1. Purpose of Report

To provide members with an update on the Alcohol Delivery Plan and the partnership activity and progress to date which supports the work identified in the plan.

2. Recommendation The Healthier Communities Select Committee is asked to note the report.

3. Policy Context

3.1 Alcohol use has a major impact on health, anti-social behaviour, crime and other important social issues, including the wellbeing and development of Children. Alcohol related harm is significant and increasing in Lewisham. In Lewisham there are an estimated: 11365 higher risk drinkers (5%), 31,873 increasing risk drinkers (15%), 118,194 lower risk drinkers (57%) and 46,029 abstainers (22%).

3.2 The first national alcohol harm reduction strategy was published in

2004. It aimed to prevent a further increase in alcohol-related harm in England and to tackle the costs of alcohol misuse. The patterns of alcohol which were identified as likely to raise the risk of harm were binge drinking and chronic drinking. The strategy included measures to achieve a long-term change in attitudes to irresponsible drinking, measures to improve early identification and treatment of alcohol problems and measures to combat alcohol-related crime and disorder.

3.3 The ‘Safe Sensible social: next steps in alcohol’ strategy built upon the

recommendations from the 2004 strategy, with an increased focus on under-age drinking,18-24 year-old binge drinkers and harmful drinkers. It recommended changes to the criminal justice system to offer interventions for those whose offences are linking to their alcohol use; a review of NHS alcohol spending; more help for people who want to drink less; toughened enforcement of underage sales; trusted guidance for parents and young people; public information campaigns

Healthier Communities Select Committee

Report Title Lewisham Alcohol Strategy and Action Plan

Author Executive Director for Community Services and Director of Public Health

Date of meeting 19 March 2013 Item No: 5

to promote a new ‘sensible drinking’ culture; public consultation on alcohol pricing and promotion; and local alcohol strategies.

3.4 The Drug Strategy ‘Reducing demand, restricting supply, building

recovery, supporting people to live a drug free life’ was launched by the Government in December 2010. This Strategy has seen a departure from previous government policy as it places greater focus on the problems associated with alcohol use and a more holistic approach to tackling drug and alcohol misuse.

3.5 The new Public Health Outcomes Framework sets out the desired

outcomes for Public Health (updated in November 2012), this includes a greater focus on alcohol harm reduction.

3.6 The Government’s Alcohol Strategy was published in March 2012, it

sets out proposals to crack down on ‘binge drinking’ culture, cut alcohol fuelled violence and disorder and reduce the number of people drinking to dangerous levels.

3.7 The strategy includes a commitment to:

• Introduce a minimum price for alcohol • Consult on a ban on the sale of multi buy alcohol discounting • Introduce stronger powers for local areas to control the density of licensed

premises including making the impact on health a consideration • Pilot innovative sobriety schemes to challenge alcohol related offending

3.8 The Lewisham Strategic Partnership’s Sustainable Community Strategy identifies six priorities. The key priorities which relate to alcohol include:

• Safer – where people feel safe and live free from crime, antisocial behaviour

and abuse; • Healthy, active and enjoyable – where people can actively participate in

maintaining and improving their health and wellbeing.

3.9 Reducing alcohol harm is one of the priority outcomes identified in the Lewisham draft Health and Wellbeing Strategy.

3.10 The Police and Crime Plan is the Mayor of London’s Strategy for tackling crime

and making London safer. The Mayor of London is required by law to outline a plan that explains how Police, community safety partnerships and other criminal justice agencies will work together to reduce crime in the capital. The draft plan was published in January; the plan outlines the need to develop smarter solutions to alcohol and drug crime.

4. Background 4.1 Lewisham’s Alcohol Strategy and Action Plan 2009-2012 aimed to reduce

alcohol related harm for people who live, work and visit Lewisham and links the principles and priority outcomes in Lewisham’s Sustainable Community Strategy. The Action Plan 2012-14 (appendix 1) has been updated as a result of the 2012 Needs Assessment. Key actions have been identified to reduce alcohol related harm.

