoners within HMP Shotts, and continue to provide shortterm funding to our colleagues in Strathclyde Police and our local authority partners (North & South Councils) to deliver on the Safer initiatives ( 200k) and the Persistent Offender Programme ( 90k). Delivering Recovery Orientated Systems of Care The Scottish Government have highlighted that a key role for Alcohol and Drug Partnerships is to ensure that the ring fenced funding available to them is used to support the development and provision of recovery-oriented systems of care. The factors that impact on an individuals ability to achieving recovery are many and complex, and will include wider economic and social trends. However, there are a number of key factors which, if effectively addressed, should lead to an improvement in their overall quality of life. 7 Delivery Plan

8 We will ensure therefore that when we commission services that our commissioning processes and subsequent monitoring arrangements have a clear focus on outcomes which improve the quality of life for individuals and/or their family members affected by substance misuse problems in compliance with the recovery ethos in the following domains:- Improvements in psychological health (self esteem and self efficacy) Enhanced citizenship and community involvement (community based activities) Enhanced social support (family, friends, peer support groups) Improved relationships between individuals and families Increased engagement in meaningful activities (leisure, volunteering, employment) Reduction in risk taking behaviours (sexual health, offending behaviours) Enhanced coping and life functioning (diet, budgeting, daily routines) Reduced exposure to abuse and violence In we are measuring these changes by the use of the Assessment of Recovery Capital scale and our Well Being Indicator for young people which is focused around the eight well-being indicators for Getting it Right for Every Child. We have also invested 113k per annum in a peer support service which should act as a bridge between our treatment and community based supports. The following section of our Delivery Plan provides the key actions (inputs) and the detail on how we will measure the success of these interventions to improve the lives of individuals, families and communities in affected by alcohol and/or drug problems. 8 Delivery Plan

9 HEALTH: People are healthier and experience fewer risks as a result of alcohol use and drug use: a range of improvements to physical and mental health, as well as wider well-being, should be experienced by individuals and communities where harmful alcohol use is being reduced, including fewer acute and long-term risks to physical and mental health, and a reduced risk of or alcohol-related mortality. National Outcome 1: People are healthier and experience fewer risks as a result of alcohol and drug use Fewer individuals in will suffer alcohol related injuries, physical and psychological morbidity and mortality. General Acute Inpatient Discharges with an Alcohol-Related Diagnosis (EASR rate per 100,000 population) General acute inpatient discharges with a diagnosis of Alcoholic Liver Disease ISD Scottish Morbidity Records (SMR 01) ISD 558 (2009/10) 650 (2009/10) Reduce the rate of alcohol related hospital discharges by 2015 Reduce mortality and morbidity from alcohol related liver disease by 2015 We will extend the Service Level Agreement with our three Acute Hospitals to ensure that all patients are:- Provided with advice and support to reduce problems related to alcohol and drug misuse, including health, social and psychological problems. Provide access to practical supportive measures for harm reduction and for accessing health and social care. Advised on safer sex and reducing the risks of sexually transmitted infections. Given information about other alcohol and drug misuse treatment services or referred direct for further comprehensive assessment where appropriate. Our six specialist substance misuse nurses will also provide interventions and health promotion advice (e.g. BBV screening and vaccination). NHSL Acute Services No of screenings and alcohol brief interventions delivered within acute setting Quarterly performance reports on HEAT 4 Standard 5,021 delivered by acute services ,200 alcohol brief interventions to be delivered in acute settings by 2011/12 In addition we will ensure that training is provided on screening and the delivery of alcohol brief interventions to medical and nursing staff throughout our hospital sites Provide on-site support and training to other staff within our three accident and emergency departments 9 Delivery Plan

10 National Outcome 1: People are healthier and experience fewer risks as a result of alcohol and drug use Fewer individuals in will suffer alcohol related injuries, physical and psychological morbidity and mortality. Number of screenings and brief interventions delivered in the community Number of alcohol related deaths (EASR rate per 100,000 population) Quarterly performance reports on HEAT 4 Standard GROS 18,970 alcohol brief interventions delivered by NHSL ,080 alcohol brief interventions delivered in Primary Care (2009) 16,057 ABI delivered in between 1st April 2008 and 31st March ABI delivered in between 1st April 2011 and 31st March Reduce the total number, by at least 25% by 2015 We will embed the routine screening and delivery of alcohol brief interventions by: Monitoring the Service Level Agreement for our community nursing staff to ensure that there are appropriate systems in place so support the ongoing change of practice which will enable systems to capture the number of FAST screenings and ABIs Working in partnership with Keep Well to ensure there are effective mechanisms in place which will facilitate access to Tier 2 alcohol services Delivering training to our community nurses, allied health professionals and staff in other settings Developing additional resources to support delivery (e.g. unit calculators, Alco meters) HEAT 4 Steering 10 Delivery Plan

