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					Alcohol Harm Reduction Strategy For Barnsley
2006 - 2008

Alcohol Harm Reduction Strategy – June 06

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Contents
1. 2. FOREWORD NATIONAL AND LOCAL BACKGROUND TO BARNSLEY ALCOHOL HARM REDUCTION STRATEGY 2.1 2.2 2.3 2.4 2.5 3. Crime and Disorder Licensing Health Regeneration Cost of Alcohol Misuse

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4 4 5 5 8 9 10 11 12 13 13 17 19 20 21 22 22 26 27 27 27 29 31 32 33

BARNSLEY - STRATEGIC AIMS AND OBJECTIVES 3.1 3.2 3.3 Aims Structure Objectives

3.3.1 Better Information, Communication and Education 3.3.2 Improving Health and Treatment Services: Fairer, Better, Faster Treatment 3.3.3 Combating Alcohol Related Crime and Disorder 3.3.4 Working with the Alcohol Industry: Legal, Social and Ethical Responsibilities of Barnsley Drinks Industry 3.3.5 Creation of Healthy Leisure Opportunities 3.3.6 Support for People Affected by Other‟s Drinking 3.3.7 Children and Young People 4. 5. CONCLUSION ACTION PLANS 5.1 5.2 6. 7. 8. 9. Description of Layout of Action Plans Targets

GLOSSARY OF TERMS AND ABBREVIATIONS REFERENCES AND USEFUL WEBSITES ACKNOWLEDGEMENTS APPENDIX ONE – ACTION PLANS

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1. 1.1

FOREWORD This strategy has been developed by the Alcohol Task Group (ATG); a multi agency sub group of the Drug and Alcohol (DAAT) Board. Partners in the ATG began work in advance of national policy but incorporated this when the National Alcohol Harm Reduction Strategy for England (March 2004) was published. The purpose of this strategy is to present a cohesive drive to focus attention on alcohol harm reduction. This will enable Barnsley to develop an infrastructure, which builds on existing resources and local policies effectively to reduce the harm from alcohol. This strategy will enable organisations and people within Barnsley to work in partnership in preventing and reducing the harm associated with alcohol. This document renews and confirms local partnership commitment to reduce harm caused by alcohol. The strategy presents an updated local approach to alcohol harm reduction developed using:     Local key stakeholder views collected during 2004. Achievements of alcohol harm reduction measures proposed by the first Barnsley Strategy in 1998. The framework of actions laid out in the national policy for the next 3 years. Alcohol Misuse interventions: Guidance of developing a local programme of improvement, DH 2005

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Alcohol is beneficial to health and social well being when used sensibly and responsibly. However it is recognised that for some individuals, families and communities the consumption of alcohol poses significant problems. This strategy sets out i) a response for preventing the harm that alcohol can cause and ii) help for those who are currently negatively affected by alcohol. It calls for a balanced approach to be adopted to ensure that the health, social and economic benefits of alcohol are not outweighed by the human and financial costs of alcohol related crime, illness, educational and workplace performance and breakdown of family and social networks. This document contributes to other major strategies within Barnsley, which include:      
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1.4

Crime, Drugs and Disorder Strategy 2005-8 DAAT Strategy Barnsley Metropolitan Borough Council Licensing Policy 2005 Remaking Barnsley Strategy South Yorkshire Fire and Civil Defence Authority Integrated Risk Management Plan Fit for the Future Strategy Housing and Support Strategy for Substance Misuse

Members of the Alcohol Task Group request that this document is:   Adopted by all partners in Barnsley, Resourced by partners in Barnsley,

resulting in partners including this strategy in their priorities and progressing work as and when resources become available. 3

2.

NATIONAL AND LOCAL BACKGROUND TO THE ALCOHOL HARM REDUCTION STRATEGY

This chapter highlights the common problems and costs associated with alcohol and places in context the background to Barnsley‟s approach to preventing and tackling alcohol related harm. Alcohol misuse causes, or is associated with a wide array of physical and psychological ill health problems and is commonly associated with physical, sexual and emotional abuse of children (although it is not a cause), domestic abuse, household fires and other crime and disorder offences. There are genuine concerns about alcohol consumption within the UK, because as a population we are drinking larger quantities and more frequently. (LDAN and Alcohol Concern 2004). 2.1 Crime and Disorder Increasingly it has been recognised that alcohol is an underlying cause of crime. In the past there has been a focus on drug misuse and acquisitive crime but there is now increasing concern for night time safety issues in inner city and town centres where people congregate to drink alcohol. This has resulted in initiatives aimed to crack down on alcohol related fuelled violence during 2004. The recent Criminal Justice Act has increased police powers to use both Anti-Social Behaviour Orders and to encourage the use of Fixed Penalty Notices to deter nuisance and disorder problems caused by alcohol. This is supported by the National Alcohol Harm Reduction Strategy. Funded initiatives to combat alcohol related violence during 2004 have strengthened the criminal justice approach to tackling harm from alcohol in advance of substantial funding for other areas such as health and treatment. The South Yorkshire Fire Authority also has statutory responsibilities under the Crime and Disorder Act.

2.1.1 There is evidence to suggest that Barnsley has an increasing problem when it comes to crime and disorder in and around licensed premises when compared to other towns in South Yorkshire. The table below shows Barnsley with a higher rate of violent offences committed in connection with licensed premises than the county average in 2003/04, a significant increase on the previous years. 2.1.2 Violent Offences Committed in Connection with Licensed Premises in South Yorkshire 2002/03 and 2003/04 2002/03 no. 220 453 268 1624 Rate per1000 population 1.01 1.58 1.08 1.28 2003/04 no. 287 397 246 1581 Rate per 1000 population 1.32 1.38 0.99 1.25

Barnsley Doncaster Rotherham South Yorkshire Total
Source: South Yorkshire Police

However this table does not show whether these figures are as a result of greater problems within Barnsley, or a proactive policing and arrest approach by Barnsley Basic Command Unit (BCU).

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2.1.3 Domestic abuse involves any act or threat of physical, emotional, mental, psychological, financial or sexual abuse in the context of a current or past intimate relationship. Unlike other alcohol related crime, it is largely hidden with only a percentage of incidents reported to the police. Nationally, almost one in four women is estimated to have been assaulted by a partner since the age 16, with rates of alcohol misuse significantly higher among perpetrators of domestic abuse than in the general population. (Strategy Unit's Interim Analytical Report) There is not only a connection between alcohol and the perpetrators of domestic violence; many victims use alcohol as a form of selfmedication and a coping mechanism. Also, perpetrators may use their partners' drunkenness as an excuse for their own aggression. Children may witness domestic abuse within their families and agencies will continue to work together to protect children. 2.2 Licensing The Licensing Act 2003 has changed the legislative landscape in relation to licensing policy and practice, with the Local Authority taking on a much more prominent role in this important area of work. One of the significant changes was the transfer of licensing for the sale of alcohol from the Magistrates‟ Court to the Local Authority. As a result of this a new Licensing Committee was constituted and its membership determined.

2.2.1 A key aspect of these changes was the requirement for the Council, as the new Licensing Authority, to publish a Licensing Policy Statement outlining how the Council will promote the „ 4 licensing objectives‟, which are: 1 2 3 4 The prevention of crime and disorder Public safety The prevention of public nuisance The protection of children from harm

Key partners in this work are South Yorkshire Police, South Yorkshire Fire Authority and Barnsley PCT. 2.3 Health Alcohol misuse can have a significant negative impact on both mental and physical health. Alcohol is associated with up to 65% of suicide attempts (DoH 1993) and contributes to cancer, vascular disease, mental illness, accidents (including fires) and complications in pregnancy. Alcohol misuse is also associated with a range of problems such as hypertension, depression, and dyspepsia. There is an increased risk of malnutrition for those who are chronic drinkers. Alcohol has „empty calories‟ (whilst high in calories alcohol provides no nutritional value) so an individual may be overweight or obese but still be malnourished. Overall there is a worrying trend that alcohol harm is growing, with a resultant increase in the need for counselling and medication. Alcohol poses a greater risk to particular groups, for example women, young people and some black and ethnic minority groups (BEM) who are at increased risk from cancer, digestive problems and coronary heart disease as a result of excessive drinking. Currently alcohol misuse accounts for 10% of premature death and disability worldwide posing a significant threat to public health.

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Over the past 10 years national policy towards alcohol harm reduction has been overshadowed by drug misuse policy. The significant adverse impact which alcohol causes, resulting in premature death, was seen as secondary in importance to the rising problem of premature death and illness from illicit drug use during the 1990‟s. This was despite the numbers from the former far exceeding the latter. 2.3.1 Community Alcohol Treatment teams and counselling services were available in the late 1980‟s for people with alcohol problems and anti drink-driving campaigns were evident. Barnsley was no exception with development of a local advisory service supported by a specialist in-patient and community alcohol treatment services. The Barnsley Alcohol and Drugs Advisory Service (BADAS) started in the 1990‟s as an agency, which predominantly gave counselling and advice to people with alcohol problems. Despite the health policy shift in the 1990s, which increased the focus on illegal drug use, BADAS continued to provide an alcohol counselling service and referral service for people with alcohol problems, albeit without adequate financial support. This has allowed practitioners to keep up specialist skills in alcohol counselling and provides them with a current, up to date understanding of local drinking culture in Barnsley. 2.3.2 There is evidence to suggest that the harm from alcohol is increasing with people dying at a younger age from alcoholic liver cirrhosis. The Chief Medical Officer in 2001 drew attention to the rising trend in younger deaths from alcoholic liver cirrhosis. Nationally, since the 1970's the age at death for men and women has dropped to between 35 to 54 years and the number of deaths due to alcoholic liver disease has risen. A similar picture of mortality is reflected in recent Barnsley figures below, which show 7 people died in 2001 under the age of 50 compared to 15 in 2002. This represents over 100% increase in deaths as a result of alcohol (emboldened digits). 2.3.3 Deaths in Barnsley residents from alcoholic liver failure Age Group Deaths in 2001 25 to 29 1 30 to 34 1 35 to 39 0 40 to 44 4 45 to 49 1 50 to 54 3 55 to 59 5 60 to 64 2 Total 17 Source: BHNFT, Barnsley Public Health Dept Deaths in 2002 0 0 1 5 9 2 2 4 23

