Alcohol and Drug Strategy

RENFREWSHIRE ALCOHOL AND DRUG PARTNERSHIP Alcohol and Drug Strategy 2011-2014 Page 1

Contents 1. Introduction 2. Current Situation in Renfrewshire 3. National Frameworks 4. Building on Strengths Planning Structures in Renfrewshire 5. Current Service Provision in Renfrewshire 6. Renfrewshire s Strategic Priority Outcome Areas 7. Commissioning Strategy 8. Financial Framework 9. Monitoring and Reviewing the Strategy Appendix One Renfrewshire Community Planning Partnership Reporting Structures Appendix Two Renfrewshire ADP Needs Assessment Page 2

1. Introduction Renfrewshire Alcohol and Drug Partnership (ADP) was established in October 2009 with the key aim of addressing Renfrewshire s long standing challenges associated with alcohol problems and drug misuse. The ADP has been tasked with delivering a shared vision of the kind of outcomes partners want to see in Renfrewshire and to set out the way in which they will be achieved. As part of the Renfrewshire Community Planning Partnership it is the vision of the Renfrewshire ADP to deliver a healthier, happier and safer Renfrewshire and to set out high level outcomes to ensure the harm caused by alcohol or drugs can be minimised or even prevented in Renfrewshire. Renfrewshire Community Planning Partnership Vision - In 2017, Renfrewshire thrives with learning, business and opportunity. Its people are fitter, healthier, more confident and productive. Vulnerable people are supported and cared for. The area thrives due to its safe environment, rich heritage, wealth of cultural events and eco-friendly towns and villages. The structure of the Renfrewshire Community Planning Partnership has been aligned with the five national priorities for Scotland: Wealthier and Fairer; Smarter; Healthier; Safer and Stronger; and Greener. The ADP will coordinate activity with the other seven thematic groups to meet the National Priorities (see appendix one for structure of the Renfrewshire Community Planning Partnership). 2. Current Situation in Renfrewshire Population Profile Renfrewshire is the ninth largest Council area in Scotland and has a population of 170,250 (GROS, 2010) which is an increase of 0.2 per cent from 169,910 in 2009. The population of Renfrewshire accounts for 3.3 per cent of the total population of Scotland. 17.9% of our population is aged 16-29 and 22.9% is aged 60 or over. Since 1984, our total population has fallen overall compared to Scotland which has risen over the same period. The Scottish Index of Multiple Deprivation (SIMD) 2009 shows Renfrewshire to have a population of 29,190 within the most deprived 15% in Scotland. This is an 11% increase from the SIMD 2006 in which Renfrewshire had a population of 26,321 within the most deprived 15%. This still compares well to the SIMD 2004 position, where a population of 32,450 lived within the most deprived 15% areas in Scotland. Page 3

Drugs The national prevalence study carried out in 2006 estimated that the number of drug users (opiate and/or benzodiazepine) in Renfrewshire was 2083 (1.84%); Scotland was 55,328 (1.62%). The estimated number of drug injectors was 1,024 (0.90%); Scotland was 23,933 (0.71%). The number of new individuals attending treatment services in 2009/10 in Renfrewshire was 474 with an average age of 31 with the majority reporting the use of heroin (Source: Drug Misuse Statistics Scotland, Information and Statistics Division, 2010). From 1 st April 2009 to 31 st March 2011 there have been 2987 referrals to Drug and Alcohol Services in Renfrewshire. 141 (5%) were in the 0-18 age group with the remaining 2846 (95%) were aged 19 years and older (Source: SUMS, Renfrewshire Council, 2011). In 2009 there were 26 drug related deaths in Renfrewshire heroin was involved in the majority of deaths and 80% of deaths were known to have issues with problematic alcohol use at some point in their lives. According to the most recent SALSUS report 2006 carried out in Renfrewshire 8% of 13 year olds and 26% of 15 year olds reported having used or taken drugs and 3% of 13 year olds reported using drugs in the last month compared to 11% of 15 year olds. Based on those who had used drugs, the average age of pupils when they first tried using drugs was 13 year olds. The most commonly drug used in the last month was cannabis (11%).(Source: Scottish Schools Adolescent Lifestyle and Substance Misuse Survey, SALSUS, 2006) In Renfrewshire s Health and Wellbeing Survey of Secondary School age Young People (2008) 4% of lower school pupils and 24% of upper school pupils reported taking drugs in the last year. Alcohol In 2009/10 there were 1,527 general acute inpatient and day case discharges with an alcohol related diagnosis and 268 psychiatric inpatient discharges (2009/10) with an alcohol related diagnosis, in Renfrewshire. The alcohol related death (underlying cause) rate per 100,000 population in 2009 was 28.8 for males and 16.0 for females for Renfrewshire. (Scotland, 30.0 in males; 14.4 in females) According to Health and Wellbeing Survey (2008) nearly 40% of males and 25% of females exceeded the recommended weekly alcohol limits who had a drink in the last week, in Renfrewshire (Source: NHS Greater Glasgow and Clyde, Health and Wellbeing Survey, 2008). The findings from the SALSUS report 2006 showed that 10% of 13 year olds and 27% of 15 year olds reported that they usually drink alcohol at least once a week. All pupils who had ever had an alcohol drink were asked whether they had ever been drunk 37% had never been really, 16% had been drunk once, 21% had been drunk 2-3 times, 14% had been drunk 4-10 times and 13% had been drunk more than Page 4