• Improving targeted education and communication. • Increasing the rapid identification and treatment of alcohol problems wherever

people present within the system. • Improving the co-ordination and enforcement of existing powers against

alcohol-related crime and disorder. • Encouraging licensed premises to promote responsible drinking and to take a

role in reducing alcohol related harm. • Improving the recording, collating, analysing and monitoring alcohol related

data, including an annual alcohol needs assessment. 5. Alcohol Delivery Group 5.1 The Alcohol Delivery Group exists to promote harm reduction in relation to

alcohol within the borough of Lewisham. The group is chaired by the Deputy Director for Public Health and is co-ordinated by the Drug and Alcohol action Team (DAAT). Members include, GPs, Police, London Probation, Fire Service, Housing, Lewisham Healthcare Trust, Trading Standards, Licensing, Service User representatives, Voluntary Sector and providers.

5.2 The responsibilities of the group include raising awareness of harm reduction

within the borough using multi agency working, sharing good practice and problem solving where necessary, providing a forum for discussion of matters relating to reduction in Lewisham, sharing, promoting and identifying good practice and initiatives relating to the development and promotion of harm reduction in Lewisham. The group is also responsible for agreeing and developing a rolling programme of action and to monitor performance against the action plan.

5.3 Lead representatives from the group have been identified to progress the actions

in each section of the alcohol strategy action plan. Key Objectives include ensuring Licensing law and regulations are used whenever possible, delivering consistent messages about alcohol use and alcohol related harm and using evidence based interventions to reduce alcohol related misuse. There has been good progress made against all sections with most scoring green against each objective.

6. Alcohol Needs Assessment 2012 6.1 The alcohol needs assessment provides an up-to-date picture about alcohol

related harm in Lewisham and suggests how it can be addressed. It builds upon the previous alcohol needs assessment undertaken in 2009.

6.2 Alcohol plays an important role in society, being consumed by the majority of

adults and making an important contribution to the economy. However, the consumption of alcohol has both health and social consequences, including related health problems and loss of economic activity. There is a direct close-response relationship between alcohol consumption and risk of death. Alcohol misuse also affects wider society through crime and adverse effects on inter-personal relationships. It is also well established that alcohol consumption contributes to traumatic outcomes through violence and injury. Alcohol harm costs London £2.5bn per annum.

6.3 The needs assessment was conducted between January and November 2011.

Both quantitative and qualitative data was collected, analysed and interpreted from various sources and a review of current literature and guidance was conducted.

6.4 An expert group was set up to draw upon local expertise from a range of different

local agencies working with alcohol clients or concerned about alcohol related harm. Its role was to advise on the development of the needs assessment; help with access to data and inform the recommendations arising from the needs assessment.

7. Alcohol Pathways – Service redesign 7.1 In 2010 drug and alcohol treatment services were recommissioned in Lewisham.

This provided an opportunity to review access and the pathways for people requiring drug and alcohol treatment. Members of the Alcohol Delivery Group contributed to the process mapping which has informed the provision. This includes screening and referral pathways within the Accident and Emergency Department at University Hospital Lewisham and brief interventions in community settings.

8. Key Findings

• Alcohol related harm is significant and increasing in Lewisham, exacerbated by recession.

• Alcohol contributes to the London economy, but its economic costs are estimated at £2.5bn per year. Estimated costs to Lewisham of £800m far outweigh the allocated budget of £1.4m.

• Levels of alcohol use are amongst the highest in Western Europe. • Alcohol use has a major impact on health, anti-social behaviour, crime and

other important social issues, including the well-being and development of children.

• In Lewisham there are an estimated: 11365 higher risk drinkers (5%), 31,873 increasing risk drinkers (15%), 118,194 lower risk drinkers (57%) & 46,029 abstainers (22%).

• Alcohol-related hospital admissions are high in England and Lewisham and are rising.

• England has one of the highest liver disease death rates in Western Europe and it is the only disease where the death rate among those under 65 has been rising.

• A survey of 7,500 Londoners showed that 72% were concerned about the impact of alcohol on their communities and want a concerted response

• Alcohol service value for money £5 saved for every £1 spent. 9. Current and Future Activity 9.1 Alcohol is one of three priorities which the Shadow Health and Wellbeing Board

has agreed it should focus on during 2012/13. Using the information from the Alcohol Needs Assessment the alcohol Delivery Group has identified three key areas where the Health and Wellbeing Board can add value to the alcohol delivery work plan for this year. Paragraphs 10 - 12 detail these.

10. Make every contact count 10.1 The evidence base for undertaking opportunistic brief interventions on alcohol

(as with other areas such as smoking) is very strong. A brief intervention delivered by front line staff would mean a brief conversation raising the issue of alcohol, the risks associated with excessive drinking and signposting to local services.