Alcohol misuse costs an estimated £6.8 million per annum in Barnsley in terms of healthcare to address the effects (adapted from the Y&H figures). The % cost breakdown within the health service has been estimated as: 32% Inpatient 27% A&E 24% Outpatient 6

8% GP 5% Alcohol Services 3% Other Primary Care 1% Dependency drugs 2.3.4 Every year, 20 per cent of general hospital beds are occupied by people with alcohol-related problems. 1 in 7 acute hospital admissions are alcohol related and alcohol is a factor in 35% of all A&E attendance. The Royal College of Practitioners has recommended that an „alcohol liaison nurse‟ should be placed in each hospital. These nurses work in the hospital and community, and are the main point of contact if alcohol misuse is a concern and have shown to be very cost effective. As part of the Alcohol Treatment Services commissioned by the DAAT, it has been agreed that within the PCT Service Level Agreement there will be an Alcohol Health Worker who will liaise with hospital and primary care staff. 2.3.5 Barnsley Hospital National Foundation Trust A&E Attendances 12 midnight – 3am Sat/Sun July 1st 2001-June 30th 2004 Type of attendance Number % of total number of attendances 100 62 29 33

All types of attendances No. of alcohol related attendances No. of alcohol crime related attendances No. of alcohol ill health related attendances
Source: BHNFT

2092 1311 611 700

The table above reveals that alcohol was implicated in up to 29% of Saturday night Barnsley Hospital National Foundation Trust (BHNFT) Accident and Emergency attendances where a possible crime was committed and 33% were related to ill health as a result of alcohol consumption. 2.3.6 Within primary care The Barnsley Health Equity Audit (Public Health 2003) showed that 97% of GP practices recorded alcohol consumption levels, however only 37% had a protocol in place which dealt with alcohol issues but 61% did offer services for patients who encountered problems with alcohol. The results of the audit clearly indicate that brief interventions are already being offered to some patients served by the Primary Care Trust (PCT). However just under half of GP practices do not offer this service and even less offer standardised care through the use of practice protocols. Most of the practices that do offer brief interventions participate in the Shared Care scheme providing care for drug and alcohol misusers within GP practice. However many areas of high deprivation are not served by Shared Care practices.

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2.3.7 There has been a rise in monthly expenditure on acamprosate, disulfuram and chlordiazepoxide (which are all medicines to treat people who are dependent on alcohol) from February 2003 to January 2004, which indicates that demand for treatment is increasing. Referrals for counselling and in-patient detoxification for alcohol misuse have risen over the past year. Both Barnsley Alcohol and Drugs Advisory Service and the PCT Department of Substance Misuse have seen a rise in the proportion of referrals for alcohol misuse compared to drugs misuse. 2.3.8 As stated previously alcohol affects mental and not just physical health. Often people with mental health problems drink to excess. Implementation of Dual Diagnosis services began locally in 2003. These services are specifically designed to meet the needs of people with diagnosed mental health problems where substance abuse co-exists. Alcohol misuse is a common cause of recurrent illness in people with mental health problems. Dual Diagnosis services are developing to help people with alcohol misuse and mental health problems to provide more holistic and effective care for this group. 2.3.9 The information and needs assessments carried out at local and national levels have resulted in a national cultural shift in alcohol policy. Alcohol is now recognised as having great potential risks for the population, particularly health risks. It is anticipated that the National Treatment Agency (NTA) alongside the Healthcare Commission will play a role in developing and improving treatment for people who encounter problems with alcohol, similar to the role it plays now in the drug treatment field, which will cover primary care and specialist services. 2.3.10 Although gaps in funding remain, especially within local health service initiatives, the Alcohol Harm Reduction Strategy for England 2004 has indicated that a broad range of piloted work will be rolled out over the next 3 years once research findings of effectiveness are known. The Drug and Alcohol Action Team (DAAT), at the current time also has very limited funds for alcohol, although Partnership in Action has identified funding for alcohol treatment services for 2006/2007. 2.4 Regeneration The Town Centre Management Group, The Barnsley Community Plan and “Remaking Barnsley” initiative define an achievable vision for the future in which Barnsley is an innovative and vibrant 21st Century market town at the centre of a modern dynamic economy and a great place to live. Priorities within the Community Plan to transform the Borough include bringing about a step change in the approach and vision for regeneration in the borough, ensuring that a new and sustainable economic future is achieved with support in the community to tackle anti-social behaviour and drug use. Remaking Barnsley is a long-term strategy to revitalise Barnsley town centre and the wider economy. The Barnsley urban area plan will play a pivotal role and the town centre itself will be transformed into a modern urban living space offering shoppers and visitors exciting retail, recreational, entertainment and cultural experiences that will enable it compete successfully with neighbouring centres.

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Part of this transformation includes the proposal to encourage a „café culture‟, with external pavement areas where refreshments, including alcoholic drinks, can be enjoyed. Regeneration in the Borough‟s rural areas will be based on diversification and sustainable development. Cultural and leisure facilities appropriate in type and scale will be encouraged in the smaller market towns. It is recognised that regeneration can often be seen as being in conflict with alcohol harm reduction strategies as regeneration often results in more licensed premises. 2.5 The Cost of Alcohol Misuse The Interim Analytical Report compiled national statistics and trends on the areas of harm caused by alcohol. During 2003-4 agencies working within the Safer and Stronger Communities Partnership, the Drug and Alcohol Board and Fit For The Future initiative pulled together datasets to reveal the local picture of alcohol related harm. National estimates of the costs of harm caused by alcohol were published in 2004. The table below has been calculated to estimate the cost of alcohol related harm in 4 broad areas of family/social networks; health; crime; workplace:
FAMILY AND SOCIAL NETWORKS 3900 – 6500 children affected by parental alcohol problems HEALTH CRIME AND PUBLIC DISORDER Up £25 million costs of drink driving WORKPLACE

£ 7 million cost to the health service of alcohol related harm

Up to 100 000 days lost due to reduced employment

Up to 90 deaths per year due to alcohol related chronic disease Up to 100 street drinkers

Up to £9 million cost to the criminal justice system

Up to £10 million alcohol-related lost working days Up to £12 million cost to the economy of alcohol related deaths 85000 days lost to alcohol related sickness

Up to £17 million cost to services as consequence of alcohol-related crime 400 arrests for drunkenness and disorder 1800 victims of alcohol-related domestic violence

Source: Public Health Department, Barnsley PCT

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3.

STRATEGIC AIMS AND OBJECTIVES

The information and policy initiatives at local and national level outlined above, alongside a broader local needs assessment using stakeholder views has resulted in the Barnsley Alcohol Harm Reduction Strategy. This strategy represents a shared vision to the local approach in alcohol harm reduction. The benefits of alcohol are recognised and can contribute to a balanced strategic approach to using alcohol sensibly and responsibly. It is recognised that for some individuals, families and communities alcohol poses a significant problem that can impact negatively on all aspects of life. With this in mind the alcohol strategy sets out a response for those who need help relating to alcohol as well as developing measures to prevent alcohol harm. Individuals, communities, suppliers of alcohol, law enforcers and national policy makers all have a role to play in promoting socially acceptable behaviour around alcohol that reduces the harm and nuisance associated with alcohol. This strategy is based upon the positive outcomes already achieved in Barnsley in reducing alcohol related harm and provides a framework that will enable communities and professionals to work together on long term targets. This will contribute to positive health, social well-being, better educational attainment and earning potential for the population of Barnsley. This strategy is not „stand alone‟ and is part of the other major strategies in Barnsley that contribute to health and social regeneration. There are 4 key areas in the National Alcohol Harm Reduction Strategy: 1 2 3 4 Better information, education and communication Improving health and treatment services Combating alcohol related crime and disorder Working with the alcohol industry

This strategy is our local response to the national document. The monitoring and evaluation of the strategy will lie with the Alcohol Task Group, which is a sub group of Barnsley DAAT (see page 12 for further details on structure). It is recognised that the DAAT has given much support and encouragement to those people who are concerned with the harm that alcohol can cause and the future role it will play in alcohol harm reduction in line with national policy. The purpose of this strategy is to present a cohesive drive to focus attention on alcohol harm reduction. This will enable Barnsley to develop an infrastructure, which will use existing and future resources and local policies effectively to reduce the harm from alcohol. The strategy will enable organisations and people within Barnsley to work in partnership in preventing and reducing the harm associated with alcohol.

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3.1

Aims

The aims of this Barnsley Alcohol Harm Reduction Strategy are:

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To redress the balance of economic and social benefits produced by alcohol through local regeneration by committing resources to reduce the adverse effects of alcohol known to cause harm to health and social well being. To support the alcohol harm reduction initiatives in Barnsley town centre and other areas of the Borough to address public nuisance and violent crime and to protect the young and vulnerable people from alcohol related harm. To support provision of help for people suffering alcohol problems as a result of their own or others‟ drinking. To ensure relevant organisations in Barnsley consider the impact of plans and commissioned resources in terms of alcohol harm reduction and to ensure that vulnerable people are able to access services which meet their needs. To encourage voluntary and community organisations, licence and trade to incorporate alcohol harm reduction principles when developing proposals and services. To ensure all relevant agencies and organisations work in a co-ordinated manner to prevent the harm associated with alcohol.

