Agenda item

The Committee received a report of the Director of Public Health which provided an update on the work of the County Durham and Darlington Combatting Drugs and Alcohol Partnership.  The report informed members of the progress of the County Durham and Darlington Combatting Drugs and Alcohol Delivery Plan 2023-2025 (for copy see file of minutes).

J Sunter, Public Health Strategic Manager explained that the Combatting Drugs and Alcohol Partnership had been established following the publication of the government’s 10 year strategy ‘From harm to hope: A 10-year drugs plan to cut crime and save lives’. The strategy set the requirements for the completion of a local joint needs and asset assessment (JNAA), the establishment of local multi-agency combatting drugs partnerships, the design of a local delivery plan and the development of key performance indicators (KPIs) and reporting mechanisms.  A JNAA had been undertaken which informed the design of the 3-year multiagency County Durham and Darlington Combatting Drugs and Alcohol Delivery Plan 2023-2025 to track and monitor the implementation of the national strategy.

She added that a County Durham and Darlington Combatting Drugs and Alcohol Partnership (chaired by the Police Crime Commissioner) was established to provide governance and oversight along with the establishment of a Combatting Drugs and Alcohol Operation group (chaired by Public Health in County Durham) to identify key partners to lead on each objective within the delivery plan. 

The Public Health Strategic Manager advised that the County Durham and Darlington Combatting Drugs and Alcohol Delivery Plan 2023-2025 was based around the six outcomes of the national framework:

·      Reduce drug and alcohol use,

·      Reduce drug and alcohol related crime,

·      Reduce drug and alcohol related deaths and harm,

·      Reduce drug and alcohol supply,

·      Increase engagement in drug and alcohol treatment and

·      Improving drug and alcohol recovery

She added that the outcomes were themed on the three aims of the national drug strategy:

i)               To break the drugs supply chain;

ii)             To deliver world-class treatment and recovery systems; and

iii)            To achieve a generational shift in in the demand for recreational drugs.  

Joint working had seen the implementation of a Drugs and Alcohol Care Team in the Tees, Esk and Wear Valleys NHS Trust and an Alcohol Care Team in the County Durham and Darlington NHS Foundation Trust. 

The Public Health Strategic Manager stated that rapid process improvement workshops had been held in response to the review of the health and justice pathways to proactively monitor all requests that came in to establish what was in place and what extra was needed.  She noted that the Dame Carol Black funding had been vital to fund all the work that had occurred.  There had been promised assurances for funding for a further year.  A fresh JNAA would take place in quarter four to set the baseline for additional improvements to look at assets and identify any gaps. She noted that over 3000 clients accessed support on an annual basis within County Durham which had improved better outcomes for service users that lasted longer.  County Durham were above the national average for crack and heroin usage with the cohort of opiate users being older who got sicker with chest infections.  The younger generation tended to use powdered cocaine with alcohol which was lethal.   Work continued with people released from prison to support them in staying clean and maintaining homes and employment.

Councillor R Potts asked if there was any reason why Durham Constabulary used one organisation for drug and alcohol recovery (Humankind) and Darlington Police used another organisation (Stride) if they were promoting joint working.

The Public Health Strategic Manager responded that it was purely down to the procurement process for each police force as to which organisation they used.  The relationship between the two police forces was improving due to increased partnership working for a safer Durham and Darlington.

Councillor R Potts enquired about the number of deaths amongst people who misused drugs and alcohol as to whether this had increased or decreased.

The Public Health Strategic Manager explained that new data and statistics for Durham showed that deaths had decreased.  Durham was the third lowest in the northeast which had been reenforced by the new naloxone programme. Data was also received from the coroner’s officer who compiled information on each death from substance misuse.  Information included toxicology reports which identified what substances they died from.  This intelligence was plotted on to maps to highlight hot spots of where the most substance misuse activities occurred.  This enabled mobile support services to be deployed in these areas and drug alerts circulated to colleges and vulnerable people if new synthetic drugs were detected to enable a reactive response to the work.

Mrs R Gott thanked the officer for a comprehensive report.  She asked if GP surgeries received additional help and support to combat substance misuse in patients.  She was concerned that GPs did not receive up to date training so had very little insight to the problem.  She thought that help should be available as soon as possible.

The Public Health Strategic Manager replied that service users did not like to attend GP surgeries as they felt they were judged so they were not relied upon by the Drug and Alcohol service for referrals.   GP surgeries along with PCNs (Primary Care Networks) did link up with the HOPE (Hospital Outreach, Prevention and Engagement) team which was a more specialist service if required. Work was ongoing with GP surgeries for prescriptive medications for getting clean.

Councillor E Mavin admired the work of the service and although positive there was a reality that drugs were rife and the problems would not be beaten.  He asked how much grant funding had been received to tackle the issues.

The Public Health Strategic Manager stated that there were different funding allocations that had been received from the Dame Carol Black Grant to finance the work. There was also money within the core budget for service delivery to enable targeted activities. She noted that there were several success stories because of all the hard work seeing people who had received treatment live their lives substance free and within the work the police did who were active in breaking drug supply chains within county lines.   Training had been held recently with the police, social care, probation and the new justice service on how gangs operated using cuckooing in the local housing sector.  She agreed to circulate further information about the Dame Carol Black Grant.

Councillor C Hunt asked what the estimated waiting times were for a medical detox and residential rehabilitation for service users.

The Public Health Strategic Manager responded that there were two ways for a service user to detox.  The first was in their own home with the appropriate medications that was managed clinically and the second was by attending a rehabilitation centre as an inpatient. Rehabilitation centres were generally out of the northeast and gave Turning Point in Manchester as an example.  Travel was also provided to and from the centre.  Waiting times were generally 2-3 weeks but this depended on whether the service user was ready to accept help and be committed to getting sober.  She had not received any issues with waiting times.

Councillor C Hunt asked if there was a gap between mental health issues being identified and substance misuse with service users self-medicating to help their mental state. 

The Public Health Strategic Manager confirmed that work was ongoing for dual needs to be addressed.

Councillor V Andrews found the report very useful and asked if data was broken down into social groups and if some required more help than others.

The Public Health Strategic Manager responded that substance misuse was higher in areas of poverty and higher in males but there were substance misusers in every cohort of society. 

Councillor D Nicholls was concerned about the shortage of some prescribed medicines and the number of chemists which were closing.  This could have a knock-on effect for those trying to get clean and expose people to gain medicine from elsewhere.  He was afraid this would have implications on people’s mental health and affect trends in controlled substances.

The Public Health Strategic Manager stated that it was hard to quantify people who accessed heroin and diamorphine sold on the black market or benzodiazepines through drug dealers from abroad. She was aware that people sold their prescriptions for pain relief or other ailments to substance misusers. Work was ongoing with GPs to create awareness and establish ways to manage this.  She advised that services for mental health were available at Spectrum.  Prescription drugs did show in toxicology reports which was mapped to highlight hot spot areas.

Chief Fire Officer S Helps confirmed that the fire service worked with the public health team around synthetic opiates which were also discussed at the local resilience forum to help deal with fatalities. He reassured the committee that work crossed over from office hours to the police and fire services to provide additional support out of hours.

Resolved:

i)               That the report be noted.

ii)             That the continued work of the Combatting Drugs and Alcohol Partnership and implementation of the delivery plan be supported.

iii)            That the improvements in performance indicators for successful treatment completions and continuity of care and that the investment of the additional Dame Carol Black grant funding had contributed to these improvements be noted.

iv)           That the Dame Carol Black grant funding would end in March 2025 and that the partnership escalated this matter and sought assurance regarding future funding from government be noted.