10.2 The provision of brief interventions in a systematic way by staff in a range of

agencies across Lewisham will reach a far greater number of people than are currently reached. Brief intervention training is currently provided and tailor made training can be provided for groups of staff on delivering brief interventions. Each partner has been tasked with identifying key staff to deliver brief interventions and to access brief intervention training.

11. Deliver consistent messages through a multi-agency communications plan 11.1 On account of the plethora of confusing messages that people are bombarded

with about alcohol it is important that a communications plan enables local agencies to deliver the same message.

11.2 The Alcohol Delivery Group has developed a Communication Plan and will co-

ordinate its implementation. The Plan includes targeting key groups through social marketing in addition to broad based communication through existing channels.

11.3 Deliver consistent messages through a multi-agency communications plan.

• Board to agree to the development of a multi –agency communications plan. • Each partner to suggest ways to disseminate consistent messages through

their organisations and networks. • Each partner to make a commitment to contribute to the delivery of the

communications plan 11.4 Targeted work includes the development of an application to be used on mobile

phones by young people, this is being developed together with pupils in Lewisham and the Young Mayor’s Advisory group.

12. Address Alcohol in the Workplace 12.1 A large proportion of employees of partner organisations are Lewisham

residents. Many of these employees will be on relatively low incomes with poor health outcomes. Workplace Wellbeing policies can make a large contribution to improving the health of the working population and reducing sickness absence.

12.2 Lewisham’s public health function will provide support and advice in developing

and reviewing workplace wellbeing policies and the Alcohol Delivery Group will provide advice and support on addressing alcohol within the overall policy.

• Board to agree on a concerted focus on workplace wellbeing • Each partner to undertake to develop or review its workplace wellbeing policy • Each partner to agree to address alcohol within its workplace wellbeing policy

12.3 The Alcohol Action Plan will be monitored and reviewed by the Shadow Health

and Wellbeing Board. 13. Financial Implications

There are no specific financial implications arising from this report. Most of the activity described will be funded from the drug and alcohol budget within Community Services. In 2013/14 this budget will be £4.393m and will be funded from the new specific grant associated with the transfer to the Council of Public Health.

14. Legal Implications

Save for the following, there are no additional specific legal implications. 14.1 The Equality Act 2010 (the Act) introduced a new public sector equality duty (the

equality duty or the duty). It covers the following nine protected characteristics: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation.

14.2 In summary, the Council must, in the exercise of its functions, have due regard to the need to:

• eliminate unlawful discrimination, harassment and victimisation and other

conduct prohibited by the Act. • advance equality of opportunity between people who share a protected

characteristic and those who do not. • foster good relations between people who share a protected characteristic

and those who do not.

14.3 The duty continues to be a “have regard duty”, and the weight to be attached to it is a matter for the Mayor, bearing in mind the issues of relevance and proportionality. It is not an absolute requirement to eliminate unlawful discrimination, advance equality of opportunity or foster good relations.

14.4 The Equality and Human Rights Commission has recently issued Technical Guidance on the Public Sector Equality Duty and statutory guidance entitled “Equality Act 2010 Services, Public Functions & Associations Statutory Code of Practice”. The Council must have regard to the statutory code in so far as it relates to the duty and attention is drawn to Chapter 11 which deals particularly with the equality duty. The Technical Guidance also covers what public authorities should do to meet the duty. This includes steps that are legally required, as well as recommended actions. The guidance does not have statutory force but nonetheless regard should be had to it, as failure to do so without compelling reason would be of evidential value. The statutory code and the technical guidance can be found at: http://www.equalityhumanrights.com/legal-and-policy/equality-act/equality-act-codes-of-practice-and-technical-guidance/

14.5 The Equality and Human Rights Commission (EHRC) has previously issued five guides for public authorities in England giving advice on the equality duty:

1. The essential guide to the public sector equality duty 2. Meeting the equality duty in policy and decision-making 3. Engagement and the equality duty 4. Equality objectives and the equality duty 5. Equality information and the equality duty

14.6 The essential guide provides an overview of the equality duty requirements

including the general equality duty, the specific duties and who they apply to. It covers what public authorities should do to meet the duty including steps that are legally required, as well as recommended actions. The other four documents provide more detailed guidance on key areas and advice on good practice. Further information and resources are available at: http://www.equalityhumanrights.com/advice-and-guidance/public-sector-equality-duty/guidance-on-the-equality-duty/