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3.2

Structure

To deliver these aims the following structure is recommended. Further links are established with the National Treatment Agency (NTA) and partners at Government Office Yorkshire and Humber:

Joint Agency Group

Joint Commissioning Group

Drug and Alcohol Board

Safer & Stronger Communities Partnership

Alcohol Task Group (ATG)
(Multi Agency group - Authors of the Barnsley Alcohol Harm Reduction Strategy)

Task groups will be developed by the ATG as necessary to achieve aims of strategy
For example, Information, Communication and Education, Support for People Affected by Another‟s Drinking. Sub groups will reflect the multi agency partnership working arrangements

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3.3

Objectives

3.3.1 Objective 1: Better Information, Communication and Education A key feature of this strategy is the improvement of information, communication and education. This will cover the areas of sensible drinking messages, general and targeted campaigns, lobbying, training and the dissemination of good practice. Awareness-raising though education, communication and information aims to challenge cultural attitudes to alcohol that sees drunkenness and binge drinking as acceptable. Barnsley differs little to other areas within the UK where attitudes and behaviour towards alcohol could be improved. It is recognised that changes are needed to promote a healthy, safe and enjoyable approach to alcohol consumption. Information, communication and education can form a large part of changing attitudes towards unhealthy and irresponsible alcohol consumption. A holistic approach is needed in education around alcohol, whether this is in educational, workplace, leisure, primary or secondary care service settings. This means that a balanced approach is needed; not one that focuses solely on alcohol‟s potential harm, but one that also promotes sensible alcohol consumption. A consistent approach that raises awareness of alcohol‟s benefits and potential harm is required in all settings. Such an approach needs co-ordination and leadership. It needs to be backed up by a quality training package aimed at professionals in health and social settings who are involved in the delivery of alcohol education. It will also include the use of peer educators, parents and the media. Information Drinkers have a right to clear, accurate information on which to make choices about their alcohol consumption. To make an informed and responsible choice, people need to know and understand the effects of alcohol on their own, their families and the community‟s health and welfare. Clear and credible information and education are needed from those responsible for health and social welfare within Barnsley to enable people to make these choices. Whilst drinking alcohol is for many an enjoyable experience there are dangers in excessive use, in both the short and long term to both physical and mental health. These dangers need to be highlighted in an appropriate and relevant way that reaches vulnerable groups of people, those that drink to excess occasionally (known as binge drinking where over twice the recommended daily amount is consumed in one session and chronic drinkers (men that drink 21 units or over per week, women 14 or over per week). A “sensible drinking” message needs to be given. The Government‟s current “sensible drinking” message is a benchmark for sensible drinking, designed to increase the public‟s awareness of the longand short-term health effects of excessive drinking. The “sensible drinking” message was first referred to in Government‟s 1992 Health of the Nation 13

White Paper. This recommended that men should consume no more than 21 and women no more than 14 units per week. Since 1995 and in recognition of the dangers of excessive drinking in a single session, the sensible drinking message was changed to focus on daily guidelines. These are as follows:    Maximum intake of 2-3 units per day for women and 3-4 for men, with two alcohol-free days after heavy drinking; continued alcohol consumption at the upper level is not advised; Intake of up to two units a day can have a moderate protective effect against heart disease for men over 40 and post-menopausal women; and Groups, such as pregnant women and those engaging in potentially dangerous activities (such as operating heavy machinery), should drink less or nothing at all. The Government plans to make the sensible drinking message easier to understand. When these changes have occurred the revised message will be disseminated within Barnsley. Parents, the general public, professionals and the media are all deliverers of information around alcohol. This could be exploited to help deliver the sensible drinking message. Barnsley will benefit from increased health and social outcomes if we are successful in delivering sensible drinking messages. The following types of drinkers and drinking patterns have been recognised nationally and also within Barnsley. Possible responses to their particular needs are highlighted below: Underage Drinkers People under the age of 18 must be made aware of the risks they take by attempting to purchase alcohol and the risks they pose to their health by drinking. Young people are at increased risks from the harm of alcohol. The Responsible Retailer Scheme (RRS) will have a role to play in giving the retailer the knowledge and confidence to refuse underage sales, and the publicity given to scheme members will send a clear message to young people that retailers will not sell alcohol to underage purchasers. The aim is to reduce the number of requests for alcohol by young people. Through close links with schools and the community the Responsible Retailing Scheme will identify problem retailers. Binge Drinkers The risks to health must be made apparent. Many people who binge drink may not be aware of the risks posed to their health. Tailoring information specific to their needs will be more effective than general information. Chronic Drinkers Tailoring information specific to the needs of chronic drinkers will be more effective than general information. Employers also have a role to play in supporting and helping employees who drink large amounts regularly.

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Black and Ethnic Minority Groups Research on ethnic minority drinking patterns is limited but so far suggests that all minority ethnic groups, except Irish people, drink smaller quantities than the general population. Similarly they drink less frequently, again except for Irish people, who drink as frequently as the general population. However, within some communities, religious restrictions can lead to hidden and / or heavy secret drinking. Religious and cultural restrictions may also create problems for people who wish to seek help. Research does suggest that some ethnic groups are particularly vulnerable to suffer alcohol-related morbidity and mortality. This means that information to ethnic minority groups needs to specifically meet their needs, including sources of culturally appropriate help. Women Alcohol poses a greater risk to women's health than men‟s. This means that women are more at risk from cancer, digestive problems and coronary heart disease as a result of excessive drinking. Women may be particularly reluctant to admit to alcohol problems or alcohol misuse because of social stigma and perceived fear of social service involvement if they have dependents. Information and education to women, particularly those in need of help needs to be sensitive to such issues. Older People The information needs of older people regarding alcohol consumption are often missed. Although drinking to excess declines as people age, there is still a need to provide appropriate information and identify appropriate interventions. Drink Spiking Over recent years there has been growing concern regarding alcoholic drinks being spiked. The dangers of such activities will be highlighted to people at risk through information campaigns and displaying relevant information in licensed premises. Communication The overall aim of the strategy is to communicate a clear and sensible drinking message to help reduce alcohol related harm. Communication will form part of the Responsible Retailer Scheme (RRS). Those that sell alcohol who are part of the RRS will be encouraged to display information about units and sensible drinking limits near to where they sell alcohol. It is recognised that making information available at the point of sale alone is unlikely to change behaviour, but it is an excellent way of disseminating information, which may play a useful role in raising awareness and educating drinkers about the risks associated with alcohol misuse. The development of an alcohol website could also be used as an opportunity for further communication. This could deal with alcohol issues and provide links to other useful information sources including Government guidelines.

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There is also a role in communicating the latest evidenced based practice and responding to government regarding their consultation documents that cover alcohol issues. The alcohol task group will look to promote a sensible approach on the way alcohol is advertised at both local and national level and will develop ways of disseminating sensible drinking information, for example leaflets in pay packets. The task group will also explore best practice regarding the dissemination of accurate and relevant information to particular groups as it is recognised that alcohol consumption behaviour varies between different groups. A media campaign should form part of improving communication. The media can be a powerful tool in raising awareness, changing opinion and can be instrumental in changing cultural attitudes towards alcohol. Local media campaigns should aim to maximise the national media campaigns, for example drink driving campaigns at Christmas and summer evening anti drink driving campaigns. Fit For the Future (FFF) is Barnsley PCT‟s initiative to raise awareness regarding health issues. FFF includes alcohol as one lifestyle factor that may have a detrimental affect on health, and could assist with local media campaigns. It is recognised that different groups of drinkers need to be targeted with information relevant to their alcohol consumption behaviour if the campaigns are to have an effect. Specific information relating to binge drinking and the consequent risks associated will also be targeted at young people. The Alcohol Task Group will also lead on a general health promotion campaign. There is willingness from public health practitioners and those working in the alcohol field to hold „roadshows‟ in the town centre of Barnsley. Roadshows that have been held in the past have been described as useful by practitioners. For all media enquiries regarding alcohol a single point of contact will be made available. Education Education is also a key area of work that will be promoted by the Alcohol Task Group. The alcohol task group will focus on training needs, children and young people and developing policies in the workplace. Currently within Barnsley an „Alcohol Facts‟ course exists, which is accredited to level 2 for practitioners with „Alcohol and Child Protection‟ being accredited at level 3. Education for young people is covered in more detail under Objective 7: Children and Young People. Education in the Workplace Alcohol misuse is very common. People who experience problems with alcohol may be in employment and in some cases alcohol may have a direct influence on performance or affect the number of days taken off work. Employers have an ethical duty to support employees who are experiencing difficulties with alcohol and to balance the safety of other employees and users of services. Employers can assist employees in a number of ways, 16

which will be governed by the services they provide. However, employers at the present time may be unaware of the help and assistance they can offer or what the early indicators of alcohol misuse are. There is a role therefore to educate employers about these matters, raising their awareness and enabling them to help others. An assessment of workplace policies, practices and procedures can be undertaken with a view to raising awareness of the possible need for and development and introduction of such policies. Potential partners in this work could include Trade Unions, BMBC Healthy Workplace Advisor, the Drug and Alcohol Action Team (DAAT), employer organisations, Public Health and ACAS. The Government has produced a Drugs and Alcohol in the Workplace toolkit. The DAAT strategy team have already conducted 2 seminars, which have incorporated the toolkit. Training Issues Good high quality training and support is needed for those delivering alcohol education. A Needs Assessment will take place to identify the training needs of different staff in different settings and looking at both general and specialised education packages. Delivery Particular attention will be given to improving information, communication and education. An information, communication and education action plan has been created to address these issues and will be monitored regularly. Significant partners have also been identified to ensure the delivery of the action plan is successful. This area of work will also include young people and relevant young people‟s services. 5.3.2 Objective 2: Improving Health and Treatment Services – Fairer, Better, Faster Treatment It has been demonstrated previously that alcohol costs health services within Barnsley £6.8 million per year. These costs could be reduced by more preventative work. For example more investment in brief interventions would result in savings from current healthcare costs, including, inpatient stays, referrals to outpatients, primary care consultation costs and prescription costs. Health promotion work regarding alcohol can be implemented in primary and secondary care and partners at Barnsley Hospital NHS Foundation Trust can play a role in assisting people to adopt lifestyles where alcohol harm is reduced. We expect the release of the Models of Care framework for alcohol misuse (MoCAM) by the National Treatment Agency in the near future. Therefore, the ground work in the first year of the strategy implementation for alcohol identification and treatment will be structured by the framework. However, the Alcohol Task Group will explore the current options available for improving treatment.