11 National Outcome 1: People are healthier and experience fewer risks as a result of alcohol and drug use Fewer individuals in will suffer drug related injuries, physical and psychological morbidity and mortality. Proportion of IDUs reporting using shared needles/syringes in past month Total Needles and Syringes Distributed No of Hepatitis C positive individuals starting treatment (new treatment initiations) % of known injecting drug users tested for Hepatitis B SMR25 Harm Reduction Team HIV Hep Centre SMR25 5% (2009/10) 421, /10) 83 (2010/11) 68% (2009/10) Reduced proportion of IDU sharing needles/ syringes in past month by 10% by 2015 Increase total number of needles/syringes distributed by 10% by 2015 Target for 2011/12 = % of drug users are offered Hepatitis B vaccinations We will work with the BBV Prevention Network, and the BBV Managed Care Network for Hepatitis C to ensure that: Needle exchange programmes within pharmacies are accessible within every locality of Staff employed within s Alcohol & Drug Services are able to provide appropriate harm reduction advice and information A Harm Reduction Newsletter is freely available with the local pharmacies which alert drug users to the dangers of sharing and injecting. Patients are able to access Hep A & B vaccinations & BBV testing and referral to specialist treatment services when and where they need it BBV Prevention Network and the BBV MCN % of known injecting drug users tested for Hepatitis C SMR25 69% (2009/10) 100% of drug users are offered Hepatitis C testing Number of drug related deaths GROS 47 (2010) Reverse the upward trend in drug related deaths & reduce the total number, by at least 25% by The Drug Death Review & Prevention will monitor the action plan based on the recommendations of the national Drug Related Death Forums in Staff working within our addiction services will provide overdose awareness training and encourage patients to participate in the roll out of the Naloxone programme Drug Death Review & Prevention 11 Delivery Plan

12 2. PREVALENCE: Fewer adults and children are drinking or using drugs at levels or patterns that are damaging to themselves or others: a reduction in the prevalence of harmful levels of drug and alcohol use as a result of prevention, changing social attitudes, and recovery is a vital intermediate outcome in delivering improved long-term health, social and economic outcomes. Reducing the number of young people misusing alcohol and drugs will also reduce health risks, improve life-chances and may reduce the likelihood of individuals developing problematic use in the future. National Outcome 2: Fewer adults and children are drinking or using drugs at levels or patterns that are damaging to themselves or others There are fewer adults who are drinking or using drugs at levels or patterns that are damaging to themselves or others in No of adults exceeding weekly recommend limits Scottish Health Survey 4-YEARLY 23% (2008/09) Reduce the incidence of adults exceeding weekly recommended limits to 22% by We will develop a communication campaign as part of alcohol awareness week which will seek to raise the public awareness of the risks associated with drinking too much Embed the routine screening for alcohol related problems and the delivery of alcohol brief interventions, where appropriate within a range of health and social care settings Collaborative Themes Working HEAT 4 Steering Working in partnership with our local licensing forums we will actively support, at local level, Alcohol Focus Scotland s campaign: Reducing Harm Caused By Alcohol A Call to Action which has as it s key themes: Minimum Pricing, reducing young peoples exposure to alcohol marketing, targeting supermarkets for increased regulatory measures and reducing outlet density/opening hours. Licensing forums 12 Delivery Plan

