Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
East Ayrshire Alcohol and Drugs Partnership Delivery Plan 2012 - 2015 1 Introduction This delivery plan for the years 2012 – 2015 sets out the strategic direction of East Ayrshire Alcohol and Drugs Partnership for the three year period. This delivery plan, as the reporting instrument for Scottish Government, further sets out the key strategic aims of the East Ayrshire as well as the specific changes that the ADP wish to see occur. It is therefore crucial that in viewing this delivery plan it is viewed in context alongside the ADP alcohol and drugs strategy (and associated documentation including the treatment and recovery needs assessment, commissioning strategy), the East Ayrshire Single Outcome Agreement (SOA) as well as the East Ayrshire Community Plan. 2 Key Changes East Ayrshire ADP during the lifetime of the delivery plan seek to shift the balance of care from specialist services at tier 3 to universal/community based interventions at Tier 1. The diagram below seeks to illustrate this process. Tier 1 – Interventions available within broader community settings, such as education, training, Welfare rights, housing, meaningful activities and employability services COMMUNITY TIER 2 - Local services including harm reduction team and local counseling services SERVICES TIER 4- Inpatient/ residential Raising aspirations and hope TIER 3 – Specialist alcohol and drug support services 3 In shifting this balance of care, East Ayrshire ADP will prioritise:1. Increasing the number of problem drug/alcohol users being discharged from service to positive destinations, 2. Decreasing the impact of problem drug/alcohol use on local communities. 3. Enhance the availability and ability to access support and advice for people affected by problematic substance use 4. Minimise risks to children as a consequence of substance misuse by ensuring early intervention and support is available. 5. Minimise risks to vulnerable adults as a consequence of substance misuse by ensuring early intervention and support is available 6. Quantify the total cost to the Community Planning partnership of alcohol and drug use in East Ayrshire. 4 Core & Local Outcomes to be achieved ADP stream work Local outcomes Core alcohol outcomes drug Local SOA Outcome 2.2 Education: Preventing alcohol and drug use in young people Decrease the proportion of young people who have been offered drugs in the last year Fewer adults and children are drinking or using drugs at levels or patterns that are damaging to themselves or others (CO2) Alcohol and Drug Related Harm reduced 2.3 Prevention Community Focused: Positive attitudes positive choices Decrease the proportion of individuals drinking above daily and/or weekly recommended limits People are healthier and experience fewer risks as a result of alcohol and drug use (CO1) Increase in services offering leisure and recreation Fewer adults and children are drinking or using drugs at levels or patterns that are damaging to themselves or others (CO2) 2.4 Prevention Early Intervention: Supporting families and communities reduction in the number of maternities recording drug or alcohol use Children and family members of people who misuse alcohol and drugs are safe, well supported and have improved life chances (CO4) Decrease the proportion of 13 year olds who have had an alcoholic drink. Minimise the number of children looked after and accommodated/separated from parents by reducing the impact of parental substance misuse Increased number of children affected by parental alcohol/drug use identified 5 and National Outcomes We live healthier lives longer, We have tackled the significant inequalities in Scottish society. We have improved the life chances for children, young people and families at risk. We live our lives safe from crime, disorder and danger. We have strong, resilient and supportive communities where people take responsibility for their own actions and how they affect others. ADP stream work 2.5 Treatment and Recovery: Promoting Recovery Local outcomes Core alcohol outcomes Reduction in drug and alcohol related morbidity, mortality and deaths Increase available treatment options in order to enable individuals to move on from problem drug use, towards a drug free life. Reduction in drug and alcohol related morbidity, mortality and deaths Increase in drug/alcohol users engaging in employment, education, leisure 2.6 Protection: Reducing consumption and Law Enforcement Reduced alcohol and drug related violence and offences Increased detections possession of drugs for the Increased detection rates for the supply of drugs in the local area and drug Local SOA Outcome Individuals are improving their health, well being and life chances by recovering from problematic alcohol and drug use (CO3) Alcohol and Drug Related Harm reduced Alcohol and drug services are high quality, continually improving, efficient, evidence based and responsive, ensuring