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The task group will develop an infrastructure to help prevent serious alcohol harm occurring by early identification in primary and secondary care settings. The group will also look at how brief interventions by people not involved in the medical profession (for example employers, community and voluntary workers) can identify people who may be developing excessive drinking problems, or behavioural problems related to drinking and give relevant information. The Joint Commissioning Group (JCG) will work with service users and ex service user groups to publicise the “harm to health” message. Attention will be paid to the development of aftercare programmes to benefit local people accessing treatment and partnership work with Mental Health Service providers to improve Dual Diagnosis service. Consideration will also be given to the possibility of A&E secondary care liaison work. Training will also be considered for relevant staff. The DAAT is currently developing an Accommodation and Support Strategy for substance misusers and contributing to the Accommodation Group, chaired by the Chief Executive, to develop accommodation provision and housing support for vulnerable groups, including drug and alcohol misusers. Appropriate and sustainable housing and housing support is a foundation for the successful rehabilitation of alcohol misusers. Without housing, or with housing problems, alcohol misusers may have difficulty sustaining or entering treatment services and their rehabilitation will be put in jeopardy. It is also essential to ensure that people who choose to drink are able to access and maintain accommodation. The development of a holistic package of wraparound support, including, where necessary, the provision of housing and housing related support is also crucial to community reintegration, training and employment. Adequate housing and support is also a major resettlement need for those leaving prison or residential rehabilitation. The Supporting People 5 Year Strategy identifies substance misuse, including alcohol, as the highest priority for the delivery of new services. This is under pinned by the need to further develop the needs analysis and models of service delivery for this client group. This is to be completed in October 2006 and will feed into the South Yorkshire Housing Investment Programme priorities. The DAAT are currently working closely with Supporting People and other agencies to progress work in this area. Currently the Richmond Fellowship Scheme (William Street project) is the only supported accommodation service available to alcohol users in Barnsley. Following a recent Supporting People Review a proposal has been submitted to re-model the scheme to provide 4 self-contained flats and 5 units of floating support. This model will enable support to be provided to clients with different levels of drinking and also to offer support to people in their own home, including those at risk of losing their tenancy and those moving on from the supported accommodation scheme.

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3.3.3 Objective 3: Combating Alcohol Related Crime and Disorder Drinking is strongly linked to crime, disorder and anti-social behaviour. The Alcohol Harm Reduction Strategy for England (AHRSE) states that the areas of concern for most people include:
      

Alcohol-related disorder and anti-social behaviour in towns and cities at night Under-age drinking Crime, disorder and anti-social behaviour - often caused by repeat offenders Domestic violence Drink-driving Urinating in public Drinking on the street and in other open public places

Some offences are specific to alcohol such as driving over the prescribed limit, licensing offences, drunk and disorderly and contravention of the terms of a designated area declaration (this relates to drinking in public). Alcohol is also associated with other crime, particularly breach of the peace, criminal damage and assault (including sexual assault and domestic violence). Anti-social behaviour includes a range of problems such as noisy neighbours, vandalism, litter and youth nuisance - all of these can have associations with drinking. It is common therefore for people with drinking problems to be in contact with the criminal justice system. The criminal justice system has a key role to play in directing people to get the help and support they need with alcohol problems. Training will be offered to magistrates to make them aware of the services available for people where alcohol may be a problem. Magistrates will be encouraged to require people where alcohol is a feature of their crime to access help from a range of services, from both the voluntary and statutory sector. Therefore it is important that magistrates understand what treatment is available. Training will also include references to gender; it is perceived that women are dealt with more harshly than men when it comes to alcohol misbehaviour and that in many cases the crime is not taken as seriously when committed under the influence of alcohol. Domestic Abuse Police will actively prosecute anyone whom they suspect to be committing domestic abuse, not necessarily using the victim as a witness. Children who are from families where domestic abuse and/or drinking to excess are apparent will be referred to social services. Magistrates will be encouraged to refer people who commit domestic abuse and drink to excess to agencies that can address both issues. Victims should be referred to domestic abuse support agencies. Liaison between Safer Neighbourhood Teams (SNTs) and A& E Liaison between SNTs and A&E could be improved without breaching a patient‟s confidentiality, to help assist targeting areas where alcohol related crime and violence might particularly feature.

19

Underage Sales Youth nuisance and antisocial behaviour is often associated with alcohol and street drinking. The law relating to under age sales covers off licences as well as pubs, bars and nightclubs. The Responsible Retailing Scheme will target off licences as they are often cited as a particular source of problems in local communities where under age drinking is a problem. The results of the RRS can be seen within off licences with posters regarding ID and underage sales being clearly displayed in participating stores. There is an ongoing requirement that proof of age be requested, where appropriate, to retain membership of the scheme and this may be tested at any time by making test purchases. If a shop is ignoring the law on underage sales enforcement officers will consider whether to prosecute, and the trader‟s membership of the RRS will be terminated. The RRS will continue to work closely with the retailer to ensure illegal sales will not be made in the future. The RRS scheme will encourage the use of ID and accredited Proof of Age cards

3.3.4 Objective 4: Working with the Alcohol Industry (Legal, Social and Ethical Responsibilities of Barnsley Drinks Industry) Strong partnership working is a key element of any strategy. Major partners in the Barnsley Alcohol Harm Reduction Strategy are those employed within the drinks industry in off licences, pubs, bars and nightclubs. Within Barnsley the Licensing Forum has been developed. Considerable success has already been achieved and there is evidence of good links with the industry. It is an aim of this strategy to build upon what is already in place and encourage further involvement from the drinks industry within Barnsley. There are social and ethical responsibilities associated with the sale of alcohol as well as legal responsibilities. This strategy will enable those employed in the drinks industry to comply with their legal responsibilities and also offer support and ideas for an ethical harm reduction approach to selling alcohol and other drinks. Bars, Pubs and Nightclubs Bars, pubs and nightclubs do not exist in a vacuum and have links to community safety, planning, regeneration, the environment, transport and health. This strategy considers these issues alongside health issues. Over the last decade, there has been a huge growth in the number of licensed premises in Barnsley (particularly the town centre). This includes a number of „super pubs‟ that tend to be far bigger and have less seating than traditional pubs. The night-time economy has a beneficial role to play in rebuilding urban economies, attracting tourism and investment. However, if there is little or no night time infrastructure or assistance to the industry to behave responsibly, problems may be created. Irresponsible drinks promotions within bars and nightclubs encourage binge drinking. This, coupled with the current design of bars with few seating areas, encourages people to drink quickly. Instead of irresponsible drinks offers the alcohol industry will be encouraged to reduce the price of soft drinks, or to offer soft drinks promotions to drivers. 20

The Safe and Enjoyable Drinking Protocol for Barnsley was launched in 2004 and has the potential to be further developed and expanded. Licensees joining the scheme are encouraged to adopt a number of measures to ensure that they behave responsibly and promote safe and sensible drinking. A review of the protocol will take place in 2006. Furthermore, to assist in the achievement of an integrated approach to licensing matters, the Authority hosts a Licensing Forum at which members of the licensed trade, the Local Authority, PCT and Magistrates come together to raise awareness, share information and consider issues and problems in an open forum. OTHER ISSUES The Environment Environmental problems related to licensed premises include noise, anti-social behaviour (such as arguments, street urination and fouling, al-fresco sex, increased street refuse, and vandalism) potentially leading to loss of earnings for business premises. The Licensing Act however encompasses all businesses, including food and non-alcoholic drinks outlets that operate between 11pm and 5am, which will aid the Local Authority powers to keep areas clean and tidy. Bottle bins and recycling measures can also be developed which may impact positively. It is important that streets are kept clean, as it is notable that people's perception of the cleanliness of their streets is a key indicator of how safe they feel. Transport Fights can often break out where there is a concentration of people in taxi ranks and bus queues in city centres. These can be minimised by improved late-night transport provision, ensuring the rapid dispersal of crowds. A partnership between the Local Authority, transport providers and police, perhaps formalised in the Local Authority's Local Transport Plan, should look, for example, at the provision of night buses, and encouragement of late night taxi services. Improved transport provision could be complemented by schemes such as that in Manchester, where wardens around bus and taxi queues have proved successful in inhibiting violence. It is essential that links are made with the “Re-making Barnsley” Agenda and Town Centre Management Forum to ensure alcohol and related issues are considered. 3.3.5 Objective 5: Creation of Healthy Leisure Opportunities Barnsley Town Centre has a vibrant nightlife; unfortunately much of this is based on the sale of alcohol. There are few alternative leisure activities. However, there is the Metrodome and the Lamproom Theatre. The Alcohol Task Group (ATG) will work with such organisations and the Town Centre Management Forum to assist in developing real alternatives to drinking focussed activities. Remaking Barnsley aims to diversify the central monoculture which exists in Barnsley Town Centre. The Task Group will work 21

closely with Remaking Barnsley to encourage safer drinking areas. The Passport to Leisure Card (a card that enables access to leisure opportunities at a reduced rate) will also be promoted and supported by the ATG. The picture outside the town centre is similar to the one within. There is a recognition that few alternatives to drinking exist, particularly in run down communities where alcohol is cheap and easy to obtain. Smaller town centres within the Borough also need a diversity of nightlife and leisure opportunities. On the doorstep leisure opportunities where alcohol plays a part with other lifestyle factors and social interventions may result in less alcohol related problems and vibrant communities that have a host of leisure opportunities. The benefits of such an approach is to give communities, and particularly young people, the clear messages that social interaction and fun is not just drinking. There are many other enjoyable leisure activities, which the Alcohol Task Group will support. If a variety of affordable entertainment is on offer there may be a reduction in drinking alcohol and the view that this is the only evening leisure activity.