13 National Outcome 2: Fewer adults and children are drinking or using drugs at levels or patterns that are damaging to themselves or others Frequency Type/ Fewer young people in will drink at levels and patterns that are damaging to themselves or others Fewer young people in will use drugs at levels and patterns that are damaging to themselves or others Number of licensed premises who have failed test purchasing No of 13 year old and 15 year olds reported having drunk alcohol on at least one occasion in their lives. No of 13 year old and 15 year olds reported having drunk alcohol in the last month. No of 13 and 15 year olds reported having taken drugs on at least one occasion in their lives No of 13 and 15 year olds reported having taken drugs in the last month No of 13 and 15 year olds being offered drugs Strathclyde Police 4 YEARLY / SALSUS 4 YEARLY / SALSUS 4 YEARLY / SALSUS 4 YEARLY / SALSUS 4 YEARLY / SALSUS N Div = 2/47 (4%) Q Div = 6/84 (7%) (2010/11) North: 41% of 13 year olds & 76% of 15 year olds South: 44% of 13 year olds and 76% of 15 year olds (2010) North: 3% of 13 years olds & 11% of 15 year olds South: 4% of 13 years olds & 10% of 15 year olds (2010) North: 8% of 13 year olds & 24% of 15 year olds South: 6% of 13 year olds & 25% of 15 year olds (2010) North: 5% of 13 year olds & 13% of 15 year olds South: 3% of 13 year olds & 14% of 15 year olds (2010) North: 20% of 13 year olds & 43% of 15 year olds South: 18% of 13 year olds and 45% of 15 year olds (2010) Proactively target & test purchase licensed premises Reduce the proportion of young people reporting alcohol use by Reduce proportion of young people reporting use of illegal drugs by Reduce proportion of young people being offered drugs by Strathclyde police will use intelligence led policing using Test Purchasing to target irresponsible licensed premises We will support a range of actions including: Delivery of Alcohol Brief Interventions across statutory and voluntary youth provision including Youth Counselling Service, Sexual Health Nurses and Meridian Strengthening the role of schools with an emphasis on early years, primary education, early identification and provision of in-school support to achieve the outcomes sought through the Curriculum for Excellence. Implementing the recommendations of a scoping study on resources available for the year age group and ensure that every school in will have access to them. Scoping out with North and South Education Departments the level of CPD input required for teachers to feel confident in delivering on the key health and wellbeing topics to support Curriculum for Excellence topics including drugs and alcohol Support the LANDED Peer Education Service to ensure that they can add capacity to the delivery of training to teachers on drugs and alcohol. Working with our partners across North and South to develop a range of targeted prevention and diversionary activities, including outreach and streetwork for young people. Divisional Commanders N & Q Division Workforce Development (Young People) Directors of Education North and South Councils ADP Support Staff 13 Delivery Plan

14 3. RECOVERY: Individuals are improving their health, well-being and life-chances by recovering from problematic drug and alcohol use: a range of health, psychological, social and economic improvements in well-being should be experienced by individuals who are recovering from problematic drug and alcohol use, including reduced consumption, fewer co-occurring health issues, improved family relationships and parenting skills, stable housing; participation in education and employment, and involvement in social and community activities. National Outcome 3: Individuals are improving their health, well-being and life-chances by recovering from problematic drug and alcohol use People will recover from their alcohol and drug problems and live longer, healthier lives, making a positive contribution to society and the economy. Assessment of Recovery Capital (ARC) At assessment & review Baseline data available June 2012 Improvement demonstrated across the ten domains of the ARC We will ensure that when we commission services that our commissioning processes and subsequent monitoring arrangements have a clear focus on outcomes which improve the quality of life for individuals and/or their family members affected by substance misuse problems in compliance with the recovery ethos in the following domains:- Improvements in psychological health (self esteem and self efficacy) Enhanced citizenship and community involvement (community based activities) Enhanced social support (family, friends, peer support groups) Improved relationships between individuals and families Increased engagement in meaningful activities (leisure, volunteering, employment) Reduction in risk taking behaviours (sexual health, offending behaviours) Enhanced coping and life functioning (diet, budgeting, daily routines) Reduced exposure to abuse and violence ADP Commissioning 14 Delivery Plan

15 National Outcome 3: Individuals are improving their health, well-being and life-chances by recovering from problematic drug and alcohol use People will recover from their alcohol and drug problems and live longer, healthier lives, making a positive contribution to society and the economy. SMR25 (b) returns to ISD Christo Inventory of Substance Misuse Services ISD ADP 1346 SMR25(b) submitted in 10/11 Reduced scores of between % of SMR25 forms completed Reduced scores of between 1-3 We will ensure that All of statutory service providers have Service Level Agreements in Place which emphasize the role of focusing on improving the outcomes for clients as described above. All clients in tier 2 and 3 drug services have SMR 25a & b completed as part of their recovery journey South Council North Council NHS No of peer support volunteers with services. Annual Reports 4 10 peer volunteers, engaged with services across by March 2015 We will support the development of a peer support infrastructure across the 10 localities of by:- Training volunteers (3 years + in recovery) to offer peer support using MyRap as part of a menu of options to support clients accessing Tier 2 and Tier 3 services Working in partnership with other agencies to develop drop in cafes Peer Support Service 15 Delivery Plan