10 times. 14% of pupils reported that they had five or more drinks on the same occasion four times or more in the last 30 days. A full needs assessment for Renfrewshire ADP is detailed in Appendix 2. 3. National Frameworks The Scottish Government published 'The Road to Recovery' in May 2008 and 'Changing Scotland s Relationship with Alcohol: A Framework for Action' in March 2009. The drugs strategy and the alcohol framework marks a new beginning and both signalled the need to ensure that local delivery of alcohol and drugs services were effective, efficient, accountable and able to contribute to local and national outcomes. The Road to Recovery goes on to describe recovery as a process through which an individual is enabled to move on from their problem drug use, towards a drug-free life as an active and contributing member of society". The strategy does recognise that recovery will mean different things, at different times to different people. The recovery journey is an aspirational, person-centred process. There is clear agreement that individuals who have addiction problems require highly flexible treatment and support options which respond specifically to their own circumstances and needs. Both strategic frameworks will assist the ADP in driving forward the recovery agenda on drugs and applying a whole population approach to alcohol. This will help us to provide further support and drive to build on existing service provision, joint delivery of prevention services, screening and brief interventions, joint specialist services which are all recognised for the central role they play in driving individual behaviour change. Changing Scotland s Relationship with Alcohol: A Framework for Action In March 2009 the Scottish Government published Changing Scotland s Relationship with Alcohol: A Framework for Action. The Framework sets out the strategy for tackling alcohol misuse in Scotland and adopts a whole population approach with specific interventions targeting particular groups. The Framework sets out the Scottish Government s strategic approach to tackling alcohol misuse in Scotland and will inform our Strategic Priorities detailed later in the Strategy. The Scottish Government makes clear that they are not anti-alcohol but are anti-alcohol misuse recognising that the impact and extent of alcohol misuse requires a new approach. Significant increase in the affordability of alcohol (alcohol is now 70% more affordable than in 1980 and has helped drive an increase in consumption of 19% over the same period. This has led to significant increases in deaths and illness. The Framework identifies the need for sustained action in four areas:- Reduced alcohol consumption Page 5

Supporting families and communities Positive public attitudes, positive choices Improved treatment and support The Road to Recovery A New Approach to Tackling Scotland s Drug Problem Scotland s Drug Strategy Road to Recovery: A New Approach to Tackling Scotland s Drug Problem was published in May 2008 outlining their vision for the future direction of drug services. Central to the new approach is a cultural shift focusing on the concept of recovery a process through which a person is enabled to move on from their problem drug use towards a drug-free life and become an active and contributing member of society. This will mean a significant change in both the way services are commissioned and in the way practitioners work with individuals. The purpose of the Strategy is: To signal a step change in the way that Scotland deals with its drug problem. To explain how we need to change our way of thinking about drug use, and to set out what actions are effective in tackling it. Above all, to set out a new vision where all our drug treatment and rehabilitation services are based on the principle of recovery. The document sets out Scotland's objectives in tackling drug misuse and the action plan required to assist in meeting them which are based around the following four themes:- Preventing Drug Use Promoting Recovery Law Enforcement Getting it Right for Children in Substance Misusing Families There is a strong focus on recovery for individuals and outcomes, and the Strategy incorporates the range of services which will facilitate this for individuals. Other key policy documents - Quality Alcohol Treatment and Support (QATS) Scottish Ministerial Advisory Committee on Alcohol Problems (SMACAP) Essential Services Working Group The Quality Alcohol Treatment and Support (QATS) Report was published by the Scottish Government in March 2011. The Report focuses on tier 3 and 4 alcohol services and advocates for a person-centred, recovery-focused approach ensuring the unique needs of individuals are identified and met. The Healthcare Quality Strategy for Scotland (2010) has informed this report Page 6