15. Conclusion and Next Steps 15.1 The current Alcohol Deliver Plan ends at the end of March 2013 and the plan will

now be reviewed by the Alcohol Delivery Group. New objectives will be set and tasks identified which support the overall aim of promoting harm reduction in relation to alcohol. The Objectives set out in the 2012/13 Alcohol Delivery Plan have been met and the actions have delivered key improvements in targeted education and communication, increasing the rapid identification and treatment of people with alcohol problems and improving the co-ordination and enforcement of existing powers against alcohol-related crime and disorder. The development of the Alcohol Needs assessment has also been a key success of the Alcohol Delivery Group. However, other objectives will require further focus in 2013/14 and this will include extending the delivery of opportunistic brief interventions on alcohol by frontline staff and continuing to improve the recording, collating and analysis of alcohol related data.

Background Documents 1.Cabinet Office (2004) Alcohol Harm Reduction Strategy for England, London Crown Copyright 2.Department of health and Home Office (2007) safe Sensible: next steps in alcohol strategy (London Crown Copyright) 4. Public Health Outcome Framework, Department of Health 2012 5. http://www.lewishamstrategicpartnership.org.uk/docs/scs.pdf White IR, Altman DR, Nanchanel K (2002) alcohol Consumption and mortality: modelling risks for men and women at different ages BMJ 325, 191-198, 2002 6. London Health Improvement Board November 2011 9. NW England Public Health Observatory, Topography of drinking Behaviours in England 2011 10. Lewisham Public Health 2011 11. London Health Improvement Board November 2011

Alcohol Needs Assessment (2012) Alcohol Needs Assessment summary version

For Further information please contact Fiona Kirkman, Community Services Prevention and Inclusion Manager on ext 49626

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Appendix 1

Lewisham Partnership

Lewisham Alcohol Delivery Plan - 2012/2013

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Section A: Prevention Objective Task Links to Other

Plans Timescales Progress

Update Progress Against RAG

Deliver Consistent Messages about Alcohol Use and Alcohol Related Harm

Produce and widely distribute consistent alcohol messages & signposting to support services in all main community languages via leaflets and websites.

Maximise opportunities to deliver messages in a range of ways, including: access faith and BME communities through links established with churches; through community/voluntary sector and Voluntary Action Lewisham (Grapevine);through North Lewisham Health Improvement stakeholder group and Bellingham Health forum.

North Lewisham plan.

Bellingham 2nd

Phase Well London Plan.

March 2013

Alcohol key messages to be part of the Bellingham 2

nd

Phase of the Well London work. Attended workshop, June 2012. Community Health Improvement Team using Change4Life Alcohol booklet at outreach events. Dec 2012 delivered presentation to the North Lewisham Steering Group promoting new Alcohol leaflet, key alcohol messages and development of borough alcohol campaign. And information on North Lewisham Xmas alcohol campaign.

Christmas alcohol campaign completed –prepared and gave out to the public 500 alcohol information bags (New Cross to NX Gate).

Support central Government drink drive campaign with local campaigns. Twice a year aimed at council staff and general public. (December and May) providing education and awareness of the number of units in drinks, the time it takes for your body to clear alcohol and

Road Safety core business

March 2013

First Drink Drive campaign December 2012 – literature circulated Council notice boards and events.

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the issues of morning after drink drive casualties and offences with the intention of reducing drink driving offences/alcohol related road accidents.

Ensure Health trainers, Community groups and primary care staff access alcohol awareness training, to improve delivery of consistent alcohol messages to clients. Promote and integrate the Alcohol referral systems between the Health Trainers Scheme, and primary care to improve the referral and signposting pathway and service provided. To ensure the NHS Health Check programme promotes the alcohol pathway. By providing information in the NHS HC Manual on alcohol advice and information on Alcohol services to appropriate clients and ensuring NHS Health Check providers understand the pathway..

Health Trainers core business

March 2013

Organised and completed with DAAT & CRI 4 GP Neighbourhood training sessions for primary care staff. Covered Alcohol service information and delivering a brief intervention.

Facilitated the alcohol referral information to be loaded on GPINTERACTIVE website.

Alcohol training update for health trainers and Community groups delivered November 2012

Reviewed and updated alcohol information for Health Check resource manual Dec 2012.

Next Practice Nurse Forum alcohol update-20

th March.