3.3.6 Objective 6: Support for People Affected by Others Drinking Alcohol affects more than the person who is drinking; partners, parents and children can all be negatively affected by another person‟s drinking therefore support is important. Support can take many forms. Carers support groups and self help are ways in which many adults have found support. Services can have a role to play in supporting people by signposting them to relevant agencies, self help groups and by providing relevant information. The needs of children affected by another person‟s drinking are of special consideration. Where it is felt there are risks to the child then child protection procedures must be instigated. Children who are affected by their parent‟s drinking are at particular risk. Information will be targeted at this group so that they are able to seek help and assistance from national or local organisations. (See Objective 7, Hidden Harm). 3.3.7 Objective 7 – Children and Young People The DAAT/CYPSP Young People‟s Substance Misuse Group (YPSMG) leads on the planning, commissioning and performance monitoring of young people‟s services. The remit of the group covers alcohol as well as drugs, as unlike adult substance misuse, YPSM funding is not ring fenced to cover illegal drugs only. In April 2005 Barnsley was selected as one of 30 National High Focus Areas (HFAs) for Young People‟s Substance Misuse. In line with the published guidance „Every Child Matters: Young People & Drugs‟, HFA‟s were charged with making accelerated and sustained progress against National drug 22

strategy targets for young peoples substance misuse (YPSM) and with delivering against the 5 outcomes for all young people, whilst integrating YPSM commissioning and service provision with main stream children‟s services and the „Change for Children‟ agenda. Education Education of young people can take place in both formal and informal settings; the different settings call for different approaches. Alcohol education is already a statutory requirement of the National Curriculum Science Order. This represents the statutory minimum, and schools are expected to use the non-statutory framework for personal, social and health education (PSHE) as the basis for extending their provision. PSHE provides pupils with opportunities to develop their knowledge, skills, attitudes and understanding about alcohol. The YPSM Group have been focusing on strengthening the Healthy Schools Standard and on developing joint approaches to delivering the whole PSHE agenda in the most effective and balanced way. Use of evidence –based practice and distribution of good quality resources will be a priority for drug education and current auditing of existing provision across schools will help to identify gaps and duplication to improve future planning and commissioning in this area. Other avenues for alcohol education also exist. The Youth Service, the Connexions service, and further/higher education colleges also have opportunities for educating young people about alcohol. Within Barnsley the Youth Service leads the way in education in informal settings and alcohol forms part of Barnsley‟s Youth Service curriculum. This expertise needs to be recognised and used to form part of informal alcohol awareness training for young people. Barnsley Youth Service also has some experience in peer education methods and these opportunities should be explored as it is suggested that peer education may be effective with young people. Work around achieving the Healthy Colleges standard will also be continued with Barnsley College and will include the launch of “Be Aware” for college personal tutors as well as the possible targeting of specialist outreach as a visible presence in college on a regular basis. The Voluntary Sector also has a role to play, as do groups of parents and carers, users and ex- users of alcohol services. Information and Communication It was recognised that the effectiveness of ad hoc communications initiatives could be significantly improved by the development of an agreed communications strategy for YPSM. Capacity and expertise has been procured externally to forward this work and to give tactical support with publicising several current initiatives. The extra support has enabled the development of a communications strategy which builds on the topical and universal interest in alcohol consumption amongst young people to introduce links to the wider CYP agenda i.e. teenage pregnancy, anti-social behaviour etc, whilst suggesting a timetable for the improvement of communications with all stakeholder groups. 23

Tactical support with existing projects has included increasing media coverage around resources such as „carrying the can‟, initiatives such as the Tackling Drugs Changing Lives awards and to raise public awareness around the wider agenda e.g HFA status. Most recently extra support assisted with a media launch event for the National Children‟s Bureau „Be Aware‟ toolkit which involved the 2 local young people who had been responsible for its design. . As an HFA the YPSM Group have been in receipt of increased support from the National FRANK team, this has included the piloting of a scheme using street marketing peer-to-peer teams made up of local young people. The idea is that local young people are recruited and receive training to deliver this using street sofas to engage young people. The pilot has been successful in other areas and youth council, voice and influence, and the wider youth service were all keen to be involved in this project which is aimed at gathering the views etc of vulnerable young people. Local events are scheduled to take place in 2006. All young people‟s services, particularly those working with identified vulnerable people, have a role to play in highlighting the dangers of drugs and alcohol to young people. The Young People‟s Substance Misuse Group is working with local services such as the Child and Adolescent Mental Health Services, Strengthening Families Programme, BMBC Social Services, youth Service, Domestic Abuse services and Child Protection Services, School Nursing Services, Health Visitor service and Sure Starts to ensure that children at risk from their own personal drinking problems and/or other people‟s drinking receive advice and treatment where appropriate. Lack of communication between services has often resulted in children and young people at risk being identified long after preventative interventions could have been effective. Young People‟s services need to have relevant frameworks in place to ensure the early identification of alcohol/substance misuse and to carry out appropriate referrals or targeted interventions where appropriate. To ensure this happens a YPSM screening tool was developed over the course of two multi-agency workshop days and based on models used in other DAT areas. With the development of the Common Assessment Framework (CAF) pilot project at Priory School and the training sessions for all mainstream workers generated by this, the need to link this to the YPSM specialist tool was identified. After making contact with relevant individuals responsible for CAF development it was agreed that with the CAF screening tool collecting more general information at tier 1, the local YPSM tool would best serve as a tier 2 specialist assessment. The YPSM assessment will have a clearly defined referral pathway from CAF and training to deliver the assessment will begin as a next steps „add on‟ to CAF training now the first programme has been completed. The BARN will provide support to mainstream workers to deliver the assessment on a consultancy basis and new and existing specialist drug workers co-located in various children‟s services will ensure that all young people at risk of

24

substance misuse are assessed at tier 2 and referred to specialist services as appropriate. As a 2 way concept the CAF training has also been undertaken by YP drug service staff who will use it to identify holistic needs of young people in their care who may require intervention by other children‟s sector agencies. The first CAF assessment undertaken by a specialist drug worker was completed in January 2006. Further need around awareness raising and CAF training for adult drug service providers as been identified as a priority particularly with regard to „Hidden Harm‟ issues. Hidden Harm The DfES has published the Government‟s response to Hidden Harm: an Inquiry by the Advisory Council for the Misuse of Drugs that contains 48 recommendations to address the effect of parental drug/alcohol misuse on children. The 6 key messages of the original „Hidden Harm‟ report are considered in the light of „Every Child Matters‟. General themes to emerge include ensuring that obstacles, such as parental problem drug use, do not stop children from achieving positive outcomes, with the aim of reducing levels of educational failure arising from ill health through substance misuse. The publication of the government‟s response highlighted gaps in provision for this „at risk‟ group locally. The YPSM group established task groups to tackle issues and an initial investment was made to work with families with younger children who were considered most at risk. Links made with adult treatment commissioners identified the possible linkages of the adult sector and the „change for children‟ agenda. From this it was highlighted that adult providers ‟duty to cooperate‟ with screening, referral and tracking of families with dependant children or young people should be emphasised. It has therefore been agreed that a section will be added to adult service SLA‟s outlining the duty to cooperate with a quality measure around number of referrals for children of problem drug and alcohol users. Attempts were made to scope service need amongst older children and young people of substance misusing parents, leaflets have also been developed to provide information to parents. At the end of 2005 a meeting of key agencies who have a remit involving sections of this need group were held. The outcome of this meeting was that the Family Service Unit agreed to host a dedicated service for young people who are affected by parental alcohol and substance misuse, by secondment of an existing worker, and to build on expertise in similar local fields and with other agencies across the country. Phase one of this work is a 3-month scoping and development exercise. The outcome of this will be a recommendations paper for implementing service delivery. The service will hopefully begin to take referrals from June 2006. The needs of children affected by another person‟s drinking are of special consideration. Where it is felt there are risks to the child then child protection procedures must be instigated. Children who are affected by their parent‟s

25

drinking are at particular risk. Information will be targeted at this group so that they are able to seek help and assistance from national or local organisations Research into drinking behaviour Research into drinking behaviour in secondary school children in Barnsley, attitudes on drinking and issues of hidden harm where parental drinking affects children have been undertaken since 2005. Findings from the Barnsley PCT School Survey 2005 and 2006; Fit For The Future alcohol research (findings to be completed by Autumn 2006) and the findings from the 3-month scoping and development exercise mentioned above, will all be used to inform local commissioning and implementation of effective interventions to reduce alcohol related harm in children in Barnsley. Health Work undertaken in 2004 on A&E attendances, identified that 10 to 19 year olds in Barnsley were being treated in A&E for alcohol related injuries and illnesses. Baseline annual measures of alcohol related attendance at A&E, admissions to Paediatric wards and referrals to the BARN should be determined. Thereafter the number of young people with alcohol related problems should be monitored and interventions can be targeted appropriately.

4.