which also advocates the importance of person-centred treatment and support and the focus on outcomes. The recommendations within this report seek to strengthen this approach and improve consistency of service planning and delivery throughout Scotland. The recommendations highlighted within this key report will underpin service delivery across Renfrewshire. Supporting the Development of Scotland s Alcohol and Drug Workforce This is a joint Scottish Government and CoSLA statement published in December 2010. The statement targets anyone who has a key role in improving outcomes for individuals, families or communities experiencing problematic drug and alcohol use. The key purpose of the statement is to:- Set out why action is required to develop the alcohol and drug workforce and to outline the important roles and contributions of those directly involved in this area; Acknowledge the need for strategic leadership and outlines the responsibilities of decision makers at national and local level; Set out learning prioritiies for all levels of the drug and alcohol workforce The ADP is currently working towards producing a Workforce Development Plan and will be fully informed by a Training Needs Analysis which is being developed. 4. Building on Strengths Planning Structures in Renfrewshire In April 2009 the Scottish Government launched a new framework for local partnerships on alcohol and drugs, which was jointly signed by the Scottish Government, NHS and the Convention of Scottish Local Authorities (COSLA). The framework confirmed the creation of new dedicated partnerships on alcohol and drugs to be known as Alcohol and Drug Partnerships (ADPs). These replaced the previous model of Alcohol and Drug Action Teams (ADATs). The national framework states that ADPs will operate in each local authority area and should be firmly embedded within wider arrangements for community planning (organisational chart detailed in appendix one). The national framework aims to ensure that all partners are clear about their roles and responsibilities and to focus activity on the identification, pursuit and achievement of agreed outcomes. The new framework has been developed to enable the Government to work towards achieving their overall purpose and strategic objectives set out in their Economic Strategy (2007). Their purpose is to focus the Government and public services on creating a more successful country, with opportunities for all of Scotland to flourish, through increasing sustainable economic growth. (Scottish Government (2007) The Government Economic Strategy. Edinburgh: Scottish Government). The Scottish Government s purpose is supported by five strategic objectives to make Scotland wealthier and fairer, smarter, healthier, safer and stronger and greener supported by 15 national outcomes and measured through 45 national indicators which make up the National Performance Framework. Page 7

Improvements in drugs and alcohol problems will help to contribute to a number of these outcomes. The National Outcomes most relevant to alcohol and drugs are: Outcome 2 Outcome 4 Outcome 5 Outcome 6 Outcome 7 Outcome 8 Outcome 9 Outcome 11 Economic potential Young people successful learners Children get the best start in life Longer, healthier lives Tackled inequalities Improved life chances of those at risk Lives safe from crime, danger & disorder Strong, resilient communities The impact will be measured through the Renfrewshire s Single Outcome Agreements (SOAs) which formed part of the Concordat agreed in 2007 between Scottish Government and local government. This will enable each local authority area to identify their contribution in achieving their local outcomes and meeting the Government s overall purpose for Scotland. Renfrewshire Alcohol and Drug Partnership The Renfrewshire Alcohol and Drug Partnership was established in October 2009 with the responsibility of delivering a shared vision of the kind of outcomes partners want to see in Renfrewshire and to set out the way in which they will be achieved. The governance and accountability arrangements for the ADP forms part of the existing arrangements between Scottish Government and Community Planning Partnerships (CPPs) via their Single Outcome Agreement and the NHS Performance Management arrangements via HEAT Targets. Membership of the ADP comprises of senior representatives from a variety of agencies in Renfrewshire which include: Renfrewshire Council Renfrewshire Community Health Partnership Strathclyde Police Strathclyde Fire and Rescue Voluntary Sector Service Users The ADP will ensure the delivery of key outcomes to address alcohol problems and drug misuse in Renfrewshire; influence the planning and commissioning of appropriate services and ensure that the provision of these services meet local needs and priorities. Page 8

The work of the ADP is supported by a range of sub groups which drives national and local focussed work identified by the ADP. These groups report to the ADP and contribute to overall outcomes focussed work in line with Single Outcome Agreements. The groups meet on a planned basis prior to ADP meeting cycles to ensure issues in relation to funding, reporting and planning are co-ordinated. Planning structures within Renfrewshire will be reviewed on a regular basis to ensure they continue to meet our Strategic Outcome Priority Areas. The groups supporting the ADP are: Addictions Operational Planning Group Remit of the Group - Preparation of joint plans for drug and alcohol services that reflect the needs of services which meets the needs of service users, carers and key stakeholders; Ensuring the preparation of performance reports as requested by the ADP; Preparing and implementing a joint financial framework for agreement by the ADP; Ensuring the development and implementation of evidence based pathways of care; Providing a forum for discussion and agreement regarding joint operational management issues; Ensure progress on actions between meetings of the ADP. Prevention and Education Group (SPEAR) Remit of the Group Ensuring best practice based on the principles of the Greater Glasgow and Clyde Alcohol and Drug Prevention model; Co-ordinating prevention and education activity; Developing clear channels of communications amongst a wide range of partners including community involvement; Ensuring co-ordinated approach to workforce development; and Coordinating activity and reporting against national HEAT targets Drug Deaths Group Remit of group Collating, analysing and discussing issues in relation to drug related deaths identifying risk factors which could influence future service developments. Working with wider partners to share and disseminate information and areas of good practice in reducing drug related deaths Consideration the key priorities identified within National Audit of Drug Related Deaths Providing reports and statistical information as required. Page 9