16 National Outcome 3: Individuals are improving their health, well-being and life-chances by recovering from problematic drug and alcohol use People will recover from their alcohol and drug problems and live longer, healthier lives, making a positive contribution to society and the economy. % of working age population claiming benefits % of population that is economically active % of population in employment Annual Office for National Statistics) Annual Office for National Statistics Annual Office for National Statistics North 21.2% South 17.7% (May 2011) North 78.1% South 76.3% (March 2011) North 70.4% South 71.6% (March 2011) Reduction in individuals claiming DWP benefits 89% 80% The following actions will help us to achieve this outcome: We will work with NHS, Jobcentre Plus and North and South Councils to co-ordinate the management of alcohol and drug misusers through treatment and into work We will establish better links with training providers and work with other organisations providing training/ vocational programmes for people with substance misuse problems Treatment Providers JobCentre Plus Percentage of adult service users with literacy and numeracy difficulties Scottish Survey of Adult Literacies 2009 Annual Population Survey, ONS (proxy) 26.7% of working age population have trouble with adult literacy skills (Nationally, 2009) 14.6% of working age adults with low or no qualifications (SCQF Level 4 or below). (Nationally, 2009) Improve levels of literacy by 10% by 2015 We will ensure that Service Level Agreements with our statutory and third sector organisations incorporate interventions which promote access to additional support and consolidate the benefits of treatment e.g. access to training schemes and literacy programmes ADP Implementation & Finance 16 Delivery Plan

17 4. FAMILIES: Children and family members of people misusing alcohol and drugs are safe, well-supported and have improved life-chances: this will include reducing the risks and impact of drug and alcohol misuse on users children and other family members; supporting the social, educational and economic potential of children and other family members; and helping family members support the recovery of their parents, children and significant others. National Outcome 4: Children and family members of people misusing alcohol and drugs are safe, well-supported and have improved life-chances We have improved the life chances for children, and young people allowing them to realise their full potential in all areas of their lives No. of brief interventions carried out in midwifery services HEAT 4 quarterly performance data 869 alcohol brief interventions delivered in maternity services % of pregnant women screened for alcohol related problems We will:- Continue to fund our specialist midwifery posts to provide guidance/training on brief interventions and ensure that locally developed Getting it Right for Every Child guidance is implemented across midwifery services. Enhance multi-agency working via training, support and practice development. Raise awareness of Foetal Alcohol Syndrome and neonatal abstinence by a range of mediums e.g. stakeholders events, conferences. Women s Services No of pregnancies in under 16s Prevalence of sexually transmitted diseases Annual/ISD 8.7 per 1000 females, aged (North = 9.3, South = 7.2) (2008) 892 per 100,000 population in NHS (2009) Reduce no of pregnancies in under 16s by 2015 Monitor the performance of our sexual health specialist nurses to ensure that the service achieves positives outcomes in terms of reducing underage pregnancy and reduced prevalence of sexually transmitted diseases for young people who are drinking above recommended levels. Young People s Sexual Health Steering 17 Delivery Plan

18 National Outcome 4: Children and family members of people misusing alcohol and drugs are safe, well-supported and have improved life-chances We have improved the life chances for children, and young people allowing them to realise their full potential in all areas of their lives Satisfaction scores on key quality indicators within HMIE Inspection Reports Annual/ North & South Councils North Mar 2011 Children are listened to and respected Very good Children are helped to keep safe Very good Response to immediate concerns Very good Meeting needs and reducing long term harm Very good South Dec 2010 Children are listened to and respected Very good Children are helped to keep safe Very good Response to immediate concerns Very good Meeting needs and reducing long term harm Very good Action key recommendations of HMIE Inspection reports The Child Protection Committees in will promote better outcomes for children affected by drug and alcohol use in the home by providing: Multi-agency training to help identify children at risk at an early stage including those of our specialist alcohol and drug services Guidance, via the Getting it Right for Every Child Protocols, to know when to seek support from specialist areas and when to share information Guidance on the sharing and embedding of good practice around single and inter-agency assessment when planning for children Wider distribution of the GIRFEC risk assessment framework to support appropriate and consistent intervention in the management of immediate risk. Child Protection Committees Data Sharing Partnership Board 18 Delivery Plan