CONCLUSION

The harms of alcohol have been clearly demonstrated within this strategy and cover:     Harms to physical health as a result of binge and chronic drinking Alcohol fuelled crime issues including drink driving, anti social behaviour and domestic violence Loss of productivity and impact on the workplace Social harms, including the negative effect of alcohol on families

This Alcohol Harm Reduction Strategy for Barnsley has been produced to give strategic direction to partners involved in alcohol harm reduction work. The direction set out in this strategy is based on detailed analysis of key issues and the current situation within Barnsley. The key ways in which the harms from alcohol can be tackled are as follows:     Improved communication, information and education Early identification of alcohol problems and treatment Co-ordinated approach to crime and disorder issues Working in partnership with the alcohol industry in Barnsley

This strategy requests that all partners engage with the vision and tasks within this document resulting in a coherent and sustained approach to tackling the harms of alcohol.

26

5.

ACTION PLANS

SEE APPENDIX ONE FOR DETAILED ACTION PLANS

5.1 Description of layout of action plans The Alcohol Task Group is responsible for the overall implementation of this strategy and action plans which are split into the following areas: 1 2 3 4 5 6 7 Better Information, Communication and Education Improving Health and Treatment Services – Fairer, Better, Faster, Treatment Combating Alcohol Related Crime and Disorder Working with the Alcohol Industry - Legal Social and Ethical Responsibilities of Barnsley Drinks Industry Creation of Healthy Leisure Opportunities Support for People Affected by Another‟s Drinking Children and Young People

The Alcohol Task Group will prioritise the activities listed within the action plans and monitor the progress made. Certain activities listed are active, where this is occurring the ATG will work to support and develop these activities within a strategic context. Some of the activities will relate to more than one area. The list does not exclude other work to reduce alcohol related harm where resources are available. Potential Sources of Funding and Resources Current ring fenced funding for Alcohol Harm Reduction measures exists for limited projects e.g. Nightsafe and the Responsible Retailer Scheme. Other organisations such as the Drug and Alcohol Board, Safer and Stronger Communities Partnership, BMBC and PCT are potential statutory funders. Community and Voluntary groups are also active in Barnsley and may already be contributing towards alcohol harm reduction. The ATG aims to identify groups, which may already be providing resources, and to match them to activities described in the action plans in order to make the best use of limited resources. Timescales and Lead Organisations Specific projects such as Nightsafe and the Responsible Retailing Scheme may already have project timescales developed. Other activities described may need development from the start following resource allocation. Lead organisations have been identified and consulted when developing the action plans. 5.2 Targets

The role of alcohol in Public Service Agreements (PSA) are key mechanisms through which the government is able to set targets for public services, whilst enabling local autonomy and freedom in the processes used to deliver them. They are an integral part of the government‟s expenditure framework and a mechanism for focusing on priorities. The document “Taking Measures” identifies targets from 2005-8 PSA which could support the development of alcohol harm reduction measures to meet PSA‟s set by various government departments. 27

Local Area Agreements have been used to set alcohol harm reduction targets across the blocks of Healthy Communities and Older People, Children and Young People, Safer and Stronger Communities and Economic Development and Enterprise .

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6. 6.1

GLOSSARY OF TERMS AND ABBREVIATIONS Glossary

Binge Drinkers – Binge-drinking is a term that applies to people who drink to get drunk, they are likely to be aged under 25. People who binge drink are more likely to be men, although women‟s drinking has been rising quickly over the last ten years. People who binge drink are at increased risk of accidents and alcohol poisoning. Men in particular are more likely both to be a victim of violence, and to commit violent offences; there are also greater risks of sexual assault when under the influence of alcohol. The impacts on society are visible in, for example, high levels of attendance at A&E related to alcohol. Binge drinking is classified as drinking over twice the double recommended daily guidelines in the last week. Within this group there are many who are drinking more than twice the recommended level more than once a week while others only do so rarely. Using this measure of binge drinking the Government has estimated that 5.9 million adults drink above this level. Chronic Drinkers - People who are classed as chronic drinkers are likely to be aged over 30 with around two-thirds being men. They are at increased risk of a variety of health harms such as cirrhosis (which has nearly doubled in the last 10 years), cancer, and hemorrhagic stroke; they are also at higher risk of premature death and suicide. If chronic drinkers come into contact with the criminal justice system, it is more likely to be through crimes such as domestic violence and drink-driving. The impacts on society are less visible but are reflected in effects on their families, lost productivity and costs to the health service. Chronic drinking is drinking large amounts regularly. Around a quarter of the population drink above the former weekly guidance of 14 units for women and 21 units for men. 6.4 million drink up to 35 units a week (women) or 50 units a week (men). A further 1.8 million, drink above these levels. Vulnerable Groups - In addition, alcohol-related harm may be experienced by a range of vulnerable groups. These include problem drinkers who are from vulnerable groups such as ex prisoners, street drinkers, those who suffered abuse as children, children of those who misuse alcohol, and young drinkers. As well as alcohol problems they are more likely to experience a whole range of other problems, such as mental illness, drug use and homelessness, which may compound their multiple needs.

6.2.

Abbreviations Alcohol Harm Reduction Strategy for England Alcohol Misuse Enforcement Campaign Alcohol Task Group Barnsley Chamber of Commerce and Industry Basic Command Unit (Police) Barnsley Hospital National Foundation Trust 29

AHRSE AMEC ATG BCCI BCU BHNFT

CAMHS CYPSP DAAT DfES FfF GLAD HFA NTA PSHE RRS SNT SSCP SFP YPSMG

Child and Adolescent Mental Health Services Children and Young People‟s Strategic Partnership Drug and Alcohol Action Team Department for Education and Science Fit for the Future (a major initiative to improve health in Barnsley) Greater Life After Detox (self help group in Barnsley) High Focus Area National Treatment Agency Personal Health and Social Education Responsible Retailer Scheme Safer Neighbourhood Team Safer and Stronger Communities Partnership Strengthening Families Programme Young People‟s Substance Misuse Group (Joint Sub Group of the Drug and Alcohol Board and Children and Young People‟s Strategic Partnership) Youth Service

YS

30

7.

REFERENCES AND USEFUL WEB SITES

This document can also be accessed via the Fit For The Future website: www.barnsleyfit4thefuture.co.uk

Below are documents, which have been used in preparation of the strategy document (although specific text to which they refer is not indicated). 1. Barnsley Crime and Drugs Audit 2004, Barnsley Community Safety Partnership, www.sscp.co.uk Cabinet Office, Prime Minister's Strategy Unit. Alcohol harm reduction strategy for England. London, Cabinet Office, 2004 – full document found on www.barnsleyfit4thefuture.co.uk http://www.strategy.gov.uk/files/pdf/al04SU.pdf National Services Framework for Mental Health, Implementation of Dual Diagnosis, 2002, DoH Fit For The Future Strategy, 2003, Barnsley, www.barnsleyfit4thefuture.co.uk Department of Health. Annual report of the Chief Medical Officer‟s London: Department of Health, 2001. http://www.publications.doh.gov.uk/cmo/annualreport2001/livercirrhosis.htm The Academy of Medical Sciences. Calling time: the nation's drinking as a major health issue. London: Academy of Medical Sciences, 2004 Regional Director of Public Health Annual Report, Alcohol and Health, 2003 Taking Measures, Alcohol Strategy Group Center for Public Health, Faculty of Health and Applied Social Sciences, Liverpool John Moores University, September 2004, http://www.cph.org.uk - full document found on www.barnsleyfit4thefuture.co.uk Director of Public Health, Annual Report 2003 Barnsley Primary Care Trust Management of harmful drinking and alcohol dependence in primary care, Scottish Intercollegiate Guidelines Network, 2003 Over the Limit? Alcohol Use in Yorkshire and the Humber, 2005 Bottling It Up. The effects of alcohol misuse on children, parents and families, 2006 Alcohol Misuse Interventions: Guidance on developing a local programme of improvement

2.

3.

4. 5.

6.

7. 8.

9. 10.

11. 12.

13.

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8.

ACKNOWLEDGEMENTS

Alcohol Strategy Group All participants at stakeholder event Barnsley DAAT Strategy Team Community Dietitians Drug and Alcohol Board Drug and Alcohol Agencies, voluntary and statutory Fit for the Future Fire Service Greater Life After Detox group PHSE Co-ordinators Town Centre Management Group South Yorkshire Police South Yorkshire Fire service

32

Alcohol Harm Reduction Strategy Action Plans
2006 - 2008

Alcohol Harm Reduction Strategy – June 06.

33

OBJECTIVE 1 – TO PROVIDE BETTER INFORMATION, COMMUNICATION AND EDUCATION
Ref 1.1 Objective To develop, facilitate and promote a coordinated approach to alcohol related harm in Barnsley To work with other healthy lifestyle groups to promote a healthy drinking message. Lead DAAT/ PCT/ SSCP FFTF Timescale 2006/2007  Action/Milestones Identify funding to recruit a full time Alcohol Co-ordinator Resources £28K Measures  Funding secured and post established  4 press releases delivered by April 2007  4 press releases delivered by April 2008  Production of training package  2 training sessions to be delivered by April 2007  4 Sessions to be delivered by April 2008  Communication Plan agreed and implemented and links made with YP plan.  Information and events etc publicised in a co-ordinated manner  2 networking sessions held per year  1 multi-agency campaign held per year Priority High

1.2

On-going

 

Identify appropriate groups Develop key information to be promoted targeting different drinking groups with specific information. Identify staff requiring training Commission training provider to develop and deliver basic alcohol awareness package

Within existing resources

Low

1.3

Develop and deliver alcohol awareness training for workers in the statutory and voluntary sector

DAAT

2006/2007

 

Within existing resources (fig to be identified) Within existing resources

High

1.4

Develop a Communication Plan to disseminate the sensible drinking message to a wide variety of audiences.

