Members considered the outcome of the comprehensive review of drug and alcohol services commissioned by Cabinet in October 2015 and undertaken by a multi-stakeholder Task and Finish Group (TFG).

The Deputy Lead Member for Public Health and Communications explained that the detailed, comprehensive and high quality report was the result of significant work by officers and members of the TFG. The outcome showed the benefit of a collaborative stakeholder approach.

The objective was to present to Cabinet the most cost effective outcome-based service. A comprehensive review of the current service had been undertaken including benchmarking, a focus on best practice, identification of areas of risk and a stakeholder consultation. Transformation principles were also followed.

Members noted that benchmarking and best practice research showed the current service was performing well and delivered value for money to residents and service users. The latest Public Health England estimates showed that for every £1 spent, a saving of £5.51 in cost avoidance was achieved. In this respect the borough was above the national average.

Flexibility, adaptability and responsiveness were key factors in any service model. Members noted the recommended cohort approach detailed in paragraph 2.8 of the report, alongside greater emphasis on prevention, better integration with the Joint Health and Wellbeing Strategy and better signposting of services. A specific feasibility study was proposed in relation to additional services.

The Lead Member for Finance commented that the TFG had been led by the Deputy Lead Member in an exemplary fashion. The work undertaken  by the Working Group had been diligent and comprehensive. The Group was determined to protect critical treatment services to a small number of residents in dire need of help. At the same time the aim was to extend the role of the DAAT as a lightning rod for a range of prevention, advisory and support services so that all residents had easy access to the various bodies able to inform, guide and help them to avoid or manage their addictions, from younger people with many temptations and those more mature who turned to alcohol. This was a classic example of ‘more for less’. A more flexible and agile service was better able to help all residents within budgetary pressures.

Dr. Kirstin Ostle, a member of the TFG, addressed Cabinet. Dr. Ostle explained that she was a GP based in Dedworth and Eton. She had been very impressed with the organisation of the TFG and the work undertaken by officers in a  tight timescale. The DAAT service was often undervalued; it was relied upon heavily in general practice and needed support.  Dr. Ostle commented that alcoholism was a hidden problem in the population. Affluent residents did not necessarily admit how much they drank. Loneliness was also a factor, as was PTSD in the armed services. The DAAT helped a range of people. She had experienced situations were children were affected or taken into care because their mothers drank too much. She was aware of three cases of death due to alcoholism in soldiers affected by tours of duty in Afghanistan and the Gulf. There was also an increasing problem with legal highs. Alcoholism destroyed lives and could result in homelessness.

The Chairman thanked Dr. Ostle for her work on the frontline.

Councillor Hilton, as the former Chairman of the Crime and Disorder Overview and Scrutiny Panel, addressed Cabinet. Viewed in isolation the DAAT was a small service to 500 adults at a cost of £920,000. With budget pressures it was not surprising that it had come under scrutiny. However the service had an impact on key partners including the police. Acquisitive crime to fund habits was reduced if additions were managed. Violent crime and domestic abuse was often fuelled by alcohol. Substance abuse led to ill health and therefore impacted the health services. The TFG had been the ideal method to take in views. Even if the council provided the full cost of the service the proposal was still £76,000 less than the current structure and included a number of additions. 

The Lead Member for Adult Services and Health commented that the members of the TFG had been chosen carefully to ensure all aspects of the service were challenged.

Dr.Ostle explained that preventative work was being undertaken in schools in relation to psychoactive substances. The issue highlighted the need for the DAAT to be adaptable.

Councillor Beer reported that Councillor Jones, who had been a member of the TFG, had been delighted with the results. However, she had requested that the additional services in Table 6 be included, as she felt they were cost effective steps to avoid repeat users.  The Deputy Lead Member explained that the feasibility study proposed would look at these areas in detail.  The Chairman commented that the proposals would be considered by the Overview and Scrutiny Panel therefore Councillor Jones would have an opportunity to input.

The Managing Director highlighted that the council was working with the Sue Brett Foundation to address the issue of homelessness in the borough. Proposals would be presented to Cabinet in the coming months. She thanked the Sue Brett Foundation for its work with borough residents.

RECOMMENDATION: That Cabinet:

              i.        Notes the outcome of the Drug and Alcohol Services review undertaken by the Task and Finish Group and agrees the recommendations, see box 1.

            ii.        Approves a tender exercise to secure drug and alcohol services for adults, effective from 1 April 2017.

                iii.            Notes that Cabinet will receive a report back on the outcome of the tender in January 2017.