1. Reducing the Strength & Operation P.O.L.A.D

2. An over view Population of Portsmouth 206,836 15.5 square miles 13,276 People per square mile 184 Off Licenses £74 Million spent annually

3. Liver disease in the City 40,000 drink above recommended limits Men 50% More likely to die Women 47% More likely to die 1,213 people in treatment (2014)

4. We asked retailers to remove Beers Lager and Ciders over 6.5%ABV (excluding premium products)

5. Products of concern High in strength Sold in plastic bottle or cans Sold very cheaply Polish lagers

6. EngagementEducationEnforcement

7. Engagement Store Visits Company/Trade Approach Evidence Sharing Community Engagement

8. Education In store advice Best Practice Seminar Off-Licence ‘Tool Kit’

9. Enforcement Test Purchasing Inspections (P.O.L.A.D) Individual action plans Review Mechanism

10. Operation P.O.L.A.D Multi Agency Operation 152 Simultaneous inspections One Day! Stores were graded on the day Green (compliant) 90 Amber (minor issues) 30 Red (non compliant) 32

11. 8 stores needed instant intervention.. Basic licensing offences Selling below Cost + VAT Products of concern

12. Actions Taken after P.O.L.A.D Action Plan’s for improvement Review Hearings & Conditioning Prosecution HMRC follow up

13. Results 100+ stores signed up in support Drop in ASB relating to streetdrinking Increased retailer compliance Increased test purchase pass rate

14. Moving Forward More stores signing up Portsmouth campaign features in LGA guidance Work with Portman Group Community Alcohol Partnership

15. Thank you for listening Questions & Answers

16. Hampshire County Council Substance Misuse Team & Tower House Horses Substance Misuse & Equine Assisted Recovery

17. Equine Assisted Recovery Hampshire County Council Adult Services Substance Misuse Team Community rehab package 2012 EAR pilot study

18. Substance Misuse Team Development Day “ This afternoon helped us to identify strengths and challenges for the team, but in a non threatening and fun way. We learnt a lot about ourselves as colleagues and friends. ”

19. Equine Assisted Recovery “In its broadest sense, equine assisted learning is any interaction between a person and a horse where the person learns something about themselves.” Experiential Ground-based

20. Equine Assisted Recovery US research... “…reduction in psychological distress and enhancements to wellbeing… significant immediately after treatment and stable at 6-month follow up.”

21. Equine Assisted Recovery How does it work? Finely-tuned survival instincts of herd animals Highly developed limbic system – emotional intelligence Masters of non-verbal communication – energy/body language Instant, accurate feedback

22. Equine Assisted Recovery How does it work? Horses as “therapists” Facilitator-guided interaction and reflection Role models of living in the moment No judgement No “baggage” Safe, nurturing environment

23. Equine Assisted Recovery Programme designed to: Develop self-awareness Expand comfort zones Build confidence Establish healthy boundaries Restore trust

24. Equine Assisted Recovery Programme designed to: Distinguish assertiveness from aggression Develop interpersonal skills Build teamwork Provide transferrable skills for everyday life

25. Equine Assisted Recovery Small groups of 4 or 5 6 x 2 hour sessions Portfolio of photos, reflections, observations, feedback Certificate course Integrated working with Substance Misuse Team Service User support

26. Equine Assisted Recovery “It stopped the voices in my head, grounded me and helped me be in the here and now.” “ It was amazing for me, my life is so much better, I feel more confident. It was a healing experience.”

27. Equine Assisted Recovery “I learned that all the horses have different personalities…peopl e are all different too and I need to be aware of that when dealing with them. I transferred the learning around the horses to people.”

28. Equine Assisted Recovery “I have much better self- awareness and I noticed how negative I can be and how I can change this behaviour.” “It was really relaxing and helped me with my sleep problems. It also helped me with my temper, possibly because I was sleeping better and so much more relaxed.”

29. Equine Assisted Recovery Equine video

30. Contact Substance Misuse Team: substance.misuse@hants.gov.uksubstance.misuse@hants.gov.uk Tower House Horses: info@towerhousehorses.co.ukinfo@towerhousehorses.co.uk

31. What does true integration look like? And how can this be achieved… Gethin Jones Alcohol Interventions Manager

32. Integrated a word or an action? 1. We all talk about integrated working and how this can best support both clients and services. 2. In truth how often does this happen? 3. A lot of the time the practical action gets lost on the way. 4. Here is a picture of our journey into becoming an integrated service

33. What were our aims 1. We wanted to Reduce Hospital admissions 2. Increase GP referrals 3. Reduce Alcohol related offending 4. Build better relationships with services

34. What was the first steps? We became VisibleVisibleVisibleVisible

35. Integrated Action now starts we build a picture a. What are the clients needs b. What are Individual services needs c. How can we fit to the individual services rather than services fit to us …

36. Methods of working 1. Simple referral a. What is best for individual services i.e. slip, phone, post or email. 2. Holistic ways of working b. We don’t just concentrating on Alcohol i.e. MECC (Make Every Contact Count) Housing, Debt, Relationships, Education Employment Training. 3. Using technology c. practitioners have laptops with Wi-Fi access so they can access PCC systems anywhere in the City

37. Outcome 1. Services share the work load and understand how supporting each other leads to better outcomes for clients, services and communities. 2. The main 3 areas of this integrated services are being developed within a new service plan to support the Cities wider health needs. 3. Portsmouth City Council was highly commended in the 2014 MJ Awards for our alcohol harm reduction work

38. Thank you Alcohol Interventions Team Floor 2 core 2 Civic offices Guildhall Portsmouth PO1 2BY AIT@portsmouthcc.gov.uk 023 9284 1753