Councillors and officers are invited to provide feedback from the previous meeting and the discussions with service users, carers and volunteers.
Representatives of the Clinical Commissioning Group have also been invited to the meeting to address concerns raised in respect of access to services.
Minutes:
The Chair invited those at the meeting to provide feedback and reflect on the Scrutiny Committee’s recent engagement with Alcohol Treatment service users and carers.
A representative of the Democratic Service Manager also provided an update from the Clinical Commissioning Group (CCG) in relation to a number of points raised at the engagement session that the Scrutiny Committee had sought comment on related to the CCG activity. This included the following points:-
Dual/double diagnosis
An assessment of an individual patient be able to identify a person’s key problems and needs, including where alcohol dependency was masking an underlying mental health problem. The key to overcoming this was the effectiveness of the assessment process.
Delay in accessing IAPT and other therapies
IAPT, Self Help Services provide an e-Therapy dual diagnosis package called Breaking Free, it is targeted at people with mild to moderate conditions.
· 100 treatments are available on an annual basis
· There is open referral to this service, i.e. people can self-refer, this is seen as the preferred method because it demonstrates motivation to engage
· Referrals to the service are low
· The service report good recovery targets and very good patient experience
· Waiting times to access step two/services for people with mild to moderate problems are low, i.e. 99% of people can access Self Help Services within 4 weeks
In relation to Step 3 IAPT services, for Cognitive Behaviour Therapy (CBT) and counselling this continues to be challenging, largely based on the length of time people were in treatment, however good progress around waiting times had been made.
· 60% of people can access CBT within 18 weeks
· 455 of people can access counselling within 18 weeks (this is a much smaller service and the wait is longer)
· Access to secondary care psychological services requires people to be care co-ordinated and this therapy takes place as part of a care package.
Councillors expressed concerns that an 18 week wait was significant and would make ‘early’ intervention a challenge.
The following additional comments were made/ issues raised:-
· The role of the GP in identification of those with alcohol abuse problems. It was commented that there was often variability in awareness amongst practices and engagement with training provided by Public Health. It was not possible to monitor whether GPs raised alcohol consumption during consultations, but data did show that there were some practices that never made referrals to the Healthy Stockport service. In relation to the training of GPs, it was suggested that within a practice it may be that an individual GP specialised in a particular areas, so that not all GPs within the practice were as aware of alcohol issues as others. It was queried that if GPs were not referring to the Health Stockport service or to START, then what were they doing to address patients with unsafe drinking levels?
· The issues raised in relation to benefits and advice from DWP was not within the remit of this Scrutiny Committee but the local MPs could be asked to write to the relevant Minister. Further detail was needed from colleagues at Pennine Care NHS Trust to understand the detail of these problems.
· The role of the family was particularly important, particularly in identifying problem drinking, convincing relatives to seek help, and providing ongoing support through treatment and recovery. They could often act as an ‘ally’ to both the user and for those working within services.
RESOLVED – That in relation to the feedback from service users and carers, that further information be sought on the following issues for inclusion within the Review Final Report:-
· Clarification from the CCG on the maximum waiting times for IAPT and CBT.
· Whether the CCG had data on training and monitoring of GPs in relation to alcohol misuse.
· Further details from Pennine Care NHS Foundation Trust on problems encountered by service users in relation to benefits payments and support from DWP and Job Centre Plus.