Agenda item

Tony Bullock, Commissioning Lead for Alcohol and Drugs from Staffordshire County Council Public Health, was in attendance on behalf of the North Staffordshire Clinical Commissioning Group, to provide information on the statistics for alcohol-related admissions. There were two types of alcohol related hospital admissions: those completely caused by alcohol which accounted for a third of admissions and those partly caused by alcohol which accounted for two thirds of admissions. The Clinical Commissioning Group had invested around £500 million in redesigning treatment services. Alcohol and drugs had previously been treated separately, but were now been brought together as it was recognised they were linked. Tendering for new services relating to alcohol and drugs was currently underway, and there was confidence this would lead to a better set of services.

A Member asked whether the reasons for an individual beginning to drink were considered and addressed in the early stages of alcohol addiction. Previously there had been a 98% investment in treatment, but the strategy was moving to early intervention and prevention. There were numerous approaches, including education campaigns, and there was a widespread programme which included the use of regulatory powers. Young to old were affected by alcohol and there could be several generations of the same family with alcohol problems. The Strengthening Families programme was an example of a parenting skills programme. There would be long term work at a community level.

A Member considered that there were missed opportunities to address alcohol consumption with hospital patients. It was acknowledged that these opportunities had been missed previously, but for the past year there had been a team of dedicated nurses, the Alcohol Liaison Team, who trained hospital staff to identify alcohol related issues and provide advice. The team also saw patients. The ‘every contact counts’ initiative was also important and this was to be spread to primary care services and GP practices.

A Member noted the major impact that alcohol had on A & E departments. They also considered that there were alternative places where people with alcohol related problems could be identified, such as GP practices and the Police, and interventions needed to be made there. You could not go anywhere in the NHS without being asked whether you smoked, and the same was to be introduced with alcohol. This was in its early days, but tens of thousands of booklets had been produced which would provide basic information, and there were high profile pieces of work underway. A diversion scheme had been created for the acutely intoxicated, where individuals were taken to a unit at the Harplands Hospital to be observed whilst they slept off their alcohol consumption, if there were no other complications. This unit was of immense help to A & E. A Funding for the unit came from the CCG, with the hope it would be cost neutral in the long term. A Member questioned the capacity of the Edward Myers Unit, as they were concerned about the impact on other services. There were ten beds at the unit allocated for planned detox. Two beds had been opened up for diversions from A & E as they were not being used. These were additional beds and therefore there was no reduction in capacity.

A Member questioned whether treatment and education addressed the addictive element of alcohol, and whether people’s lifestyles were assessed to understand why they drank. One of the best rehabilitation centres was in Blurton, where professionals endeavoured to understand people’s reasons for drinking. More therapeutic services were required and basic social aspects such as support and good accommodation. There was not an expectation that commissioned services would do everything, the hope was to create hubs where it would be easier for people to access services.

The care pathway for drugs and alcohol was fragmented, as patients could present themselves to one service and be referred to other organisations for treatment of different aspects of their conditions. The redesign of the service attempted to address this to allow for one contract to cover all services, with the anticipation of a single unified system. There was a need for equivalent day services to balance centres such as the BAC O’Connor Centres, which provided residential rehabilitation. Bed-based services would still be required, but the intention was to improve community based services and invest in these over the long term.

A Member noted the influence that licensed premises had regarding alcohol. It was illegal for licensed premises to serve intoxicated people, but this was difficult to enforce. An event with the licensing trade had taken place the previous week and it was noted that drinking habits had changed as people were tending to drink in the home before going out, sometimes excessively. A new strategy was needed for the night time economy, and collaboration with the Police was required.

The Council’s Community Safety Officer (Alcohol Lead) provided a verbal update on the educational projects being delivered in schools. The current project to educate pupils from year 9 upwards on the dangers of alcohol was being led by Entrust’s local co-ordinator, Jo Abbot. There had been problems getting schools to sign up to the project, with one school signed up so far, although various schools had been identified and approached. These problems were being investigated, and with an increase in funding for the next twelve months, it was hoped that more schools could be engaged. The majority of funding was from Staffordshire County Council, and although it was initially one off funding, there was confidence it would continue. A detailed county-wide survey had been undertaken of year 9-11 pupils, the results of which the Community Safety Officer had received that day and would forward to the Committee. The Chair questioned whether there was specific data for Newcastle-under-Lyme. There was limited data from this project, but data was beginning to emerge. The Strengthening Families Programme consisted of 150 families who had been identified through Social Services and youth services, with Entrust commissioned to deliver the programme. The programme educated parents about responsible drinking and it was hoped that Jo Abbot from Entrust would attend a future meeting of the Committee if desired. A Member considered that detailed information regarding the problems being encountered should be requested from Entrust as soon as possible. A Member considered that school governors and local councillors should be used to ensure schools were involved.

Members questioned whether the programme was open to all educational establishments, including academies. It was understood that it would be open to all educational establishments, but this would be investigated and clarified.

The Community Safety Officer advised the Committee of an enhanced first aid triage project for Newcastle town centre, where St. John’s Ambulance and the Red Cross would treat minor injuries with a view to easing pressure on A & E. There was the intention of enhancing the project to enable more serious injuries to be treated. There would be a temporary minor injuries vehicle in the town centre on Friday 29 November as part of the first operation, which would be in the town centre on twelve key dates over the next year. A Member questioned whether the street triage linked in with the mental health remit. There was funding available for this, and the Member was of the opinion that this should be investigated if the triage did not link in with the mental health remit. The Police and Crime Commissioner had concerns with alcohol and its link to crime and re-offending, and had funded a review of this with the intention of developing a better way to deal with the issue.

The Committee considered the impact of alcohol on the Major Trauma unit at University Hospital North Staffordshire. A Member advised that a report had been commissioned as part of their role as an NHS Governor with regard to major incidents at the Major Trauma unit, which they would share with the Committee when it was available.

A Member was of the opinion that drink awareness courses should be introduced, similar to speed awareness courses, and be part of the criminal justice system. A similar suggestion had been made the previous week at the licensing meeting, and Tony Bullock would enquire with the Police with regard to the suggestion.

RECOMMENDATIONS:                   (a) The Community Safety Officer to circulate the results of the Insight Team School Alcohol Survey County Report.

(b) Entrust be contacted to request information regarding the problems engaging schools for the education project for alcohol.