Joint Finance Sub Group Remit of group Reviewing financial information from all ADP funded services, as well as core services delivered by the NHS and the Local Authority. Employability/Mental Health Group Remit of group Ensuring best practice based on the principles of the Greater Glasgow and Clyde Alcohol and Drug Prevention model; Co-ordinating employability education activity; Developing clear channels of communications amongst a wide range of partners including community involvement; Ensuring co-ordinated approach to workforce development needs e.g. alcohol screening, early intervention, awareness and training and mental health Coordinating activity and reporting against relevant national HEAT targets for addictions and mental health Links to other relevant groups Children Affected by Parental Substance Misuse (CAPSM) Sub Group Renfrewshire Council Social Work Department in conjunction with wider partners within the Alcohol and Drug Partnership and Child Protection Committee will set up a short life working group to take forward the Scottish Government CAPSM agenda and local strategic changes in relation to this issue. The group will provide focused action planning in relation to CAPSM covering a wide range of themes which require reviewing/updating in relation to CAPSM. This will include work in relation to the Renfrewshire Getting Our Priorities Right (GOPR) protocols and Integrated Assessment Framework within the CAPSM agenda. The work will also reflect the work in relation to the Government s review of Getting Our Priorities Right. Data collection and assessment quality in relation to CAPSM will be explored and agreed. The group will also review inter-disciplinary working across organisations and ensure the care of women and their families are prioritised and explore the work in relation to fathers and partners (where appropriate) where there are addiction issues and parenting responsibility. The work will acknowledge the recommendations set out within the toolkit for Alcohol and Drug Partnerships and translate this into local actions. North Strathclyde Community Justice Authority Renfrewshire is the lead authority of North Strathclyde Community Justice Authority (NSCJA). The key role of NSCJA is to provide leadership in the Page 10

planning and co-ordination of justice services in order to create a reduction in reoffending. The authority monitors and receives reports on the progress towards achieving this aim. Local authority councillors make up NSCJA which has a range of statutory partners including: The constituent local authorities: Argyll & Bute; East Dunbartonshire; East Renfrewshire; Inverclyde; Renfrewshire and West Dunbartonshire. Scottish Prison Service Strathclyde Police NHS Greater Glasgow & Clyde NHS Highland Scottish Court Service Crown Office and Procurator Fiscal Service Victim Support Scotland Voluntary organisations who receive funding of over 100,000 from councils to provide services to offenders and their families. Many offenders are identified as having substance misuse problems, as such the NSCJA Area Plan 2011-14 includes within its aims and objectives, to reduce the instance of alcohol related crime, and to engage with Community Health and Care Partnerships (CHPs) in the NSCJA area to ensure delivery of services for offenders and their families to meet relevant HEAT targets. As a result close links have been established with NSCJA, the chair of Renfrewshire ADP is a statutory partner of NSCJA. Licensing Renfrewshire Licensing Board The Renfrewshire Licensing Board has a statutory duty to deal with licence applications relating to the sale of alcohol. The Board launched their Joint Alcohol Policy Statement which committed members to work together in setting and delivering on challenging local action to reduce ill health and alcohol related harm under five key priorities:- Reducing alcohol related deaths and hospital admissions through the continuous improvement of alcohol services; Reducing alcohol consumption levels in the whole population and in specific target groups who binge or drink harmfully; Reducing alcohol related crime, violence and disorder; Reducing harm to children affected by alcohol problems in the family; Promoting responsible alcohol consumption among our employees and raising awareness of alcohol related harm in our role as an employer, as partners with a wide range of organisations and as procurer of services. Page 11

Renfrewshire Local Licensing Forum The role of the Forum is to keep the operation of the licensing system in Renfrewshire under review and to give advice and recommendations to the Licensing Board. This does not include reviewing, offering advice or making recommendations in relation to any particular application or case before the Board. The Licensing Board has the duty to 'have regard' to the forum's views and must offer reasons where it takes decisions against the advice of the forum. 5. Current Service Provision in Renfrewshire Across Renfrewshire alcohol and drug services are delivered by a wide range of partners:- Renfrewshire Drug Service This tier 3 specialist health drug service is fully integrated with the social work drug service and is co-located in Paisley. Renfrewshire Drug Service has been operating an integrated system offering a single point of referral for approximately 20 years. Renfrewshire Drug Service is the core service for accessing a broad range of interventions including assessment and care planning, low threshold service, access to substitute prescribing, health screening, harm reduction, needle exchange, detoxification and abstinence support. There are well established systems to support complex individuals through treatment and recovery with substitute prescribing provided by the core service but the key worker may be an Area Team Drug Worker, Family Matters Drug Worker or CACTUS (Creating Alternatives to Custody Through Understanding and Support) worker. The Service also supports the General Practitioner (GP) Local Enhanced Scheme offering either nursing or drug work support to 18 GP Practices. Needle Exchange Services operate throughout the week in Renfrewshire Drug Service and promote Harm Reduction and the encouragement of service users into mainstream services for recovery focussed treatment. The Low Threshold Service takes referrals from injecting individuals and fast tracks them into treatment. Within Area Teams in Renfrewshire there are a number of specialist posts and services which support work within the core service. SNIPS (Special Needs in Pregnancy Service) provides specialist health provision to pregnant women and enables safe prescribing and monitoring of women during their pregnancy. This Service is complemented by New Expectations which provides early intervention, support and assessment to pregnant drug users Page 12

