UNAPPROVED MINUTE ABERDEEN ALCOHOL AND DRUGS PARTNERSHIP Meeting held Monday, 17th August, 2009 at Summerfield House, Aberdeen Present:- Richard Carey (Chair); Councillors James Kiddie, Gordon Leslie; and Willie Young, Bert Donald and Andy Imray, Grampian Police; Paul Hannan, ACVO; Senga MacDonald, Aberdeen Alcohol, Drug and Blood Borne Virus Forum; Chris Stewart, Depute Manager, Aberdeen Community Health Partnership; Simon Rayner, Karen Gunn, Sandy Kelman, Jennie Biggs and Fraser Hoggan, NHS Grampian; Fred McBride, Rhona Jarvis and Mairi-Anne Macdonald, Aberdeen City Council; and Fiona Gardiner (Note). APOLOGIES Apologies for absence were submitted on behalf of Lesley Wilkie, Director of Public Health; Pat Greenhough, Scottish Drugs Forum; and Audrey Mooney, Scottish Prison Service. MINUTE OF PREVIOUS MEETING The minute of the meeting held on 11th May, 2009 was approved. As a matter arising Councillor Kiddie was disappointed to note that there was no update at today’s meeting on proposals to improve engagement including the development of Advocacy Services. Action Sandy Kelman agreed to enquire into this and ensure that an update is provided for the next Alcohol and Drugs Partnership meeting. PRESENTATION – QUAY SERVICES Richard Carey introduced Luan Grugeon of Quay Services by referring to a previous meeting he had already had with representatives of the organisation where he had learned about the potential to add to the service provision to help people combat substance misuse. Richard Carey and Fred McBride are both of the view that there is a need for a strategic framework for commissioning of services which will enhance efforts to demonstrate that decisions to fund or not fund service elements are undertaken within a robust framework and in a clear and transparent manner. Ms. Grugeon advised that Drugs Action have been providing Quay Services for 15 years and have been running a drop in centre for five years. There is a close working relationship with the City Council and Grampian Police as well as other public agencies. Feedback from Grampian Police has confirmed that the services offered and the 2 contacts made reach the vast majority of sex workers operating in Aberdeen city centre. In 2008 the service made more than 700 referrals to other agencies for advice and assistance. She said that the service has an effective management information system which ensures that outcomes can be monitored and it is clear the services are making a difference to the physical and mental health of clients and there is evidence of changes in behaviour and attitudes over time. Ms. Grugeon highlighted three key developments which the organisation would wish to launch. One is a diversion from prostitution scheme which has been welcomed by Grampian Police. It would offer a quick route out of prostitution before women become too involved in the activity and the associated lifestyle. One of the aims would be to have former sex workers undertaking case work with women new to the industry. The second developmental project would be to fund a GP and a nurse practitioner to be in the drop in centre one evening per week. This facility has been offered elsewhere in Scotland and has proved successful as physical and mental health issues can begin to be treated when they first arise rather than waiting until the women present with serious health problems. The final initiative is to build social capital as women who lack effective social networks, an employment history and a supportive family struggle to overcome problematic drug use and the prostitution activities often associated with it. The scheme would involved a volunteer co-ordinator training buddies to work with women involved in the sex industry to encourage them to undertake social and volunteering activities, attend evening classes and develop the confidence to raise their aspirations and pursue goals to change their lifestyles. On behalf of the Partnership Richard Carey thanked Luan Grugeon for her informative presentation. Action At the suggestion of Councillor Kiddie, it was agreed to request the Clerk to the Aberdeen Community Health Partnership to arrange for Ms. Grugeon to make her presentation at a future CHP meeting. PRESENTATION – STREET PASTORS Richard Carey introduced Martin Hill of the Aberdeen Street Pastors Scheme. Mr. Hill advised that the scheme presently has 50 volunteers working in teams of three on Friday and Saturday nights in the city centre. They have already built up good working relationships with Grampian Police, NHS emergency staff, door stewards and taxi marshals. City Council officials with community safety responsibilities are also linked into the work of the pastors. The pastors talk to vulnerable people on city centre streets at the weekends and their informal approach has helped defuse potential trouble and has in some cases encouraged people to seek help from mainstream services. Mr. Hill explained that volunteers pay £300 from their own funds or from their church in order to undertake the training programme. The training programme involves a total of 12 days and at least four days training must be undertaken before a volunteer can begin to take part in street patrols. On behalf of the Partnership Richard Carey thanked Mr. Hill for his presentation. 