Agenda item

Providers of alcohol treatment and support services have been invited to the meeting to provide an overview of their services and to answer questions from the Scrutiny Committee.

A copy of the presentation slides from the last meeting are included as an aide memoir.

The Chair invited representatives of organisations providing alcohol treatment and prevention services to provide an overview of their services and identify key issues for the Scrutiny Committee to consider as part of the Review of Alcohol Services.

Matthew Phoenix – Pennine Care NHS Foundation Trust (Cirtek House)

·         Services provided for adults over 26 years.

·         Focus of services provided at Cirtek House was on those who were alcohol dependent (drinking daily).

·         Treatments including detoxification (nurse led), or control and reduction of consumption.

·         Work with Stepping Hill Hospital to address repeat/frequent attenders caused by alcohol and diversion into community-based support.

·         Increased focus on aftercare provision to maintain abstinence, run principally by ex-service users. This included drop-in groups, regular phone contact to monitor and support service users, and signposting to other support. There was also an emphasis on reintegration.

Billy Hooley - Addiction Dependency Solutions (ADS)

·         ADS was a charity, working from Cirtek House, and providing support to a range of substance misusers. Recently began work with alcohol misuse.

·         Focus of activity was at the lower thresholds of misuse, usually before dependency, but where behaviour was harmful. Provided support to improve their social circumstances.

·         Service users often had multiple problems and relied on support from a range of agencies.

Brett Pagdin – Healthy Stockport

·         Working at the lower end of the spectrum of need, with a focus on prevention, health promotion and awareness raising, particularly with GPs and other health professionals in relation to symptoms and signs of risky behaviour.

·         Brief interventions provided in the form of lifestyle discussions with clients to identify reasons for change and identify goals to motivate that change.

·         Engagement with health and social care workers to encourage their clients to have a conversation about lifestyle via a referral to Healthy Stockport.

·         Healthy Stockport took a holistic approach to lifestyle that made conversations easier, rather than focus on one behaviour only.

Grant Jackson – Stockport NHS Foundation Trust

·         Alcohol nurses were now embedded within the hospital, particularly in the Emergency Department. Research indicated that 1 in 8 patients would change behaviour as a result of conversation with a practitioner in hospital. Efforts were ongoing to ensure this contact was mainstream activity.

·         There were approximately 50 admissions per week due to alcohol intoxication, not including those who did not admit to this as a cause.

·         Efforts were ongoing to bring together services to address repeat attenders.

·         There was a particular problem with those who were homeless as they did not have access to GP and primary care services. There were pathways to support these individuals but often there were serious challenges in these cases.

Dr Steve Watkins, Director for Public Health

·         Limited intake of alcohol could have a beneficial affect, but most people did not drink such small quantities.

·         There was a danger in unsafe levels of drinking not just because of its impact on health, but because of the danger in being drunk and suffering impairment of judgement.

·         There were clear benefits to early intervention but often interventions were only successful in changing behaviour after a crisis.

·         The community and families of misusers were vital to supporting people in recovery and in maintaining abstinence.

Councillors then asked questions and made comments, including:-

·         Given the rise in 30 year old adults developing liver problems, it was suggested that alcohol messages in schools were not proving effective. There was research to suggest that public health messages directed at children were most effective with those children who were least likely to engage in risky behaviour, so it would be more effective to focus on developing young people’s skills to make sound choices. In California, significant reductions in smoking had been achieved with a policy to not promote anti-smoking messages in schools as this reinforced the impressions of smoking being adult behaviour.

·         Attitudes towards drinking were ingrained within British culture, with ‘fun’ often being framed within the context of alcohol. Unsafe drinking was also often triggered by loss and trauma and used as a coping mechanism. The Alcohol Strategy emphasised skilling-up front-line services to signpost residents to support services.

·         Life changes were often damaging to health, but it was unrealistic to try to support everyone through every difficult life episode. Using resources such as Making Every Contact Count were valuable to signposting those who were at higher risk.

·         There was an important role for technology in supporting preventative work, and in particular recovery. Although not suitable for all service users, in some cases it could provide a low-cost method for maintaining contact and sending reminders for those in recovery.

·         The normalisation of drunkenness, its glamorisation, and the increasing availability of cheap alcohol were challenges to public services. The success of anti-drink driving campaigns was due in part to focussing on its anti-social character.

The Chair invited attendees to identify key measures that would improve outcomes in relation to unsafe alcohol consumption. The following issues were identified:-

·         Continuing with joint working and allowing this to become embedded within services.

·         Making the most of every contact with public services to identify those with lifestyle problems and signposting to appropriate support.

·         Providing greater time during GP consultations to identify risky behaviour and making appropriate referrals.

·         Providing more access to counselling and therapy services to respond to traumatic life events that triggered risky behaviour, and providing greater links between alcohol services and IAPT.

·         Minimum Unit Pricing for alcohol would have a significant impact on certain sections of the population.

·         Focussing limited resources on those cohorts most at risk and with greatest need.

RESOLVED – That the Matthew Phoenix, Billy Hooley, Brett Pagdin and Grant Jackson be thanked for their attendance and contribution.