and Family Matters which enable families to then make the transition to a family focussed service providing parenting support, groupwork and access to prescribing, if required. In addition there are a number of Area Team Drug and Alcohol Workers who also provide family focussed support to parents who use substances. These posts are based in Paisley, Johnstone and Renfrew and provide support to families where there may be statutory involvement due to substance misuse. A particular remit of these posts is to support the work outlined in the Renfrewshire Child Protection Committee s Protecting Children Protocols (2006). To further support this work there are Outreach Drugs Workers located in each of the Area Teams to ensure families affected by substance use are identified and receive specialist assessment and support. Renfrewshire Alcohol Service Alcohol Problems Clinic Specialist health alcohol services (Tier 3) are provided via the Alcohol Problems Clinic (APC) and the Integrated Alcohol Team (IAT), based at Dykebar Hospital in Paisley. The APC provides a service to individuals with alcohol dependence, there is an abstinence based approach and offers detoxification, a range of psychosocial interventions, and long term support. Service provision is delivered on a day service basis with a social worker attached to the service to provide home support and outreach as appropriate. In-patient detoxification is provided at the Kershaw Unit in Gartnavel Royal Hospital. The Acute Alcohol Liaison Staff are also based in the APC and provide an assessment, brief intervention and direct link to the Royal Alexandra Hospital. Access to the service is by professional referral only with fast track access for individuals involved with RCA Trust. Integrated Alcohol Team The Integrated Alcohol Team (IAT) was established in April 2010 and is based at Dykebar Hospital. The Team provides a comprehensive, multi-disciplinary and multi-agency response to individuals with alcohol problems. The Team provides a range of interventions including assertive outreach, motivational sessions, harm reduction, community detox, relapse prevention and health improvement. The Team work with individuals who are abstinent or continue to drink and offer support at home for those who require it. The Team also work closely with the Alcohol Problems Clinic and the Acute Alcohol Liaison Staff as well as Mental Health Services. A team member also provides support to Renfrewshire Drug Service for individuals who receive substitute prescribing but are drinking dependently. RCA Trust RCA Trust is a registered charity which provides a number of interventions for individuals with alcohol problems. These interventions range from the open door Alcohol Advice Centre which offers information, advice and counselling Page 13

to individuals with or affected by alcohol use to more specialist services. These include an Offenders Referral Scheme that accepts referrals from the Sheriff Court, Procurator Fiscal and Social Work Supervising Officers and a Drink Drivers Offender Scheme. RCA Trust rehabilitation services include ten supported accommodation flats in Renfrewshire and a floating support service assisting individuals with complex needs to maintain their own tenancies. Depending on service the rehabilitation team offers assessment, counselling, social and budgeting skills to enable individuals to sustain their own tenancies. Additional counselling services are available to companies. RCA Trust also offers advice and counselling to people with or affected by gambling problems. RCA Trust offers specialist training to other agencies. CACTUS (Creating Alternatives to Custody Through Understanding and Support) CACTUS, which is managed by Turning Point Scotland, provides a community based service to individuals whose substance use has resulted in involvement in the Criminal Justice System. The Service operates a prompt referral system to Courts and Criminal Justice Social Work Teams. Assessment appointments are issued within seven days of referral date and same day appointments can be offered at the referrer s request. A comprehensive drug and alcohol assessment is carried out with each individual referred to the service. Anyone who is assessed and is deemed unsuitable for the day programme will be referred on to a more appropriate service(s). The service offers person centred support within a structured programme which consists of: at least one weekly scheduled appointment with an allocated key worker, daily appointments for chaotic service users requiring intense support, weekly group work and monthly interactive workshops which are also open to staff and service users from external agencies. The service also offers computer classes and access to gym membership. If service users require access to substitute prescribing this can be facilitated through our partnership work with Renfrewshire Drugs Service where a clinic is held every two weeks. CACTUS attends statutory reviews and facilitates regular multi agency reviews with individuals. In addition, the Service provides an Arrest Referral Scheme to Courts and Police which is operated across Renfrewshire, Inverclyde and East Renfrewshire. Staff attend court daily to offer a signposting service to individuals who are identified as having a substance misuse issue. Criminal Justice Criminal justice social work in Renfrewshire provides addiction services to offenders in a number of ways: Criminal Justice presently funds CACTUS and the arrest referral service, and an Offender Referral Service within RCA Trust to deliver or link offenders to addiction services. Page 14

