To consider a presentation from the Drug and Alcohol Directorate Manager, Pennine Care NHS Foundation Trust.
The Drug and Alcohol Dirertorate Manager has been invited to the meeting to discuss the work of the Pennine Care NHS Trust in Stockport in relation to drug and alcohol services.
Contact: Liz McCoy, 0161 716 3666, e.mccoy@nhs.net
Minutes:
Liz McCoy, Drug and Alcohol Directorate Manager and Matthew Phoenix, Stockport Drug and Alcohol Service Manager (Pennine Care NHS Foundation Trust) attended the meeting to provide the Scrutiny Committee with an overview of the work of the Trust’s Drug and Alcohol Service in Stockport. Alison Leigh, Community Safety and Neighbourhoods Manager, and Phil Leigh,Community Safety Operations Manager (Drugs) (Stockport Council) also attended the meeting.
The presentation highlighted the following issues:-
· The Trust was one of a number of providers of Drug and Alcohol Services in the Stockport area, and worked mostly with those over 25 and with high levels of need.
· At any one time, there were approximately 600 service misusers of opiates, and 300 dependent alcohol abusers. The turnover of service users was increasing.
· The Trust also provided harm reduction services, such as needle exchange.
· There was an emerging problem with non-traditional substances, which was leading to increasingly severe acute medical needs.
· The Service was moving away from the traditional NHS delivery model, providing aftercare in partnership with other providers, and with the increasing use of former service users as peer supporters.
· Increasing concerns about older people losing their independence due to medical conditions or falls caused by alcohol and prescription drug abuse. Misusers often developed medical conditions sooner than they would have otherwise.
Councillors asked questions and made comments about the presentation. The following issues were raised:-
· Prescription drugs were a substance that was often overlooked and not given sufficient weight when developing policies to tackle drug abuse. It was commented that there were examples of older people being overprescribed medication that was subsequently reduced when they were hospitalised. There was a need to ensure GPs were regularly reviewing prescriptions. Medication purchased over the internet was also an increasing cause for concern.
· The connection between drug and alcohol abuse and loneliness and isolation, particularly in older people, was important to recognise. There was a danger that in a borough like Stockport, the relative affluence could exacerbate the risk of isolation.
· The involvement of service users in service provision was welcomed and showed significant leadership on the part of the Trust. Those selected were often ex-service users who had previously had severe needs as they would have the greatest insight and would be best placed to understand the wider needs of users and were often able to provide non-clinical support, such as accompanying current users to abstinence meetings. The Payment by Results model helped drive this change by giving greater focus on outcomes and recovery.
· The Payment by Results model was proving successful for Stockport. There were a range of criteria that determined a positive result for the purposes of the contract, but the Service itself considered a ‘result’ to be a service user being in contact with the service, addressing their wider wellbeing and in a stable lifestyle.
· There was an increasing problem with non-traditional drugs, such as ‘legal highs’. It was difficult for legislation to stay ahead of these substances, but these were often leading to severe medical conditions and irreversible damage. Diversionary activity was an effective tool to combat this type of substance misuse.
· Performance enhancing and image enhancing drugs were also becoming a more prevalent problem. Often the effects were hidden because abusers of these substances lived otherwise normal lives and did not conform to the stereotype of a drug-user. They may also not see themselves as drug abusers.
· There was an opportunity for the Pennine Care NHS Trust and Public Health to collaborate to provide vaccinations for users to prevent avoidable infections.
RESOLVED – (1) That Liz McCoy, Matthew Phoenix, Alison Leigh and Phil Leigh be thanked for their attendance and presentation.
(2) That the Scrutiny Committee welcome the positive work being done to support drug and alcohol misusers to recovery and abstinence, particularly the increasing emphasis on outcomes and the use of former service-users in the co-production of the services.
(3) That the Clinical Commissioning Group be requested to report back to a future meeting on the measures being used by GPs to monitor and review the appropriateness of prescription medication for patients with long term and chronic conditions.