people move through treatment into sustained recovery. (CO7) Communities and individuals are safe from alcohol and drug related offending and anti social behaviour (CO5) People live in positive, health promoting local environments where alcohol and drugs are less readily available (CO6) Reduced incidence of alcohol and/ or drug associated Anti-social behaviour Increased use of Community payback Orders as an alternative to Custody to address alcohol/drug related offending. Increased access for offenders to appropriate drug/alcohol services in the community and in custody. Increased refusal of inappropriate alcohol sales 6 National Outcomes We live longer, healthier lives We have tackled the significant inequalities in Scottish society. We have improved the life chances for children, young people and families at risk. We live our lives safe from crime, disorder and danger. We have strong, resilient and supportive communities where people take responsibility for their own actions and how they affect others. Financial Investment In 2012/13, The Scottish Government allocation for Ayrshire and Arran for alcohol is £2,662,120 and for drug use £1,739,532. Of this total East Ayrshire’s drug allocation is based on 75% prevalence and 25% NHS Scotland Resource Allocation Committee (NRAC). East Ayrshire’s alcohol allocation was based on a whole population split. East Ayrshire ADP receives £660,115 drug misuse funding and £855,624 for alcohol which includes a £51,708 alcohol prison allocation Drugs Funding In 2012/13, East Ayrshire ADP allocated its drugs funding in accordance with the following table organisation NHS Service Funding Model of care tier Substitute prescribing £101,318 3 Prevention services and support £51,414 team 1 Community addiction team £128,535 3 Primary care addiction team £125,148 3 £87,469 2/3 £166,815 2/3 SMART Recovery Addaction Community alcohol recovery service Turning Point SEASTAR – Community recovery service drug £660,699 Total 7 Alcohol Funding In 2012/13, East Ayrshire ADP allocated its alcohol funding in accordance with the following table organisation Service Funding Model of care tier A&E in - patient liaison nurses £77,661 2 Midwives £6,977 1 Community addiction team £138,461 3 Primary care addiction team £135,662 3 Prevention and Service Support £12,497 Team 1 Prison alcohol allocation £51, 708 4 Loudon House residential unit £31,460 4 GP Brief interventions £32,741 1 OT Older People £58,000 2 Strathclyde Presence at A&E Police £7,000 N/A TBC £18,838 1 £30,000 2 NHS Community Capacity building Ayrshire Council on Alcohol and Offenders Alcohol SMART Recovery Addaction Community service Alcohol Recovery £27,919 EAC Children’ Services Officer Locality Group for services for children £243,900 and children affected by parental substance misuse Total £872,824 8 2/3 2 Additional spend East Ayrshire Council Children and Families addiction workers £186,224 Early years addiction workers £55,624 Team manager community Care £48,730 Ayrshire Council on Alcohol £34,992 Turning Point Scotland £118,000 Young Carers £27,812 Total £471,382 NHS Ayrshire and Arran East Ayrshire ADP area £1,322,429 Pan-Ayrshire services £1,310,508* Total £2,632,937 *not able to accurately break this down by locality area as this funding incorporates elements of the Ayrshire wide residential rehabilitation unit, the Prevention and Service Support team and other pan-Ayrshire related costs East Ayrshire ADP is also in the process of attempting to establish total spend across East Ayrshire on dealing with the impact of alcohol and drugs on services and communities. This considerable associated spend highlighted in several national publications including Drug and alcohol services in Scotland (Audit Scotland 2009) once identified further allows the ADP to address strategic objectives and provides a further considerable evidence base for action. East Ayrshire ADP has identified four areas of drug and alcohol spend that are inter related and described by the following diagram 9 Community spend e.g criminal justice Impact Spend eg hospital admissions, child protection, sexual health Direct spend – NHS and East Ayrshire Council SG drug and alcohol allocation 10 Priority Actions & Interventions to Improve Outcomes The East Ayrshire ADP continues to operate within the East Ayrshire Community Planning structure as The Community Plan is recognised by all Partners as the sovereign strategic planning document for the delivery of public services in East Ayrshire Therefore, within this structure, actions delivered by the ADP require to fit with the key strategic priorities of the Community Planning Partnership and its 4 thematic groups towards delivery of the East Ayrshire Single Outcome Agreement (SOA) outcome of reducing alcohol and drug related harm. The Community Planning Partnership Single Outcome Agreement 2011-2015, developed during the four-yearly Review, underpins the Community Plan and provides a