To be reviewed again April 2013

Ensure North Lewisham Health Improvement Plan is aligned with this plan and the Steering Group to receive updates on relevant sections of the

North Lewisham Plan

March 2013

North Lewisham Plan alcohol objectives have been aligned with

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alcohol delivery plan. Ensure opportunities for co-ordination of awareness raising initiatives are maximised. Promotion of the Alcohol Brief Intervention worker and links with local community groups on Alcohol Health Promotion. Ensure opportunities for co-ordination of awareness raising initiatives are maximised in Bellingham through the Well London/Bellingham project and Bellingham Health Forum

Well London Plan

March 2013

the Alcohol Delivery plan Dec 2012.

Dec 2012 reviewed and updated alcohol objectives in the north Lewisham plan.

February 2013 attended North Lewisham Stakeholders event and facilitated workshop group to review alcohol objectives.

Feb 2013 met with Bellingham Project worker to discuss Alcohol Awareness Training for Well London Volunteers.

Training planned for March 2013.

Ensure parents/carers receive appropriate information on local alcohol support by making current literature and training and support services available at points of contact. Substance Misuse services for parents and children and young people to be listed on the Family Information Service (FIS) Link to carers partnership board to support strategic approach To also focus on carers of adults and young carers

DAAT Delivery Plan

March 2013

Gary to review objectives and feed back to ADG.

Support the review and redevelopment of workplace alcohol policies Make recommendation that all partners

DAAT Delivery Plan

March 2013

LBL and NHS Alcohol policies have been developed and put into Alcohol

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have alcohol policies JSNA. Planned work to identify partners & alcohol policies.

Increase number of children & young people that are affected by their own or others alcohol use being referred to appropriate services. All services working with young people to be made aware of appropriate referral routes and care pathways services through DAAT Training Team and Young Peoples Substance Misuse Service Introduction Workshops

DAAT YP Delivery Plan

March 2013

Referral pathways and Service Level Agreements drafted/disseminated i.e. CAMHS, CRI

Treatments providers and the services they offer are available via the Lewisham’ Councils Website and promoted via the DAAT’s Workforce development programme.

Use Evidence Based Interventions to Reduce Alcohol Misuse

Identify and plan Alcohol awareness events and activities, informed by the Alcohol Needs Assessment for 2012 -13. Identify stakeholders and organisations to be involved in the alcohol events Review alcohol messages in light of the needs assessment and ensure evidence based.

DAAT Delivery Plan

March 2013

Summer 2012 focus on Olympic live sites & events. Alcohol Change4Life leaflet distributed by Change Coaches, CDHT & Public Health.

CDHT/Sport &Leisure/NLP Commissioned to deliver alcohol events& messages.

Met with DAAT between Nov – Jan 2013 to agree key alcohol messages and develop new borough campaign.

Dec – Feb worked with DAAT to develop the IBA Training. Next stage

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Orgs to identify staff for the training and have a programme of training.

Run seasonal alcohol awareness campaigns (Summer & Christmas) and ensure presence at community fairs by providers

DAAT Delivery plan/North Lewisham Plan

March 2013

15th Dec 2012

completed Christmas alcohol awareness campaign. Put together 500+ alcohol information packs and distributed in North Lewisham.

Development of a social marketing campaign aimed at tackling increasing alcohol harm amongst young women.

DAAT Delivery plan

March 2013

Proposal for developing an Alcohol App for young women has been written and approved. 3 focus groups have been set up and are taking place to consult with young women about developing the phone Apps. Feb 2013

Ensure Licensing Law and Regulations are used whenever possible

Set up framework and training for PCT to support how as a Responsible authority they can respond to licensing applications Ensure the Alcohol Delivery Group are part of the consultation on the new Levy / EMRO part of the new Policy Document (October 2012) Establish some training and/or briefing to ensure that all partners involved in the strategy are aware of the powers of the LA03 and the most effective way to use it if and when possible.

March 2013

Nov 2012 met with Cheryl to discuss Public Health role in assessing License applications.

Feb 2013 met with the London Health Improvement Board – Licensing programme lead. Discussed developing criteria and guidelines for Lewisham Public

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Health.

Draft plan being developed March 2013.

15th March attending

the LHIB Licensing Network Event.

Consultation work on EMRO / Levy work from Oct 2012 due to the regulations not being published yet. To be discussed at the Dec ADG meeting. Benefits of EMRO licensing can target areas that cause trouble and limit license.