3 Action The Partnership noted the information from the presentation on Aberdeen Street Pastors and Bert Donald, Grampian Police, took the opportunity to emphasise that the scheme has already made a significant contribution to improving safety in the city centre at the weekends. DRUGS TREATMENT AND REHABILITATION Simon Rayner referred to the key improvements reflected in the performance report for the first quarter of 2009/2010 in respect of the strategic priorities of (1) reducing waiting times for drug treatment and rehabilitation services, (2) increasing the number of drug misusers in contact with treatment and care services, (3) increasing the number of drug misusers successfully completing treatment and (4) increasing the number of people recovering from drug problems who enter training, education and employment. It was noted that only the first quarter data is available for the community rehabilitation service and therefore no trend comparison is possible at this stage. The statistics show an overall improvement in performance and Simon confirmed that planned discharges from services was used as a proxy indicator of successful outcomes. In relation to progress to work the aim is to have 200 clients per year participating in employment or education. It was noted that at the first quarter of 2009/10 235 people are waiting for drug treatment services in Aberdeen city, with some of them actually receiving methadone through a treatment programme via their GP. However these clients need to be included in an appropriate rehabilitation programme in order to fulfil the Scottish Government’s drug strategy. The meeting was pleased to note progress in relation to the site of the premises for the integrated drug service and they were informed that Nicola Sturgeon Cabinet Secretary for Health and Wellbeing was visiting Aberdeen later today and would be at the Timmer market site. Action Simon Rayner will arrange to speak to Paul Hannan on further details to be included in future reports so that the Partnership can be assured that a complete picture of the pathway to services is reported. Simon will contact Senga MacDonald to discuss admin support for organisations involved in implementation of the electronic SMR 25 form. HEAT READINESS The meeting noted the progress report in relation to HEAT targets for access to drug treatment services. It is understood that in 2010/11 work will begin on establishing the equivalent HEAT targets for alcohol services. Measures are likely to be on the percentage of people seen within 21 days from referral to assessment and on percentage of people who have commenced treatment within 14 days of assessment. Simon Rayner advised the meeting that locally notional targets had been set and the quarterly performance reports benchmarked against them. It is anticipated representatives from our services will be invited to discuss the proposed HEAT targets with government representatives. 4 Action it was agreed to note the position in relation to HEAT targets. PILOT PROJECT – INTEGRATED DRUG SERVICE AND HMP CRAIGINCHES Simon Rayner advised the meeting of a proposed six month pilot project to work with 20 prisoners suitable for initiating onto substitute prescribing treatment while within prison who will be able to see the same doctor on release at the clinic within the integrated drug service. The aim would be to move the patients onto their GP once a 16 week stabilisation period has been completed with an appropriate care plan and community rehabilitation support. It was confirmed that where the patient’s GP practice is not involved in methadone prescribing then the integrated drug service will retain responsibility for them to ensure there is no break in the continuity of care and treatment. Simon Rayner confirmed that the results of the pilot project will be evaluated and a feedback report submitted to a future Partnership meeting. In relation to some concerns that prisoners and ex prisoners would be seen to be having priority over potential clients in the community it could be successfully argued that prisoners by definition are very vulnerable people and present a high risk profile. There is evidence that a high number of people going into prison are relatively stable on methadone and there is an opportunity for community based criminal justice services to undertake reducing offending work with them on their release. Action Councillors Kiddie and Leslie as members of the Aberdeen Prison Visiting Committee welcomed the proposal as they and their colleagues have been making representations for some time to have such services available to prisoners on release into the community. They indicated they would use the briefing paper to inform their colleagues on the Prison Visiting Committee of this significant progress. The Partnership welcomed the proposal and noted that the evaluation report will be submitted to a future meeting. RECOVERY STRATEGY UPDATE Mairi-Anne Macdonald advised that the City Council’s approach within its redesigned services is to develop a whole service delivery method by aligning and working more closely with partner organisations. Key components of the recovery strategy are (1) to expand input into the integrated drug service to meet the needs of more clients by enhancing staff resources in respect of social work and administration and develop stronger links with Criminal Justice Social Work services, (2) to expand social work contacts to all GP practices for the purposes of joint care planning, (3) to expand community rehabilitation and (4) to have Family Centre staff working more closely with the Substance Misuse Service in assessment, care planning and targeting services to assist substance misusing parents and children and young people who are themselves misusing substances or are affected by parental misuse of substances. The City Council and NHS Grampian are holding a rapid improvement event on the recovery strategy at the end of August and other partners will be invited to further 5 improvement events to be held in September and October. Simon Rayner advised the meeting that invitations had recently been issued for a benchmarking seminar on access and delivery on 30th September, 2009 from 10.30am to 4.30pm. The seminar is being held in Aberdeen and is targeted at senior practitioners, clinicians and service managers. The seminar chair is Neil Hunter, General Manager of Glasgow Addiction Services. Participants from Edinburgh, Glasgow and Ayrshire and Arran will be attending and the event provides a good opportunity to learn about best practice in other parts of Scotland. Action The meeting noted progress in relation to the Recovery Strategy and that a summary of the outcomes of the benchmarking seminar on 30th September, 2009 will be submitted to the next meeting of the Partnership. STRATEGIC COMMISSIONING FRAMEWORK Fred McBride, Director of Social Care and Wellbeing at the City Council and Richard Carey advised the meeting that the