19 National Outcome 4: Children and family members of people misusing alcohol and drugs are safe, well-supported and have improved life-chances We have improved the life chances for children, and young people allowing them to realise their full potential in all areas of their lives Young People s Well-being Score At assessment, review and discharge Not established Service established by November 2011, first outcomes available by June 2012 In addition we will:- Work with our partner organisations to monitor the outcomes achieved by Meridian which will seek to improve the ability of 250 parents/carers affected by substance misuse to provide consistency, care and stability to their children in line with the principles and practices of Getting it Right for Every Child. Support 100 children affected by parental substance misuse, including children who may have caring roles in the family by:- Enhancing their feelings of safety and security within the home and school environment, incorporating the establishment of routines Enhancing physical and psychological health Enhancing confidence and self efficacy We will also strengthen the focus of adult substance misuse services on the needs of children and families by including relevant outcomes in our Service Level Agreements with existing providers. Meridian Steering 19 Delivery Plan

20 National Outcome 4: Children and family members of people misusing alcohol and drugs are safe, well-supported and have improved life-chances We have improved the life chances for children, and young people allowing them to realise their full potential in all areas of their lives Young People s Well-being Score At assessment, review and discharge Not established Implemented by April 2012 We will:- Use the Young People s well-being tool, which provides a measurement of outcomes on the eight well-being indicators of Getting it Right for Every Child, to monitor the outcomes of all ADP funded services including the Youth Counselling Service, Meridian and Barnardo s Meridian Barnardo s Youth Counselling Service Develop the well-being tool to ensure that it is young people friendly and compatible with partner organisation s IT systems. ADP Support Staff 20 Delivery Plan

21 National Outcome 4: Children and family members of people misusing alcohol and drugs are safe, well-supported and have improved life-chances We have improved the life chances for children, and young people allowing them to realise their full potential in all areas of their lives Rates of domestic abuse incidence per 100,000 of population Number of domestic abuse crimes/offences Domestic abuse detection rate Number of crimes/offences involving repeat accused (domestic abuse) Number of crimes/offences involving repeat victims (domestic abuse) Strathclyde Police Strathclyde Police Strathclyde Police Strathclyde Police Strathclyde Police N Div = 336 Q Div = 280 (2010/11) N Div = 2831 Q Div = 2299 (2010/11) N Div = 67% Q Div = 62% (2010/11) N Div = 1806 Q Div = 1405 (2010/11) N Div = 1846 Q Div = 1405 (2010/11) Increase domestic abuse detections by +3.8% Reduce number of repeat accused by- 7.5% Reduce number of repeat victims by - 7.4% We will:- Implement the recommendations of a scoping study which examined the response of local service providers to the dual issues of substance use and domestic abuse Ensure that there is a co-ordinated and consistent multi-agency response to women, children and young people and perpetrators with the dual experience of domestic abuse and substance use Work with Violence Against Women s to raise awareness of gender based violence amongst staff working within Tier 2/3 of substance misuse services. Work with local partners in the substance misuse field to promote the use of routine enquiry within the assessment process Implement the recommendations of the Motherwell GIREC Test on domestic abuse within, colleagues within each of the six localities of North to ensure a coordinated response to women, children and young people with experiencing domestic abuse. Provide funding to EVA Services for the provision of advocacy for women affected by domestic abuse to enable roll-out of the service into South Further develop the domestic abuse perpetrator programme within HMP Addiewell Assistant Health Promotion Manager Violence Against Women s Partnership Board (Addictions) ADP Implementation & Finance Criminal Justice Services 21 Delivery Plan