Discussed with Cheryl possible training for community groups Bellingham and North Lewisham on Licensing laws to be better informed – especially in problem areas such as the New Cross Strip. Cheryl provided briefing paper on Licensing laws for information.

Rolling programme for test purchasing operations by Trading Standards for ‘off sales’ only.

Ongoing Under Age Sales test purchases subject to volunteer availability on various restricted products

Ongoing John currently working with Cheryl’s team to target areas such as the New Cross Strip.

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Section B: Treatment and Recovery Objective Task Links to Other

Plans Timescales Progress

Update Progress Against RAG

Increase professional awareness of alcohol issues, including identification of problems and appropriate referral

Produce and disseminate an alcohol services directory for Lewisham to include referral procedures and care pathways and ensure directory is in electronic format Continue to deliver programme of Alcohol awareness training for all for Tier 1 agencies to include referral pathways and service provision available Provide bi monthly learning sets when all treatment providers and agencies meet with commissioners to share learning and good practice around treatment interventions and care pathways Deliver presentations on alcohol services available within the borough and alcohol awareness training to Lewisham Housing and vulnerable adult support providers Deliver training sessions for the GP Neighbourhood meetings and Practice Nurse Forums on alcohol service provision and referral pathways with the aim of developing skills and increasing confidence discuss alcohol consumption. Evaluate training delivery and produce recommendations for Primary Care Training for the future.

DAAT Delivery Plan DAAT Delivery Plan

March 2013

Training sessions for the GP Neighbourhood meetings and Practice Nurse Forums on alcohol service provision and referral pathways have been completed. Achieved via DAAT Workforce Development Training Programme Delivered via Care for Recovery Group Achieved via New Direction attending LEWAHG Meeting New Direction has also met with various community groups and treatment services to discuss how people can access provision;

- Bench - St Mungo’s - Thamesreach - Dr Dewar

(Lewisham Hospital)

- IAPT - 999 Club - Ladywell unit - A+E Matrons - Fairway lodge

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Community groups and organisations to meet the CRI/New Direction alcohol services. To understand and be aware of the services provided how people can access the services

All pathways have been reviewed; AAU, A+E/Hosp Liaison, ALES, Ambulatory Detox

Monitor, review & develop the capacity of the alcohol treatment system for Lewisham

Continue to monitor effectiveness of University Hospital Lewisham Alcohol Hospital Liaison and Alcohol A&E provision Monitor and review the Primary Care Alcohol Recovery Worker for Dependant Drinker Post with the view of development following completion of pilot Continue ambulatory alcohol detox provision offered via New Direction – Lewisham Expand provision of Hospital liaison across general wards with alcohol related problems to facilitate entry to alcohol treatment pathways including AAU and Tier 4 provision

DAAT Delivery Plan

March 2013

Monitored via monthly virtual alcohol team meetings

Monthly alcohol funnel reports have been collated for ALES, A+E and Hospital liaison

Q2 and Q3

Hospital liaison; 52 referrals, 22 non-dependent, 8 open access referrals 8 commenced T3 treatment

ALES; 20 referrals, 2 non-dependent, 7 open access referrals 6 commenced T3 treatment, 4 achieved controlled drinking

A+E; 50 referrals, 2 non-dependent, 48 open access referrals 28 commenced T3 treatment

Dependent Drinker Worker: 22 referrals, 4 non-dependent, 18 open access referrals 18 commenced T3 treatment

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June 2012 – Feb 2013 19 ambulatory detox’s carried out

Improve referral pathways

Review locally defined referral routes and care pathways for alcohol (to include referral procedures) and ensure that these are embedded within partnership agencies

DAAT Delivery Plan

March 2013

All pathways have been reviewed; AAU, A+E/Hosp Liaison, ALES, Ambulatory Detox

Leaflets and GP pathway sent to GP interactive

Expand the provision of brief interventions offered at the earliest treatment opportunity

Expand satellite and outreach provision from alcohol services into partnership agencies, the community and targeted specific areas to include evenings and weekends Establish training to support the development of skills for those offering brief interventions to include GP’S, Practice Nurses, Pharmacies, School Nurses. Promote and Embed the use of a brief intervention and completion of audit C with patients by primary care staff via Alcohol Training to GP’S, Practice Nurses and Neighbourhood Meetings. Promote and embed the use of brief interventions among Lewisham healthcare staff, though tailored training. Deliver very brief intervention training to front line staff in a range of organisations including the probation service Development of RCGP Training in alcohol misuse for workers