robust performance management framework ensuring effective links to the national outcomes. Delivering Community Regeneration In supporting the Community Planning Partnership to deliver community regeneration : The Alcohol and Drug Partnership will seek to establish a network of community therapeutic and strategic ‘recovery champions’ who are visible across the whole system within all organisations and in each locality of East Ayrshire The ADP will work with communities, to challenge their attitudes in relation to their own alcohol consumption and increase knowledge across all age groups to enable individuals to make informed choices about their personal alcohol and drug use Improving Community Safety In supporting the Community Planning Partnership to improve community safety: East Ayrshire Alcohol and Drug Partnership will continue to work with Strathclyde Police in reducing the supply and demand for drugs controlled via the Misuse of Drugs Act 1971. The ADP will work as part of the partnership on the Public Reassurance Model within a specifically identified area of East Ayrshire focusing on the priority concerns of Drunk and Disorderly Behaviour and Drug Dealing and Misuse 11 The ADP will continue to work in partnership with Strathclyde Fire and rescue services to reduce alcohol and drug related fire deaths Improving Health and Wellbeing In supporting the Community Planning Partnership to improve health and wellbeing : East Ayrshire ADP will seek to minimise the number of people for whom long-term abstinence is not a viable option, and, for this group to generate meaningful pathways to maintained recovery. East Ayrshire ADP will further work with communities to build better environments, restore expectations of employment, promote the benefits of education, and promoting the value of living positively East Ayrshire ADP will develop high quality accessible recovery oriented alcohol and drug treatment and support services Promoting lifelong learning In supporting the Community Planning Partnership to promote lifelong learning : East Ayrshire ADP will increase the range of activities for children and young people in the areas of sports, and leisure opportunities to help enable them to develop personally and physically. These sporting and leisure opportunities will seek to address both participation and diversion and aim to increase the likelihood of positive long-term outcomes for those who take part. East Ayrshire Alcohol and Drug Partnership will identify the workforce development needs and work with partners to provide appropriate training opportunities. 12 Key Achievements Whilst this delivery plan seeks to outline the direction of travel for East Ayrshire ADP for the years 2012-15, it is important to note that this delivery plan builds upon significant previous work and successes. Prior to the establishment of the ADP, East Ayrshire Community Planning Partners had prioritised alcohol and drugs and had come together in developing the “Community Planning Alcohol and Drugs Pledge 2008-11”. This pledge was managed via a small multi agency working group chaired by the local authority Chief Executive During 2011/12, there were many areas of joint working with partners across the ADP. Examples of these successes include: Successfully meeting the national HEAT (Health, Improvement, Efficiency, Access, Treatment) target whereby most service users now receive first treatment within three weeks of being referred to service, and all service users received first treatment within five weeks. Supporting NHS Ayrshire & Arran in exceeding the target of delivering 4,076 Alcohol Brief Interventions (ABIs) between April 2011 and March 2012. East Ayrshire staff made an essential contribution in the overall Ayrshire delivery of 7,501 ABIs. Delivery of a successful local ‘alcohol awareness week’ which engaged with over 500 members of the public, heard the views of students and staff at Kilmarnock College and promoted safer levels of alcohol use among the 6000 employees of East Ayrshire Council Allocated resources towards supporting service users develop recovery capital. A local keep fit centre and gym now has regular attendance from drug users where previously none attended. The local boxing club is now aiming to develop drug users in recovery into coaches and mentors for local young people. Worked intensively with drug users on substitute medication managing to reduce levels of prescribing by 499ml among 21 users. Of these 21 drug users, three are now completely drug free and a further three are now a methadone detox regime. Conducted an audit of support services across East Ayrshire (particularly in tiers 1 and 2) 13 Core & Local Indicators to enable progress to be measured National Core Outcomes indicators Sources Local Outcomes Baseline Scotland average East Ayrshire People are healthier and experience fewer risks as a result of alcohol and drug use (CO1) Rate of drug-related hospital discharges (three