1. Public Health Forum
Adult Substance Misuse

2. Welcome and Introduction
Alison Challenger
Director of Public Health

3. Findings of the Joint Strategic Need Assessment
Caroline Keenan
Senior Performance and Insight Officer

4. Impact on Nottingham’s Citizens
1 in 10 Nottingham citizens are affected by drug use
1 in 5 Children in Care cases associated with parental drug use
1 in 5 Children in Care cases associated with parental alcohol use

5. Drugs: Who is at risk and why?
Young adults are most likely to use drugs

6. Drugs: Who is at risk and why?
Substance
Long term
Short term
Cannabis
Powder cocaine
Opiates
Crack cocaine
Any drug
Any stimulant
Any Class A

7. Drugs: Who is at risk and why?

8. Drugs: Health inequalities and consequences

9. Drugs: Need versus ‘treatment’

10. Alcohol: Who is at risk and why?
Increasing and higher risk drinking increases with age

11. Alcohol: Who is at risk and why?
Consumption at home is static whilst consumption outside the home reduces

12. Alcohol: Health inequalities and the alcohol-harm paradox

13. Alcohol: Health consequences

14. Alcohol: Need versus ‘treatment’

15. Alcohol: Need versus ‘treatment’

16. Strategy
Alex Castle-Clarke
Strategy and Commissioning Officer

17. The Partnership Strategies
Safe, Responsible, Healthy: Nottingham’s Approach to Alcohol
Partnership Drugs Strategy

18. Since 2013 Health and Wellbeing Boards Police and Crime Commissioners
Health and Wellbeing Strategies
Police and Crime Commissioners
Police and Crime Plan
PCC Alcohol Strategy

19. Ongoing Strategy Commitments
Partnership Plan
Statutory
Police and Crime Plan
PCC Alcohol Strategy
Non-Statutory
Health and Wellbeing Strategy
Children and Young People’s Plan
Force Substance Misuse Strategy

20. A New Approach
Partnership Board requires that a new, joint drug and alcohol strategy be developed.
It has noted the number of existing strategies. A clarified approach is suggested.
A single framework of all ongoing targets and actions has been produced.

21. Strategy Governance

22. Commissioning
Lucy Putland
Strategy and Commissioning Manager

23. Substance Misuse Treatment System Commissioning
Public Health Forum
12th August 2015

24. Vision..
A treatment system that delivers the best possible quality and standards of care, maximising numbers achieving a substance free lifestyle and recovery from substance misuse. High quality treatment will need to be delivered within the available budget in a challenging economic climate.
Objectives …
Maximise the number of clients who achieve recovery
Reduce the harm to individuals and families (including vulnerable groups) as a direct or indirect result of substance misuse; including supporting those for who recovery is not yet an option
Ensure service users and beneficiaries are at the heart of the treatment system and their own recovery journey
Respond to current need and be flexible to future changing needs
Provide treatment that is …
Able to intervene early through identification, training and screening
Recovery focused offering a visible recovery community and rebuilding community assets
Easily accessible and easy to navigate
Joined up – for poly substance users
Evidence based but with freedom for expert clinically-led innovation
Cost effective and delivering value for money
July 2015
Nottingham City Substance Misuse Treatment System

25. What is substance misuse treatment?
Inpatient and residential rehabilitation
Structured treatment interventions and recovery coordination
Brief psychosocial interventions and advice
Harm Reduction
Recovery Interventions
Treatment should:
Address service users holistic needs and support the rebuilding of recovery capital (physical and mental health, employment, training and education, finance, housing and relationships)
Focus on each service user as an individual – the therapeutic relationship between clinician and client being central
Consider the impact of substance misuse on others - in particular families, children and the community
Be delivered in line with national guidance
July 2015
Nottingham City Substance Misuse Treatment System

26. Strategies & Guidelines
Drug Misuse & Dependence: UK Guidelines on Clinical Management 2007
Drug Strategy 2010: Reducing demand, restricting supply, building recovery: supporting people to live a drug-free life
Suite of NICE Clinical Guidelines including : Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence.
Drug misuse: psychosocial interventions.
Alcohol Strategy 2012
July 2015
Nottingham City Substance Misuse Treatment System

27. Current provision
In Nottingham we currently have a range of different service areas;
The budgets available for substance misuse treatment in Nottingham are reducing year on year from 2014/15 to 2016/17. It is likely that the current economic climate will continue to have an impact and it will be necessary to look for further efficiencies within the new treatment system model.
July 2015
Nottingham City Substance Misuse Treatment System

28. What next?
It is anticipated that the new treatment system will be operational by 1st July 2016 and that services will go out to tender towards the end of this year.
During the design and consultation stage of this activity, we are seeking the views of as many people as possible
Stage one consultation and market development is now complete
Service user focus groups are taking place end July and August
Findings are being pulled together to determine a final proposed model for further consultation
Stage two consultation is planned to begin in September
Any provider pre-tender events are likely to take place October / November
Tender anticipated towards the end of this year
July 2015
Nottingham City Substance Misuse Treatment System

29. Further reading ….
Nottingham’s Alcohol Strategy: Safe. Responsible. Healthy ( )
Nottingham Crime & Drugs Partnership Strategic Assessment (2014/15)
Nottingham City Joint Strategic Needs Assessments
Nottingham Substance Misuse Commissioning Review (pending)
Criminal Justice Needs Assessment (2013)
The National Drug Strategy (2010)
The National Alcohol Strategy (2012)
July 2015
Nottingham City Substance Misuse Treatment System

30. Consultation
Glen Jarvis
Service User and Carers Involvement Officer

31. Break
Resource Centre display

32. Group Work