DAAT Delivery Plan

March 2013

Alcohol Harm Reduction Groups:

55 Dartford Road, Forest Hill: Ave average attendance 5 per week

Albany Centre, Deptford Ave average attendance 4 per week and

New Direction, Lewisham; Average 11 clients a week

AA provision at New Direction 14-21 attend per week

Early Recovery Groups developed in T2

Street Outreach (With Thamesreach in New Cross, Deptford & Sydenham

Tier 1 training delivered as part of DAAT training

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programme

Continue Provision of alcohol advice and brief interventions (ABIs) within Primary and Secondary Care

Continue provision and scope feasibility to expand the Alcohol Local Enhanced Service (ALES) to include undertaking an analysis of current ALES data including referral routes, caseloads etc.

DAAT Delivery Plan

March 2013

Provision continued - Insufficient ALES data received to undertake analysis

Improve the outcomes of children of dependent drinkers by increasing alcohol screening at antenatal to 100% in primary care thus helping to prevent foetal alcohol syndrome (FAS), risks of child protection and child mental health problems, low birth weight and infant mortality.

Improve treatment responses for victim and perpetrators of domestic violence

Treatment agencies to remain signed up to DV MARAC and receive training to ensure links into DV support agencies and appropriate channels to highlight escalating risk cases Raise awareness of alcohol services and referral pathways for victims and perpetrators of domestic violence and those agencies working with them Provide brief intervention work in custody for perpetrators of domestic violence for whom alcohol is a contributing factor

Domestic and Sexual Violence Action Plan, DAAT Delivery Plan

Achieved

Nothing received from Penrose despite requests.

Improve psychological and mental health

Pilot alcohol screening and brief intervention in one of the CMHT’s Review how alcohol treatment

DAAT Delivery Plan

Satellite clinic established in the Ladywell Unit

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treatment responses for alcohol users

agencies assess risk within mental health assessment specifically around violence and suicidal ideation. Continue to deliver alcohol awareness and dual diagnosis training as part of the drug and alcohol training programme and promote via hospitals and CMHT’s.

Alcohol Awareness and Dual Diagnosis training delivered

All young people identified as having problems with alcohol misuse will receive an appropriate intervention of care package, with support for both parents/carers

Provide a range of Tier 3 interventions for young people with substance misuse problems. Including:

• Harm reduction

• 1-2-1, group work & Care planning

• Family Support Services

• Criminal Justice interventions

Scope feasibility of pharmacological interventions, community/ambulatory detoxification and tier 4 residential for Young People within the borough presenting with higher risk of alcohol consumption Continue to provide family support facilities both for parents of alcohol using children and children of alcohol using parents. Substance Misuse services for parents and children and young people to be listed on the Family Information Service (FIS) Strengthen and embed as a priority for CYP

DAAT YP Delivery Plan DAAT YP Delivery Plan DAAT Delivery Plan

March 2013

Low numbers of YP accessing treatment with alcohol specific issues – although those who are, are offered a tailored-made personal treatment plan/journey.

Those young people that do require Tier 4 services can apply via the DAAT when required.

Achieved

Maximise the Use of Alcohol Expenditure by Balancing the Use of Resources

Fully disaggregate the expenditure on alcohol Undertake a Programme Budgeting, Marginal Analysis (PBMA) approach to alcohol to actively invest to save

DAAT Delivery Plan

March 2013

Work begun as part of the development of the needs assessment

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Section C: Co-ordination and enforcement of existing powers against alcohol-related crime, disorder and anti-social behaviour Objective Task Links to Other

Plans Timescales Progress

Update Progress Against RAG

Reduce alcohol-related violence including domestic violence

Improve police and CSU flagging of alcohol related incidents and repeat alcohol-flagging data trawl every 6 months

MPS & Lisa Fannon

March 2013

Work has begun

Ensure representation from DAAT on Domestic Violence MARAC DAAT to ensure all services are signed up to MARAC Information Sharing and Operating Protocols.

CRI New Direction, CRI YP Service and Penrose Fusion to receive one MARAC session.

Domestic & Sexual Violence Action Plan 2012/13

July 2012

All DAAT agencies have signed up to the MARAC ISP. Both CRI services have received MARAC briefings, and all three have MARAC Leads.

Penrose Fusion to provide quarterly update reports on the progress of the Stella Project – Intimate Partner Violence Pilot

Domestic & Sexual Violence Action Plan 2012/13

Quarterly reports

Nothing received from Penrose despite requests.