22 5. COMMUNITY SAFETY: Communities are safe from alcohol and drug related offending and antisocial behaviour: reducing alcohol and drug-related offending, re-offending and anti-social behaviour, including violence, acquisitive crime, drug-dealing and driving while intoxicated, will make a positive contribution in ensuring our communities are safer areas to live, work and visit. National Outcome 5: Communities are safe from alcohol and drug related offending and anti-social behaviour Communities in are safer and stronger places to live and work because crime, disorder and danger related to alcohol and drug use has been reduced Number of anti social behaviour offences reported Number of reported Youth Disorder incidents Strathclyde Police Strathclyde Police N Div = Q Div = (2010/11) N Div = Q Div = (2010/11) Monitor and reduce number of ASB crimes and offences. We will engage and persuade all stakeholders with an interest in or experience of alcohol and drug problems to become actively involved in local planning groups, licensing forums or programmes of prevention by advising them of the measures which local communities can take to highlight local problems. N and Q Divisional Commanders, Strathclyde Police Driving motor vehicle with blood alcohol content over limit Failure to provide breath specimen at roadside Strathclyde Police Strathclyde Police N Div = 351 Q Div = 258 (2010/11) N Div = 49 Q Div = 38 (2010/11) Reduce number of people involved in road accidents when under the influence of alcohol Strathclyde Police will develop targeted campaigns around the dangers of drink driving. Number of drunk & incapable offences Strathclyde Police N Div = 192 Q Div = 251 (2010/11) Reduce drunkenness offences by 10% by 2014 In conjunction with the Community Safety Partnership we will continue support of the Safer campaigns which feature a variety of initiatives designed to reduce alcohol related violence, incorporating high visibility police patrols, taxi marshalling scheme and joint visits to licensing premises which remind retailers and licensees of their responsibilities under the Licensing Act. North and South Community Safety Partnerships 22 Delivery Plan

23 National Outcome 5: Communities are safe from alcohol and drug related offending and anti-social behaviour Communities in are safer and stronger places to live and work because crime, disorder and danger related to alcohol and drug use has been reduced Number of ASBOs granted per 100,000 households Aspect of neighbourhood disliked drug misuse and dealing Personal experience of neighbourhood problem drug misuse and dealing Strathclyde Police 2 yearly/ Scottish Household Survey 2 yearly/ Scottish Household Survey N Div = 21 Q Div = 21 (2010/11) North 15% South 13% (2007/08) North 7% South 8% (2007/08) Reduce number of ASBOs granted per100,000 households by 10% by Decrease the % of adults reporting dislike and/or have personal experience of drug misuse and dealing in their neighbourhood. We will also link with our partner agencies to ensure that local problem solving groups, Local Area Partnerships and local licensing forums have adequate representative from the local community, public health & the ADP. We will work with colleagues in Strathclyde Police and other partner agencies to ensure that communities see the benefits of identifying dealers by raising awareness of the role that Crime stoppers can play in supporting local communities to take action over drug dealing. Local Problems Solving s, local licensing forums & Local Area Partnerships 23 Delivery Plan

24 National Outcome 5: Communities are safe from alcohol and drug related offending and anti-social behaviour Communities in are safer and stronger places to live and work because crime, disorder and danger related to alcohol and drug use has been reduced Assessment of Recovery Capital Client s Engagement in Treatment Recovery Participation Scale At assessment, review discharge and at 6 month follow up Not Available Improvement in ARC scores from baselines to 12 month follow-up Increased numbers of individuals participating in recovery groups from baseline to 12 month follow-up We will work with our partners in Criminal Justice to: Develop a service for offenders not otherwise subject to formal assessment serving four years and under, with a significant addiction problem and associated difficulties. This will be along the lines of the Integrated Case Management System. Introduce needs assessment tools for use by staff in HMP Addiewell and CJSW to facilitate the exchange of basic information relative to offender needs. Train the remainder of justice staff to deliver screening and brief intervention Develop an alcohol intervention pathway providing guidance about the appropriate targeting of interventions Increase our understanding of drinking profile of individuals involved in CJs through analysis of AUDIT and CJSWR In addition we will ensure that clinical services are offered using consistent outcomes for substance misusing offenders in custody within Addiewell Prison by training staff in the Treatment Process Model. We will also take cognisance of the Offender Management guidance and extend the reach of our Arrest Referral Service to include both alcohol and drug users. In addition we will fund a Persistent Offender Programme across North and South and a Drunk & Incapable pilot. CJA/ADP Working 24 Delivery Plan