DAAT

2006/2007

   

Communication Plan to be developed. Ensure plan links with Young People‟s Communication Plan Communication plan circulated for consultation Arrange networking events/workshops between professionals (statutory and voluntary) to improve communication and knowledge of different services Hold multi-agency campaigns to promote sensible drinking to the general public targeting different groups with relevant information and facts Liaise with Public Health, BMBC to identify need for workplace policy training Deliver training using Drug and Alcohol in the Workplace Government Toolkit

Medium

1.5

Organise regular networking events and multi agency alcohol awareness campaigns

DAAT

On-going

Within existing resources

Low/med



Additional funding to be identified

1.6

Contribute to Healthy Workplace Initiatives

DAAT

On-going

 

Additional funding to be identified

 Organisations identified  Number of sessions delivered in 2006/7  Number of sessions in 200/8  Drug and Alcohol Workplace policies implemented in identified areas

Low

34

1.7

To develop robust data collection systems for: (i) Alcohol related crime (ii) Alcohol misuse among victims and perpetrators of domestic abuse (iii) Alcohol related attendances at Accident and Emergency (iv) Alcohol users accessing treatment

BSSCP

2006/2007

  

BSSCP

Develop and agree project specification with relevant agencies for data collection systems Identify person responsible for collecting data Implement system

Within Existing resources

BHNFT

 Data collection systems in place  Data collected used to inform baselines, identify where targeted prevention/intervention needed

High

DAAT JCG

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OBJECTIVE 2 – TO IMPROVE HEALTH AND TREATMENT SERVICES – FAIRER, BETTER, FASTER TREATMENT
Ref 2.1 Objective Develop screening and referral tool to identify hazardous, harmful and dependant drinkers Lead BADAS/ PCT/ DAAT Timescale 2006/2007      Action/Milestones Develop and agree screening and referral tool Ensure links developed between YP and adult services Identify staff requiring training Identify costs Commission training provider to deliver appropriate training Resources Within existing resources Measures  Screening and referral tool developed and agreed by Sept 06  2 training sessions to be delivered by April 2007  4 Sessions to be delivered by April 2008
Priority

High

2.2

Develop and deliver training sessions for relevant statutory and voluntary sector staff in use of above screening and referral tools

DAAT JCG/ BADAS/ PCT

On-going

Funding identified
(included in alcohol treatment SLA)

High

2.3

Develop and deliver training to enable healthcare and other Tier 1 staff to deliver brief interventions to reduce alcohol consumption

DAAT JCG

On-going

  

Identify staff requiring training Identify costs and funding source Commission training provider to develop and deliver appropriate training Undertake needs assessment Commission services in line with identified need and provide a range of interventions at all 4 tiers Agree Service Provider Agreements and monitoring arrangements Develop Service User Involvement Strategy to ensure service user participation and achieve user led services Liaise with service providers and other agencies so providers and staff can learn from the people who use their services Provide support and guidance to established and new service user groups Review progress of groups on 6 month basis and devise action plans to give groups direction

Additional funding required

 Training package produced  2 training sessions to be delivered by April 2007  4 Sessions to be delivered by April 2008  Appropriate services commissioned and delivered  Monitoring arrangements in place

High

2.4

Commission appropriate and accessible alcohol treatment services to meet needs of alcohol misusing residents of Barnsley

DAAT JCG

2006/2007

   

Funding identified

High

2.5

Develop and increase Service User Involvement

DAAT

On-going

Within existing resources



 

 Establish Service User Strategy Focus Group  First Draft of Service User Involvement Strategy circulated for consultation  Service User Involvement Strategy agreed and in place by Sept 2006  Number of active service user groups

Med/high

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2.6

2.7

Review all clinical guidelines (RCGP, RCP, Royal College of Psychiatrists, Scottish Intercollegiate Guidelines) to produce local clinical protocols for the diagnosis and treatment of alcohol misuse To ensure the needs of alcohol users are reflected in the DAAT Accommodation and Support Strategy

PCT

2006/2007

 

Review and amend existing protocols Submit to Clinical Governance for approval

Within existing resources

 Approved protocols approved and implemented

Low

DAAT/ SP

October 2006

 Quantify local needs  Complete analysis of current provision  Complete gap analysis  Prioritise options for future service delivery

Within existing resources
Additional funding will be required for new provision



Strategy agreed and in place

High

2.8

Re-configure William Street Project in line with recommendations of the Supporting People Review

SP/RF

2006/2007

 Extension of current contract for further 12 months to enable new model to be implemented  Commence work to turn William Street into 4 Self Contained flats and begin floating support scheme  Ensure mechanisms in place to monitor number of referrals received.  Make links with service providers to improve communication and referrals if need identified.  Re-modelling of shared care contracts and monitoring arrangements in place  Revise PCT SLA to include an alcohol health worker who will liaise with Primary Care and hospital staff

Funding identified



Re-model of service completed and new service in operation

Medium

2.9

Monitor referrals to William Street project to ensure referral pathway adequate

RF

2006/2007

Within existing resources

 Monitoring system in place  Links made with providers/referrers

Medium

2.10

Develop specific incentivised initiatives to increase access to advice and treatment in primary care for patients with alcohol misuse Explore the feasibility of having an alcohol liaison nurse to work in the acute Hospital and the community

JCG/ PCT

2007/2008

Additional funding required Within existing resources

 Revised shared care contracts issued to providers  PCT SLA reviewed and agreed

Medium

2.11

JCG/ PCT/ BHNFT

2007/2008

Med/low

37

OBJECTIVE 3 –TO COMBAT AND REDUCE ALCOHOL RELATED CRIME AND DISORDER
Ref 3.1 Objective Reduce incidents of alcohol related violence and crime taking place in licensed premises, non-public and public place Lead Police Timescale On-going Action/Milestones  Continue to promote sensible drinking through delivery of Nightsafe campaign, AMEC and other supported police activities  Respond to intelligence regarding alcohol related crime/violence and increase enforcement/patrols as necessary  Use Fixed Penalty notices and Designated Drinking areas legislation to deter nuisance and disorder problems  Encourage landlords to join Pubwatch Scheme  Conduct feasibility study on “Best Bar None” scheme to reduce the risk of alcohol related crime and disorder. (see 4.3).    Increase number of retailers joining RSS scheme Identify and recruit underage volunteers to take part in test purchases Involvement in arranging test purchasing activities in an administrative capacity Drug testing kit “Drink Detective” to be issued to bars and clubs Results of tests reported to Licensing Sergeant to enable recording of positive tests Data collected used to inform size of problem, problem areas and action needed See 4.3. Best Bar None scheme would incorporate promoting safer drinking and testing on premises Resources Within existing resources Measures  Reduction in alcohol related crime and violence  Nightsafe campaign delivered twice throughout year ie Summer, Christmas  National Alcohol Misuse Enforcement Campaign (AMEC) delivered annually  Increase in Pubwatch members
Priority

High



See 4.3

3.2

The RRS scheme will work with groups and agencies to reduce the sale of alcohol to minors:

RRS

On-going

Within existing resources

 Numbers in scheme increased by current figure (end 05/06)  One test purchasing operation to be organised per quarter during 2006/7 and 2007/8. At least two of these to involve alcohol test purchases.  Drug testing kits issued to bars and clubs  Results of positive tests recorded to identify problem areas and appropriate action taken

Med

3.3

Enhance understanding of „safer drinking‟ by reducing drink spiking through testing in licensed premises

BMBC Licensing/ Police

On-going

   

Med/low

38

3.4

Work with Safer Neighbourhood teams across the Borough to reduce community problems caused by alcohol

SNTs/ DAAT

2006/2007

 Attend monthly MAAG meetings in all SNT areas  Develop alcohol related problem profile across communities and borough  Liaise with relevant agencies to target problem areas with appropriate action  Obtain access to detailed A&E data  Map out hotspot areas and identify relevant interventions needed

Within existing resources

 Reduction in community problems related to alcohol

Med

3.5

Use A&E data to determine geographical hotspot areas where crime reduction interventions should be developed to reduce town centre and community problems caused by alcohol Explore the feasibility of a local arrest referral scheme for people where the offence is alcohol related and where the alcohol use is problematic

BSSCP/ BHNFT

2007/2008

Within existing resources



Hotspot areas identified and relevant interventions implemented

Med

3.6

DAAT

2007/2008

 Conduct research exercise looking at other areas where scheme is in operation  Obtain data from custody suite regarding alcohol related offences over a period of 6 months

Additional funding to be identified

 

Research conducted and data collected Report produced identifying results of research and conclusions drawn

Low

3.7

Work with the courts and probation services to consider the use of Alcohol Treatment Requirements and/or brief interventions or attendance on relevant accredited programmes for offenders with alcohol problems Develop methods and gather intelligence to identify illicit sales/storage/distribution of alcohol (including counterfeit) in Barnsley

Probation /HMCS/ DAAT

2007/2008 To be agreed

Within existing resources

To be agreed

3.8

HMRC/ Police

2007/2008 To be agreed To be agreed

Low/med

39

OBJECTIVE 4 – TO WORK WITH THE ALCOHOL INDUSTRY – LEGAL, SOCIAL AND ETHICAL RESPONSIBILITIES OF BARNSLEY DRINKS INDUSTRY
Ref 4.1 Objective Further develop and expand the implementation of the BMBC Licensing Policy and Voluntary Protocol Lead BMBC Licensing Timescale 2006/2007   Action/Milestones Licensing Forum re-established and influencing policy development Licensing Forum to consider and review Safer Drinking Protocol Resources Within existing resources    Measures Quarterly meetings of Licensing Forum Safer drinking Protocol reviewed Number of on-licensed premises signing up to protocol
Priority

Medium

4.2

Work with the alcohol industry to reduce alcohol sales to minors

RRS

2006/2007

 

Produce joint newsletter with other RRS schemes in South Yorkshire Support, advise, assist any scheme members who fail test purchasing, or other enforcement exercises.