Provide brief interventions in custody suite at Lewisham Police Station for offenders arrested for domestic violence where alcohol is a contributing factor

Domestic & Sexual Violence Action Plan 2012/13

Quarterly reports

Penrose leading on this area of work. Nothing received from Penrose despite data requests.

Multi-agency response to street drinking that reduces public perception of anti-social

Review Recommendations of DPPO via Steering Group including the working up of feasibility of designated space for street drinkers

ASB Action Plan

There is a DPPO in place (which has been in place for the last 2.5 years. Agreement at Safer Lewisham Partnership

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behaviour

Board on street drinking that this would not be implemented.

Implement training & awareness programme for Locality Neighbourhood Community Safety (NCST’s) and Safer Neighbourhood Teams (SNT’s) in dealing with street drinking through motivational interviewing, signposting and harm reduction techniques

DAAT Delivery Plan ASB Action Plan

January 2012

Also with the police & UKBA we regularly take part in Operation Condor which is concentrating on off licences & take away venues. We have had great success in this operation which normally happens 3 times per year. If there are issues which arise from these operations we engage the assistance of the police licensing & council licensing to look at licences and relevant enforcement of that licence. All of this has been benefited by the training and awareness raised for SNTs delivered by NCSS.

Increase outreach provision for street drinkers/street communities Training to be delivered on DPPO and ‘Section 27 Direction to Leave’ to all Police Response Teams Responsible Retailers Agreements are to be signed with off licences in drinking hotspots to remind them of their licensing responsibilities and identify problem premises.

DAAT Delivery Plan ASB Action Plan

July 2012 March 2012

Training delivered to the police response teams and SNT's. In all troublesome areas the off licenses have signed RRA's in addition Off licences in Lewisham High Street have also taken part in not selling high strength Beer &

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Cider this will be rolled out to other problem areas such as Sydenham High Street & Deptford High Street , We have already started to roll it out to Rushey Green & Catford.

Probation to review their work practice with alcohol misusers

Audit offenders with alcohol related offences once a year to ensure appropriate support has been offered and review how Probation clients access alcohol services Review the Alcohol Treatment Requirements Service in Lewisham. Develop a steering group to oversee new care pathways

Completed with ATR work undertaken and regularly reviewed with CRI and Probation To date -22 referrals, 18 commencements, 1 treatment completion

To reduce crime and disorder associated with underage drinking

Reduce the level of alcohol related youth offending, ASB & nuisance by providing partnership initiatives

DAAT Delivery Plan

Low numbers of Alcohol clients entering treatment – referral pathways/service directory needs to be distributed and partnership working improved i.e. community safety, police and healthcare providers.

Establish a process that allows alcohol related assault data to be collected by A&E and shared with the police to inform a targeted response.

DAAT Delivery Plan

Quarter 2

Work started in 2012 as part of the A&E data work

24/25

Section D: Intelligence Objective Task Links to Other

Plans Timescales Progress

Update Progress Against RAG

Develop a Public Health Dashboard with Alcohol Related Harm Data Set Indicators to Link to Current Performance Data Submitted to NTA

Agree with partners a core data set for measuring alcohol related harm in Lewisham and arrangements for collection, collating and monitoring information.

DAAT Delivery Plan

Alcohol Strategy

Public Health Outcomes

Quarterly update

Dashboard complete and includes data from specialist provision, primary care and alcohol admissions.

Collate and Analyse A&E Data and Police Data to Map Alcohol Related Issues

Collate and analyse data on quarterly basis,

Agree reporting guidelines and mechanisms for data sharing with A&E department

DAAT Delivery Plan

Alcohol Strategy

Quarterly Updates

Regular analysis reports and meetings between Police, A&E, Public Health & DAAT

Bring together police data and A & E data analysis to identify key hotspots and produce action plan for response

Strategic Assessment/Community Safety Plan

Currently being updated for 2013

Preliminary discussions between Public health & police on how to do this

Evaluate Alcohol Interventions & Treatment to Ensure Cost Effective and Evidence Based

Explore ways to refine current knowledge and pull together a report with recommendations based on current and future spend.

DAAT Delivery Plan

Alcohol Strategy

Quarter three/four 2013

Preliminary work underway

25/25

Review the implementation needs assessment findings.

Produce report DAAT Delivery Plan

Alcohol Strategy

Quarter three/ four 2013