25 6 LOCAL ENVIRONMENT: People live in positive, health-promoting local environments where alcohol and drugs are less readily available: alcohol and drug misuse is less likely to develop and recovery from problematic use is more likely to be successful in strong, resilient communities where healthy lifestyles and wider well-being are promoted, where there are opportunities to participate in meaningful activities, and where alcohol and drugs are less readily available. Recovery will not be stigmatised, but supported and championed in the community. National Outcome 6: People live in positive, health-promoting local environments where alcohol and drugs are less readily available People living within our communities are engaged in a range of positive, healthpromoting activities Number of people taking prescription drugs for depression or psychosis National Survey by Health Scotland ISD / Defined daily dose (antidepressants); rate per 1000 population (NHS ) Defined daily dose (psychosis); rate per 1000 population (NHS ) 15.4 suicides per 100,000 population ( year average) North 49 suicides (2009) South 44 suicides (2009) AA groups 150 NA groups 4 CA groups 3 SMART groups 14 Al-Anon 16 Families Anonymous 1 In % annual reduction We will implement the recommendations of Mentally Flourishing Scotland re joint work with substance misuse services, and ensure the roll out of My Rap and our Recovery DVD into the Healthy Reading Scheme across North and South. NHSL Health Improvement Number of suicides and self harm GROS & ISD Reduce number of suicide and self harming episodes by 20% between 2002/13 We will work with Choose Life s in North and South to ensure that key frontline staff in mental health and substance misuse services, primary care and Accident and Emergency are being educated and trained in using suicide assessment tools/ suicide prevention training programmes We will proactively engage with mutual aid groups by:- Promoting our ADP website to ensure that all services, including mutual aid groups, are easily identified, in terms of help offered and their geographical coverage Ensuring staff within Tier 2 & Tier 3 treatment and care services actively engage with recovery champions and networks Choose Life Strategy s No of mutual aid groups in Mutual Aid websites At least 1 AA, NA, CA and SMART group in each locality by March 2014 At least 1 Al-Anon and Families Anonymous groups in each locality by March 2015 North Partnership Board & South Planning & Performance ADP Support Staff 25 Delivery Plan

26 National Outcome 6: People live in positive, health-promoting local environments where alcohol and drugs are less readily available: People living within our communities are engaged in a range of positive, healthpromoting activities Community survey on perception of recovery All services have appropriate information which is readily available within local communities % of respondents who have given up own time as organiser/ volunteer in past 12 months Community Survey Audit using National Quality Standards 2 yearly/ Scottish Household Survey Not Available 70% (2006/07) North 24% South 28% (2007/08) 1 Community Survey by March 2012 Local communities should know how to access our services Increase number of people engaged in volunteering by 10% in North and South We have developed a recovery focused community engagement strategy for which we will implement over the next three years. Key actions include: Utilizing the knowledge and networks of existing resources (e.g. local Community Engagement Officers, Recovery Champions etc.). Supporting the development and establishment of enhanced recovery capital within communities and the provision of infrastructure support (including access to training and funding opportunities) to recovery networks, communities and organisations Organizing events and promoting positive aspects of recovery, celebrating the recovery achievements of individuals, communities and organisations Workforce Development s Involving service users and wider community members in local activities such as Alcohol Awareness Week, world AIDS day, Suicide Prevention Week and the Mental Health Arts & Film Festival via Collaborative Themes Working Collaborative Themes Working Developing our website and producing local publications which provide clear and credible information about our local services and ensuring that these are available throughout ADP Support Staff Supporting individuals and organisations in putting a public face and voice on recovery Peer Support Service 26 Delivery Plan

27 7. SERVICES: Alcohol and drugs services are high quality, continually improving, efficient, evidence-based and responsive, ensuring people move through treatment into sustained recovery: services should offer timely, sensitive and appropriate support, which meets the needs of different local groups (including those with particular needs according to their age, gender, disability, health, race, ethnicity and sexual orientation) and facilitates their recovery. Services should use local data and evidence to make decisions about service improvement and re-design. National Outcome 7: Alcohol and drugs services are high quality, continually improving, efficient, evidence-based and responsive, ensuring people move through treatment into sustained recovery s alcohol and drugs services are high quality, continually improving, efficient, evidencebased and responsive whilst, ensuring people move through treatment into sustained recovery National Drug and Alcohol Treatment Waiting Times (DATWT) Did Not Attend Rates Quarterly/ ISD Local Improvement Targets ADP Apr June 2011 Overall = 97% (Completed waits = 98% Ongoing waits = 95%) 20 60% within third sector and statutory providers 100% < 3 weeks from referral to treatment by 2013 Reduce Did Not Attend rates by 10% by 2015 We will Monitor waiting times from referral to treatment via waiting times framework. These will be reported via Local Improvement Targets Monitor DNA rates for assessment and treatment via waiting times framework. These will be reported via Local Improvement Targets North Partnership Board South Planning & Performance Number of clients with a care plan Service User s perception of the quality of services delivered Case Note Audit Data annual user survey 80% (June 2011) To be established 100% of clients will have a care plan 10% year on year improvement of satisfactions levels among service users Conduct annual audits with all service providers to ensure that all case files contain a personal plan in line with the National Quality Standards for Substance Misuse Managers NLC, NHSL & Voluntary Sector Recommendations arising from ADP annual performance reviews Annual Report and presentation to ADP, NHS & North and South Health & Care Partnerships Range and quality of services and interventions delivered (2006) Improved range of services & focus on delivery of psycho social inteventions in 2012/2015 Members of the ADP Implementation & Finance will review all ADP funded services annually. Information from annual reports, HEAT, local improvement targets and workforce development plans will be used to inform these visits. ADP Implementation & Finance 27 Delivery Plan