A Throughcare Addiction Service (TAS) is provided to Renfrewshire clients managed by the Criminal Justice Throughcare team in Inverclyde. This service links offenders to addiction services, and provides additional support on release from custody. Drug Treatment and Testing Orders (DTTO) imposed on Renfrewshire clients where their high tariff offending is related to their drug use is provided by an integrated health and social work service managed by East Renfrewshire criminal justice. Criminal Justice staff undertake or have an overview of the delivery of addiction interventions where it is a condition of a probation order. Groupwork services address addiction issues within accredited programmes, women offender programmes and lifeskills groups. Offenders convicted of offences dating from 1 February 2011 can be made subject to Community Payback Orders (CPOs), this replaces Probation, Community Service and Supervised Attendance Orders, but not DTTOs. CPOs consist of nine requirements, including an Alcohol Treatment Requirement for dependant drinkers where the individual s dependence on alcohol contributes to the offending behaviour; and a Drug Treatment Requirement when there are drug issues identified, but where an individual has not established a chronic history of drug misuse and their offending history is not sufficiently high tariff to consider a DTTO. In these cases assessment for suitability is undertaken by the relevant addiction service at the Criminal Justice Social Work report stage, and the criminal justice social worker will oversee the attendance at these services whilst providing related interventions. Turnaround Community staff are based with criminal justice groupwork services within Renfrewshire, providing a range of interventions to offenders subject to Community Payback Orders, which includes addressing their addiction issues. Turnaround Turnaround is a unique partnership between three national voluntary sector organisations - Turning Point Scotland, Apex Scotland and Venture Trust funded through the Scottish Government criminal justice grant. Turnaround focuses on young men aged 18-30 years whose offending is persistent, high volume, low tariff and who are failing in other communitybased alternatives, or who have had multiple remand or short-term prison sentences, with priority to those individuals who may be vulnerable due to substance misuse, mental health issues, homelessness, lack of coping/social skills etc. A holistic, person centred and needs led approach is taken to help service users consider their offending, its causes, the impact on victims and communities and at strategies for moving forward. Turnaround works jointly with services within the community to offer these interventions within an interagency approach. An opportunity for a period of safe supported accommodation for the most vulnerable is also available within the residential unit. With referrals coming Page 15

from the courts, criminal justice social work and the Scottish Prison Service, Turnaround will offer assessment, support planning, one-to-one and group interventions to service users within their own communities. The community element has been in place since 1 st April 2011 and is funded for one year. Staff within criminal justice groupwork services in Paisley are undertaking addictions work within a range of interventions to address offending behaviours. Interventions include offender awareness, substance misuse programmes, anger management, parenting, social skills, confidence and esteem building, employability and life skills. Strathclyde Police Strathclyde Police is involved in a wide range of specialist service provision and partnership working within the Renfrewshire area, including Education, Prevention and Enforcement. Strathclyde Police has recently reviewed and streamlined many of their services, ensuring that the public continue to receive the highest quality of service. Within K Division which covers the Renfrewshire area, there are numerous specialist departments and posts supporting the core police activities. This includes our newly appointed "Campus Officers" working in partnership with local schools, daily engaging with young people and their concerns. These officers provide education and support on all alcohol and drug related issues affecting our young people in Renfrewshire. The recent streamlining of the Community Safety Department allows for our Community Safety Coordinator to develop and deliver focused initiatives in a productive manner, again in partnership with addiction and mainstream community services. This new role now incorporated into the Violent Crime Reduction Unit allows for a more sustainable approach and prescribed manner of action. Again change has also hit the enforcement side of Local Policing. The new Variable Shift Arrangement is allowing front line officers greater resources during "peak" hours. A combination of a response team and community policing teams allows operational policing to be carried out in a thorough and robust manner. The success of the Early and Effective Intervention Scheme, has seen a large number of suitable local young people who have came to the attention of the police being redirected away from the criminal process and into support services addressing amongst other issues alcohol and substance misuse. 6. Renfrewshire s Strategic Priority Outcome Areas Renfrewshire ADP will focus on the following strategic priority areas which are aligned to the National Frameworks for Drugs and Alcohol. Page 16

Preventing Drug and Alcohol Misuse Renfrewshire ADP will work to prevent harm in Renfrewshire caused by alcohol and drugs by adopting a holistic approach to prevention and education work which will be underpinned by the Greater Glasgow and Clyde Prevention and Education Model. The key strategic priority outcomes we aim to deliver are:- 1. Increased knowledge and changed attitudes to alcohol, drinking and drugs. 2. Fewer individuals drink above recommended limits. 3. Reduced per capita consumption. 4. Reduced alcohol consumption of alcohol by young people 5. Reduced drug taking 6. Reduced substance misuse in communities at risk Some of the key actions we will take to deliver our strategic priority outcomes are:- Information on the risks associated with alcohol and drug misuse will be made available to the public and will promote early intervention for young people through substance misuse education particularly in schools. We will support community led initiatives in Renfrewshire to develop whole population approaches that create environments which discourage alcohol and drug misuse and encourage cultural change. Implement the delivery of alcohol screening and brief intervention as outlined in Sign 74 and where necessary, to refer on to appropriate services. We will promote healthy activities, such as sports, hobbies and other such interests to divert people becoming involved in alcohol and drug misuse. Work with local media to challenge and reduce stigma associated with drug and/or alcohol misuse. Support the development of the alcohol and drug workforce in their role in preventing alcohol and drug misuse. Early work on shared data with Strathclyde Police shows that there is more crim, violence and poor health coutcomes in areas with higher levels of alcohol provision. We already have an over provision statement for central Paisley and will continue to work with partners to extend this in other parts of Renfrewshire. Page 17