Within existing resources



Two newsletters to be produced in 2006/7 and 2007/8

Medium

4.3

Support the test purchasing activities of the RRS and police reward schemes to prevent sales of alcohol to minors

BMBC Licensing/ Police/ DAAT/ SSCP/

2006/2007

 

See references to test purchasing activities in 3.2 Commission and conduct feasibility study on “Best Bar None” scheme to encourage responsible drinks sales in onlicensed premises (links with 3.1)

Additional funding to be identified

 

See 3.2 Decision made whether or not to implement Best Bar None scheme and appropriate action taken

Medium

4.4

Work with local business and council partners to support development of initiatives to reduce in environmental hazards caused by drinking e.g. recycling bottles and keeping the streets clean

Env Reg Unit

2006/2007

 Continue to undertake enforcement actions against people who drop litter, including use of FPs &/or prosecutions.  Publicity & education to residents & businesses regarding responsible litter management.  Target businesses selling “food on the go” in respect of litter, where problems noted.

Within existing resources
(during normal working hours).

 Numbers of enforcement actions for litter (not possible to differentiate type).  Number of press releases.  Number of businesses targeted.

Low

40

4.5

Work with local transport groups to ensure safe transport options are available for drinkers to reduce drink driving and alcohol related antisocial behaviour

SYPTE/ SSCP/ Licensing/ DAAT/ Police BMBC Licensing/ SSCP /DAAT

2006/2007

 Establish small working group with relevant parties to investigate possible options



Options investigated and next steps agreed to progress objective

Low

4.6

Develop server training courses for bar staff to reduce sale of alcohol to intoxicated customers and encourage sensible drinking

2007/2008



See 4.3. Best Bar none scheme would incorporate server training for bar staff

See 4.3

41

OBJECTIVE 5 – TO ASSIST IN THE CREATION OF HEALTHY LEISURE OPPORTUNITIES
Ref 5.1 Objective Represent alcohol harm reduction within Remaking Barnsley initiatives. Lead DAAT Timescale 2006/2007 Action /Milestones  Ensure alcohol lead attends meetings regarding Remaking Barnsley to ensure alcohol harm reduction is included  Provide relevant information to ensure alcohol harm reduction is considered when developing initiatives  Ensure alcohol lead attends meetings regarding town centre initiatives to ensure alcohol harm reduction is included and to provide co-ordinated approach  Provide relevant information to ensure alcohol harm reduction and binge drinking is considered when developing and planning activities  Identify alternative activities happening within borough  Promote activities using varied media vehicles    Identify areas where there is a lack of recreational facilities Identify alternative activities needed Liaise and feedback information to relevant planning groups Resources Funding for Alcohol Coordinator required  Measures Alcohol Harm reduction is considered in plans and developments
Priority

Low/med

5.2

Work with town centre initiatives within Remaking Barnsley to develop alternative activities to reduce binge drinking

ATG/DAA T/SSCP

On-going

Additional funding dependant on activities developed

 Alcohol Harm reduction and binge drinking is considered when planning and developing activities/initiatives

Low/med

5.3

Work with Healthy Living Barnsley and Fit For The Future projects to promote alternative activities to reduce alcohol harm

DAAT/ FFTF

On-going

Within existing resources

 

Number of activities promoted during 2006/7 Number of activities promoted during 2007/8

Low/med

5.4

Work with open spaces initiatives, BMBC Parks, Culture, Leisure and Tourism groups and BMBC Youth Service to develop alternative activities in areas where recreational facilities are few

ATG/ DAAT

2006/2007

Within existing resources
(Additional funding maybe required for dev of activities)

 Areas with lack of facilities identified  Alternative activities identified and developed

Low/med

5.5

Work with BMBC Community Partnership organisations – statutory and voluntary - to develop local activities to address community problems caused by alcohol

DAAT/ SSCP

2006/2007

 



Identify communities experiencing problems caused by alcohol (link to 3.4) Liaise with Community Partnership organisations in relevant communities to identify activities required Assist in development and promotion of identified activities

Within existing resources
(Additional funding maybe required for development of activities)

 Communities experiencing problems identified  Contact made with relevant organisations  Activities identified and developed  Number of activities held  Number of community members participating

Low/med

42

OBJECTIVE 6 – TO PROVIDE SUPPORT FOR PEOPLE AFFECTED BY ANOTHER’S DRINKING
Ref 6.1 Objective To develop support and information for parents, carers and families of alcohol users Lead DAAT/Vol sector Timescale 2006/2007 Action/Milestones  Establish focus group  Identify support and information needed  Develop information resource pack  Provide support and guidance to local self help groups already working in this area  Identify agencies providing support  Develop and maintain links and provide information/signposting to relevant groups/individuals Resources Additional funding to be identified
(for costs of resource packs)

Measures  Focus group established and level of support and information need is identified  Information resource pack developed and distributed to support groups  National, Regional and local agencies identified  Links made with such agencies  Information obtained and provided to relevant groups/individuals  Relevant agencies identified  Training sessions delivered  Counselling service commissioned and delivered  Signposting and referral pathways developed and implemented

Priority Medium

6.2

To develop links with national, regional and local agencies that can support people affected by another‟s drinking

DAAT/Vol Sector

2006/2007

Within existing resources

Low

6.3

To raise awareness among staff in the statutory and voluntary sector who are likely to come into contact with people who are experiencing domestic abuse To develop services for victims of domestic violence where alcohol/substance misuse is a contributory factor

DAF/SSCP

2006/2007

 Identify and ensure relevant agencies receive domestic abuse awareness training commissioned by the SSCP  DAF to commission counselling service  Ensure signposting and referral pathway is in place between relevant agencies

Funding identified

Medium/high

6.4

SSCP/DAF

2006/2007

Funding identified

Medium/high

43

OBJECTIVE 7 – CHILDREN AND YOUNG PEOPLE
Ref 7.1 Objective Support and Strengthen Healthy Schools initiative and ensure alcohol education is included SC Lead Timescale 2006/2007  Action/Milestones Develop joint planning & commissioning across PHSE stakeholders to pool resources, avoid duplication and provide sustainable programme Resources Within existing resources Measures  100% of schools will receive Healthy Schools Award by December 2007. Priority High

7.2

Support groups and organisations working with young people outside school hours to deliver alcohol education

YS/CB

2006/2007

 

Identify organisations working with young people outside school hours Identify support and training needed and ensure links are made with 1.3 & 7.5 Deliver CAF training across YP services Develop links between YP and adult services

Within existing resources

 Number of staff/volunteers identified receiving training

Medium

7.3

Develop and train all sectors to deliver Common Assessment Framework and screening for alcohol use, advice and intervention at Tier 2

CYPSP

2006/2007

 

Within existing resources

 No of key workers receiving CAF training  100% key workers identified by CAF roll-out process referred for YPSM Assessment Training at Tier 2  50% of key workers referred from CAF process received YPSM Assessment Training at Tier 2.  100% of vulnerable young people assessed and referred to appropriate intervention service.

High

YPSMG



Commission “add on” YPSM training programme closely linked to CAF roll-out.

Additional funding required

7.4

Screening and assessment referral systems in place to support intervention with all at risk groups.

CB

2006/2007

 

Vulnerable children worker to deliver Tier 2 Assessment to LAC, truants & excludes. YOT Staff to receive additional training to deliver Tier 2 assessment. Identify services/staff requiring alcohol awareness and harm reduction information/training Develop resource pack to distribute to services to use when engaging with young people

Within existing resources

High

7.5

Work with all young people‟s services to raise awareness of alcohol harm and alcohol harm reduction

YP agencies CB – resource pack

2006/2007

 

Additional funding required

 Services/staff identified  Resource pack produced and circulated

Medium

44

7.6

With the Local Children‟s Safeguarding Board address the needs of and safeguard all children and young people to ensure that those at risk from other people‟s drinking or their own personal drinking receive appropriate interventions.

YPSMG

2006/2007







The common assessment framework (CAF) and safeguarding procedures used to assess need and protect from harm Develop local preventative programmes and referral pathways as a primary prevention measure to protect children from alcohol misuse Develop and commission dedicated service for children with alcohol misusing parents Develop joint working protocol and monitoring arrangements

Funding identified

 See 7.3 above

High

 Referral Pathway developed and implemented.

 Appropriate service commissioned and delivered Within existing resources  100% of vulnerable young people attending A&E due to alcohol related instances are screened and appropriately referred for treatment  Areas with lack of facilities identified  Alternative activities identified and fed back  Number of young people identified and engaged on RAP (minimum 16).  Access to additional support.  Numbers taking up voluntary support post YOT involvement.  Reduction in reported levels of problems related to substance misuse, mental health or dual diagnosis. High

7.7

Ensure effective referral routes and integrated services for 10-19 year olds experiencing alcohol related harm (including A&E and Paediatric admissions)

JE/CB

2006/2007



7.8

Work with open spaces initiatives, BMBC Parks, Culture, Leisure and Tourism groups and BMBC Youth Service to develop alternative activities in areas where youth recreational facilities are few Establish Resettlement and Aftercare provision (RAP) in YOT to provide enhanced support to young people with substance misuse, mental health or dual diagnosis problems including on-going voluntary contact for up to 6 months after the close of statutory order.

DW

2006/2007

  

Identify areas where there are a lack of youth facilities Identify alternative activities Feedback information to relevant planning groups Commission BARN to deliver additional RAP support workers Increase Mental Health support capacity Establish flexible Resettlement Fund for RAP service users

Within existing resources

Medium /low

7.9

C Ba

2006-2008

  

Dedicated YJB funding secured

High

Actions highlighted in red have been identified as priorities by JAG 45


				
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