28 National Outcome 7: Alcohol and drugs services are high quality, continually improving, efficient, evidencebased and responsive, ensuring people move through treatment into sustained recovery All staff working within services are adequately qualified, trained, supported and enabled to deliver their agreed roles. Personal Development Plan Completed Audit of services re national quality standards Annual Reports 90% of services reported that they had a personal development planning process in place which identified the training needs of their staff 100% of services have a personal development planning process in place which identifies the training needs of their staff The North Partnership and South Planning & Performance will ensure that there are appropriate support and supervision structures for all health, social care and voluntary sector staff working within Tier 2/3 of young people and adult treatment services. This structure will incorporate specialist addictions psychology peer support and supervision. North Partnership Board and South Planning & Performance Organisational Readiness to Change ORC Baseline data will be established in 2011/12 for the ORC The Workforce Planning Sub- will construct an organisational development plan for all staff working within Tier 2/3 of young people and adult treatment services based on the needs identified within their personal development plans to deliver evidence based psycho-social interventions. Workforce Planning We will commission training on Getting it Right for Every child, motivational interviewing, relapse prevention, cognitive/ behavioural skills, counselling and recovery to staff identifying this as a skills deficit. Training on a range of psychosocial interventions will be taken forward by our Psychologists. ADP Support Staff NHSL Psychology 28 Delivery Plan

29 Appendix 1: ADP Budget Ref Allocation Description Overall Funding 2011/12 Overall Funding 2012/13 Overall Funding 2013/14 1 Training 10,000 10,000 10,000 2 Brief Intervention (Community Nursing) 414, , ,515 3 Specialist Midwifery nurses (Acute) 87,490 87,490 87,490 4 Substance Misuse Liaison Nurses 249, , ,289 6 Youth Counselling Service 471, , ,000 7 Alcohol Counselling (ACT) 121, Alcohol Counselling (Liber8) 121, LaRC (Liber8 Ltd) 113, Pharmacy Dispensing (Subutex etc) 186, , , Specialist Pharmacist (SPISM) 60,000 60,000 60, Harm Reduction Service 160, , FHS Prescribing 15,000 15,000 15, EVA Project 68,888 68,888 68, Meridian Project 543, , , Bernardo's Axis Service 250, , , Addiewell Throughcare (NLC) 64,323 64,323 64, Sexual Health Nurses 86,784 89,170 89, Aspire Brain Damage Service 80, Housing Support (NEST) 35,018 35, ADP Research and Info 38,007 38,007 38, NLIAS SW 308, , , SLC Substance Misuse Team 232, , , Alcohol & Drugs Services (NHS) 2,298,846 2,298,846 2,298, Third Sector Peer Support Service 113, , Shotts Prison 56,050 56,050 56, Neuropsychologist for older people 0 66,630 66, Arrest Referral 85,000 85,000 85, Contingency fund (offender management) 52,105 91, , a Healthy Working Lives 18,700 18,700 18, Suboxone 123, , ,000 Grand Total 6,352,108 6,352,108 6,352,108 Administration (ADP support) 240, , ,235 Funding (including Administration) 6,592,343 6,592,343 6,592,343 Table 3: ADP Budget (Note this is boxed on an assumption that the budget from the Scottish Goverment will not change over the next two years). 29 Delivery Plan