year rolling average) 2007/10 ISD Scotland Reduction in patients hospitalised with alcohol conditions SAMS Reduction in deaths from alcohol related diseases FACE Rate of alcohol-related hospital discharge rates (three year rolling average) 2007/10 Reduction in patients hospitalised with drug related conditions Reduction in the proportion of IV drug users reporting sharing needles or syringes Rate of alcohol-related mortality (three year rolling average) 2008/10 Increase distribution of needles and syringes Percentage of injecting drug users testing positive for HVC antibody (% is based on all injecting drug users tested) 2008/09 Increase in the % of drug users offered Hep C testing Increase in the % of Hep C positive drug users offered treatment Increase in the % of drug users offered Hep B vaccination 14 232 per 100,000 population 116 per 100,000 population 929 per 100,000 population 718 per 100,000 population 22 per 100,000 population 22 per 100,000 population 30.3% 53.5% Target Core & Local Indicators to enable progress to be measured National Core Outcomes indicators Sources Local Outcomes Baseline Scotland average East Ayrshire Fewer adults and children are drinking or using drugs at levels or patterns that are damaging to themselves or others (CO2) Estimated prevalence of Problem Drug Use Amongst 15-64 year olds in Scotland. 2009/10 Estimated prevalence of injecting drug use amongst 15-64 year olds in Scotland (ever injected) Percentage of 15 year old pupils who usually take illicit drugs at least once a month Percentage of 15 year old pupils who used illicit drugs in the last year (2006, 2010) Estimating the National and Local Prevalence of Problem Drug Misuse in Scotland. Decrease the proportion of young people who have been offered drugs in the last year ISD Scottish Schools Adolescent Lifestyle and Decrease the Substance Use Survey proportion of individuals drinking (SALSUS) above daily and/or weekly recommended Scottish Health Survey limits 3.1% 1.71% 41% 13% 11% 17% 19% 21% 20% 19.5 units 19.5 units Scottish Health Survey CAGE questionnaire The proportion of individuals drinking above daily and/or weekly recommended limits The proportion of individuals drinking above twice daily (“binge” drinking) recommended limits The proportion of individuals who are alcohol dependent Proportion of 15 year olds drinking on a weekly basis (and their mean weekly level of consumption 15 Target Core & Local Indicators to enable progress to be measured National Core Outcomes indicators Sources Local Outcomes Baseline Scotland average East Ayrshire Individuals are improving their health, well-being and life-chances by recovering from problematic drug and alcohol use (CO3) Reduction in the percentage of clients injecting in the last month during treatment Service submissions to ISD Scottish Drug Misuse Database Proportion of clients who abstain from illicit drugs between initial assessment and 12 week follow-up SAMS Increase in drug/alcohol users engaging in employment, education, leisure Reduction in the number of drug and alcohol service clients who are homeless (or where drug and alcohol support needs have been identified when person identified as homeless) Rate of maternities recording drug use (three year rolling average) 2007/10 Rate of maternities recording alcohol use (three year rolling average) 20% Reduction in drug related morbidity, mortality and deaths Proportion of clients receiving drugs treatment experiencing improvements in employment/ education profile during treatment Children and family members of people misusing alcohol and drugs are safe, well-supported and have improved life-chances (CO4) Reduction in drug and alcohol related morbidity, mortality and deaths ISD SMR 02 Scottish Government Child Protection statistics NHS Board Number of Child Protection Case Conference where parental drug and alcohol abuse has been identified as a concern/risk (data to be published from 2013). reduction in the number of maternities recording drug or alcohol use Minimise the number of children looked after and accommodated /separated from parents Increased number of children affected by parental alcohol/drug use identified 16 9% 21.0 per 100,000 population 4 (since March 31 2012) 11.9 per 100,000 population Target Core & Local Indicators to enable progress to be measured National Core Outcomes indicators Sources Local Outcomes Baseline Scotland average East Ayrshire Proportion of positive ABI screenings in ante-natal setting Communities and individuals live their lives safe from alcohol and drug related offending and anti-social behaviour (CO5) Percentage of people perceiving drug misuse or dealing to be common or very common in their neighbourhood Scottish Survey Household Service submissions to ISD Scottish Drug Misuse Database 17 Reduced alcohol and drug related violence and offences Increased detections for the possession of 21.1% 11.6% Target Core & Local Indicators to enable progress