We will implement Triple P to support parents and teenagers to work towards improved behaviour and lifestyle outcomes. High level Triple P interventions are available for families where drug or alcohol misuse is a problem. We are also exploring the use of an evidence based programme called Life Skills Training which is delivered in schools to build confidence in young people to make sensible choices around drugs, alcohol and smoking. Promoting Recovery In 2008, the Scottish Government s vision of a recovery-based model for treatment and rehabilitation saw a shift away from a focus primarily on reduction of personal and social pathology, towards a model based on improving the quality of life of the individual by developing recovery-supportive communities and services. Furthermore, the strategy states that the explicit purpose of all treatment services is recovery and that service users needs and aspirations should be placed at the centre of their care and treatment in other words an aspirational, person-centred process. Renfrewshire ADP wants all alcohol and drug services to reflect the Scottish Government s Recovery agenda. Therefore, the key strategic priority outcomes we aim to deliver are:- 1. The implementation of the recovery model in all drug and alcohol services. 2. The drug and alcohol workforce will be competent and have the necessary skills to support the recovery agenda. 3. Individuals in need receive timely, sensitive and appropriate support. 4. A reduction in the number of drug related deaths. 5. Services are compliant with national quality standards for substance misuse. 6. Meaningful involvement of service users in local planning structures, service redesign and service development. 7. Recovery communities will be developed to engage and support self aid and peer support groups. Some of the key actions we will take to deliver our strategic priority outcomes are:- Recovery plans and recording systems will be reviewed. Service monitoring and evaluation will be developed for drug services to provide ongoing review for workers and supervisors to ensure care plans are current and relevant to individuals stage of recovery. Consideration will be given to the implementation of the electronic single shared assessment and care planning system developed by Glasgow Addiction Services. Ensure consistency is the use of personal outcome scores and develop reporting systems. Page 18

Engage problem drug users in social inclusion activities which are consistent recovery focussed. Continue to support services users into education, training, volunteering and employment opportunities. Develop Workforce Development Plan in line with whole population approach for alcohol and recovery approach to drugs. Ensure continuous improvement of services across partnerships offering early intervention in a wide range of settings, better access and a comprehensive range of specialist services. Develop Alcohol Related Brain Damage (ARBD) Action Plan and increase the provision of appropriate responses in the community through the development of Care Pathways. Individuals will have their housing needs assessed and referred on or will liaise with housing officers to sustain tenancy. Law Enforcement Issues of violence, disorder and antisocial behaviour have a significant negative impact on communities, damaging levels of social trust and destroying civic pride and participation. There is a clear expectation from the public that the police should play a leading role in tackling these issues. The 2010 Force Public Consultation survey revealed that the public listed drunk and disorderly behaviour, drug misuse and violent crime in their top three public priorities for local policing. The key strategic priority outcomes we aim to deliver are:- 1. A reduction in levels of alcohol related violence and disorder. 2. An enhanced approach to target those involved in the illegal supply of controlled drugs. The key actions we will take to deliver our strategic priority outcomes are:- Continue enforcement actions to reduce the availability of illicit drugs and unlawful supply of alcohol. Work with partners to provide long-term solutions to the issues of alcohol and drug related crime across Renfrewshire. Develop and implement a Persistent Offenders Project in partnership with Renfrewshire and Inverclyde Councils. Children Affected by Parental Substance Misuse (CAPSM) Children who live with parents who have drug and alcohol problems are among the most vulnerable in society. The UK Hidden Harm report 2003, the Getting Our Priorities Right guide in Scotland (2001 and 2003) and the Scottish Executive response to Hidden Harm (2004) have been key drivers in improving support for children affected by parental substance misuse at national and local level. Page 19

Building on the success of these two documents, the National Drugs Strategy, emphasises that we must do more at a local level to achieve the following key strategic priority outcomes:- The best possible start for every child will be achieved through effective prevention and early interventions. The capacity of universal and targeted services to improve the identification, assessment, recording and planning for children at risk will be strengthened. The capacity, availability and quality of support services for children and families affected by parental substance misuse will be strengthened. The consistency and effectiveness of the management of those children known to be at immediate risk will be enhanced. Communities will be supported to protect children by encouraging the public to report concerns Some of the key actions we will take to deliver our strategic priority outcomes are:- We will work in partnership with Barnardos in an initiative to deliver outreach services to some of the most vulnerable clients in contact with childcare services in Renfrewshire. This project will provide support outwith core hours and report on outcomes through the ADP who has part funded this in conjunction with Barnardos and Lloyds TSB. Partnership work in relation to the Integrated Assessment Framework and compatibility with existing protocols and guidelines to ensure CAPSM is incorporated within. Continue to support work in relation to findings identified within the Early and Effective Intervention Screening group which has identified young people affected by parental substance misuse and at early stages of being at risk from their own alcohol consumption. The ADP has supported further work in relation to the Troubled Streets DVD. The establishment of a CAPSM group to take forward and monitor work in relation to CAPSM which will continue to strategically direct focussed work in relation to the GOPR protocols and further training established. Continue to develop services in relation to substance misusing families including work through the newly developed Integrated Alcohol Team and further shape roles within to support children. Carry out a review of drug services and ensure that family focussed recovery interventions are evident. Renfrewshire GOPR Impact Analysis Renfrewshire has continued it's commitment to the Renfrewshire Child Protection Committee's GOPR training in relation to the protocols resulting in 2,701 participants to date being trained from the Voluntary Sector, Education, Social Work and Health etc. In conjunction with STRADA an Page 20

Impact Analysis of the training was carried out with stakeholders, workers, managers and service users and the conclusions and recommendations were presented at an event to further inform work in relation to the protocols. Staff reported positively in relation to the training and confirmed the impact of training in relation to changes in practice, knowledge and confidence in managing parental substance misuse within their workload. The work will inform the strategic direction in relation to training and will also be a remit of the CAPSM group and Renfrewshire Child Protection Committee. 7. National Core Outcomes There is also work underway, nationally, to develop core outcomes and indicators which ADPs will be responsible for collecting which relate to our Strategic Priority Outcome Areas detailed in section six. These will also feature within the ADP s Delivery Plan and will be measured on an annual basis:- HEALTH: People are healthier and experience fewer risks as a result of alcohol and drug use: a range of improvements to physical and mental health, as well wider well-being, should be experienced by individuals and communities where harmful drug and alcohol use is being reduced, including fewer acute and long-term risks to physical and mental health, and a reduced risk of drug or alcohol-related mortality. 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 lifechances and may reduce the likelihood of individuals developing problematic use in the future. 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. CAPSM: 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. COMMUNITY SAFETY: Communities and individuals are safe from alcohol and drug related offending and anti-social behaviour: reducing alcohol and drugrelated offending, re-offending and anti-social behaviour, including violence, acquisitive crime, drug-dealing and driving while intoxicated, will make a positive Page 21

contribution in ensuring safer, stronger, happier and more resilient communities. 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. 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. 8. Commissioning Strategy The Renfrewshire Alcohol and Drug Partnership Commissioning Strategy is currently work in progress and will be developed with contributions from a range of partners and will be based on the findings of the needs assessment. The aim of the Commissioning Strategy is to enable partners to identify how services will support the ADP s strategic outcome priority areas. It will also provide a framework for evaluating the quality of these services, the effectiveness of their contribution, and the extent to which they meet the needs of service users and the wider community. This requires the ADP to: Identify measurable outcomes for all partners. Ensure service user outcomes are at the centre of the strategic planning process. Ensure contracting processes are transparent and fair. Systematically monitor and evaluate the performance of purchased services and ensure that this influences on-going reviews of the Commissioning Strategy and plans. The Commissioning Strategy therefore aims to outline: The current and anticipated future operating context for drug and alcohol services The key stakeholders within each care group The identified areas for improvement The commissioning and purchasing priorities in support of these areas The financial framework in which these priorities will be pursued. Page 22

It should be noted that the Commissioning Strategy will be a working document and will be subject to ongoing and regular review. 9. Financial Framework This section provides a short financial summary of the level of resources provided by NHS and Local Authorioty partners as at 31 st March 2011. Partner Organisation/Service Area 000 NHS Integrated Alcohol Team 683 Renfrewshire Drugs Service - Health 736 Addictions Secondary Services 953 Alcohol Drugs Partnership Support 84 Income (149) NHS Total 2,307 Renfrewshire Council Addiction Co-ordinators 80,285 Supported living with Short term Rehab 140,414 RCA Trust 72,984 Addiction Workers at Area Teams 242,993 Family Matters Addiction Workers 96,306 Family Support Drug Workers 36,895 Getting Our Priorities Right (GOPR) 10,760 Group Workers Drug Misuse 35,022 Integrated Alcohol Team 33,289 New Expectations Fund 59,834 Renfrewshire Drug Service 508,818 RCA Trust (funded by Criminal Justice Grant) 26,576 Turning Point Cactus (funded by Criminal Justice Grant 112,227 Aids and Adaptations 2,747 Occupational Therapy 3,926 Homecare 32,010 Housing (HALO) 31,622 Management and Support Services 577,632 Page 23

Total Gross Spend 2,072,718 Less ADP Monies Received -165,250 Total Gross Spend Less ADP Monies Received *1,939,090 Services funded from NHS budgets are included above under NHS, even where the services are actually provided by Renfrewshire Council staff. * There are shared Criminal Justice services across Renfrewshire, East Renfrewshire and Inverclyde i.e. Drug Treatment & Testing Orders (DTTO), Throughcare Addiction Service (TAS), Arrest Referral. The costs above specifically relate to Social Work, other costs may sit in within other Council services e.g. Housing 10. Monitoring and Reviewing the Strategy This three year Strategy will be monitored on an annual basis by the ADP via the development and implementation of the ADP Delivery Plan. Within the Delivery Plan each action will have an identified lead in a particular organisation/department and ADP staff will design reporting templates which will be consistent with and build on existing reporting frameworks. Page 24

Appendix One Renfrewshire Community Planning Partnership Reporting Structures Page 25