to be measured National Core Outcomes indicators Sources Local Outcomes Baseline Scotland average East Ayrshire Percentage of new clients at specialist drug treatment services who report funding their drug use through crime Scottish Government reconviction rates in Scotland One year reconviction frequencies rate for offenders given a Drug Treatment and Testing Order (2007/08, 2008/09) 16% 21.6% Increased detection rates for the supply of drugs in the local area 120.7 162.3 Crimefile recording system and the STORM command and control system anti-social behaviour offences recorded by police Number of Community Payback Orders issued where alcohol and drug treatment required, and proportion that are successfully completed. drugs Scottish Court service data Scottish Crime justice survey 18 and Increased use of CPO as an alternative to Custody to address alcohol/drug related offending. Increased access for offenders to appropriate drug/alcohol services in the community and in custody. 39.9 per 1000 population 41 35.5 per 1000 population Target Core & Local Indicators to enable progress to be measured National Core Outcomes indicators Sources Local Outcomes Baseline Scotland average East Ayrshire People live in positive, health-promoting local environments where alcohol and drugs are less readily available (CO6) Alcohol and drugs prevention, treatment and support services are high quality, continually improving, efficient, evidence-based and responsive, ensuring people move through treatment into Percentage of people noting ‘alcohol abuse’ as a negative aspect of their neighbourhood SALSUS 3% 4% Proportion of 15 year old young people who have been offered drugs in the last year 38% 42% Number of premise and occasional licences in force per annum 337 premises licenses (April 2012) The number of screenings for alcohol use disorders delivered and the percentage screening positive (with % eligible for ABI and % eligible for referral) The number of alcohol brief interventions delivered in accordance with the HEAT Scottish Survey Household Health Boards Service submissions to ISD Drug and Alcohol Treatment Waiting Times Database Service submissions to ISD Scottish Drug 19 Reduced incidence of alcohol and/ or drug associated Anti-social behaviour Services will be better adapted to the needs of groups who currently have poor access including those with childcare needs, persons who are homeless, and those with complex Target Core & Local Indicators to enable progress to be measured National Core Outcomes indicators Sources Local Outcomes Baseline Scotland average East Ayrshire sustained recovery (CO7) Standard guidance Misuse Database Number of people waiting more than three weeks between referral to a specialist drug and alcohol service and commencement of treatment Dec 2011 ISD Waiting times needs such as serious mental health 14.9% Problems Reduce number of suicide and self harming episodes PSS&T Number of homeless applications received from persons with substance misuse problems Number of staff trained in ASIST, STORM AND Safe Talk 20 15.1% Target Governance & financial accountability arrangements The diagram below illustrates the governance arrangements for East Ayrshire ADP in relation to the Community Planning Process Community Planning Partnership Board Community Safety partnership Community Health Partnership Life Long Learning Community Regeneration Alcohol and Drugs Partnership Child protection committee Adult protection committee Violence against women partnership South West Scotland CJA Key: Direct reporting Strategic linkages Decisions on spend of resources are made by partners and ratified by the full ADP Committee. Financial governance is ensured by the preparation and submission of quarterly finance reports. 21 National Support East Ayrshire ADP values the contribution made to the national agenda by the range of Scottish Government NGO’s commissioned to provide ADP’s with ongoing strategic support. As East Ayrshire continues to develop and deliver its strategic vision of shifting the balance of care towards increasing numbers of problem drug/alcohol users in recovery, East Ayrshire will seek to utilise the experience of The Scottish Recovery consortium in particular to develop strategies that build and sustain recovery by the development of recovery networks. East Ayrshire ADP has recently become involved in the pilot recovery training programme being piloted in the West of Scotland by the Scottish Recovery Consortium. The ADP further notes the contribution made by ISD in the production of baseline data and the contribution of Scottish Drugs Forum in further developing the concept of user involvement However, whilst East Ayrshire ADP recognises and values the varied contribution of the range of NGO’s it would be of particular interest to the wider ADP membership if these NGO’s were explicit within their own strategic plan as to their specific role and function in supporting ADP’s 22