briefing paper on a joint commissioning strategy is part of much larger document which is regarded as a work in progress as thinking on the strategy develops. The Aberdeen Community Health Partnership has arranged a workshop to discuss the strategy in more detail. Councillor Kiddie welcomed the fact that the framework for commissioning includes collating and analysing views of users as recent experience within the City Council shows the value of that approach. There is clearly a need to develop individual and collective advocacy. He commended to officers a book on advocacy by Professor David Donnison of the University of Glasgow. Sandy Kelman advised that he was in the process of trying to recruit a part time information officer for the Alcohol and Drugs Partnership and he envisages part of their duties involving obtaining information from service users and carers. It was noted that the Partnership’s Sub-Groups would have the opportunity to be involved in the development of the detail of the commissioning strategy. It was agreed it would be useful to have the commissioning strategy in place for the start of the financial year 2010/11 as it will be a key part of efforts by commissioning organisations to demonstrate to the public that resources are being used as effectively as possible in a constrained financial climate. Senga MacDonald offered the assistance of her Forum as they would welcome the opportunity to help in the development of the strategy. Action The meeting noted progress made in having a joint commissioning strategy. Sandy Kelman agreed to contact Councillor Kiddie to discuss in more detail his proposals in relation to the proposed role of part time Information Officer in the Support Team. PLANNING STRUCTURE Simon Rayner reminded the meeting that one of the required actions from the Scottish Government is to have a Joint Service Delivery Plan for Drug and Alcohol Treatment 6 Services. The meeting noted the proposed structure of Groups and Simon and Mairi- Anne Macdonald advised that in addition throughout the year rapid improvement events would be held which would provide opportunities for involvement by the voluntary sector. The meeting was advised that service providers are already meeting regularly with NHS Grampian and Aberdeen City Council officers and that this paper just deals with a narrow aspect of the wider issue of engagement with the voluntary sector and other partners. For instance there would need to be a consultation process to review and update the Drugs Strategy so that it also covered issues such as prevention, harm reduction and long term recovery. Action The meeting welcomed the proposed structure and Fred McBride agreed to discuss with Paul Hannan ideas and options to strengthen the involvement and engagement of the voluntary sector in a representative and strategic way. ABERDEEN CITY DRUGS, ALCOHOL AND BLOOD BORNE VIRUS FORUM Senga MacDonald referred to her report which reflects the success of the seminar on 19th June, 2009 which effectively relaunched the Forum. Since the meeting the Forum’s website has been developed and Laura Gray, Head of Communications, NHS Grampian agreed to assist in arranging for relevant documents to be added to the site. In relation to the Action Plan drawn up at the seminar it was noted that access to services and attitudes of professionals to clients would be two of the issues to be addressed by the Children’s and Young People’s Sub-Group of the Partnership. Sandy Kelman advised that the Grampian Medicines Management Group is examining the issue of the use of the drug Naloxone and there is already strong support for training to administer it. Senga advised the meeting that a research review had not yet revealed any evidence that availability of this drug led to an increase in risk taking behaviour and experience in Glasgow has shown the positive benefits of the availability of Naloxone. Action The Partnership welcomed the positive feedback in relation to the Forum and Laura Gray will contact Senga MacDonald regarding assistance in relation to the Forum’s website. CHILDREN AND YOUNG PEOPLE’S ISSUES Mairi-Anne Macdonald as Chair of the Children’s and Young People’s Sub-Group provided an update. There will be an introductory open forum meeting focusing on (1) prevention, (2) children and young people who are involved with substance misuse looking at access to services, and (3) the impact of parental substance misuse. Work has already commenced on improving the integration between children’s and adult services including devising an integrated assessment framework. It was confirmed that clients who are parents can be identified as they access services. 7 Action The meeting noted progress and Simon Rayner agreed to check relevant service specifications to ensure that all relevant data on clients who are parents is recorded. SWIA UPDATE Sandy Kelman advised the meeting that the SWIA report will be published in September, 2009. Informal indications are that the report will be largely positive with no further recommendations. Any further follow-up action by the Inspectorate will be taken forward as part of the standard inspection regime. DECLARATION OF INTEREST Councillor Leslie declared an interest in the subject of the undernoted item by virtue of his membership of the Board of Alcohol Support Limited. Councillor Leslie did not feel it necessary to withdraw from the meeting during consideration thereof. ALCOHOL ISSUES In relation to commissioning Simon Rayner advised the meeting that the retendering exercise has reached the stage of the service specification being placed on the NHS website at the end of this week. Interested parties will have six weeks to submit proposals and presentations from potential providers will take place on 14 th and 15th October, 2009. The meeting was assured that the current provision will continue to be funded meantime and any change will be undertaken in a managed process. Simon Rayner confirmed that the commissioners were looking at alternatives to hostel accommodation in addition to commissioning a place of safety. Action The meeting noted the update. ALCOHOL TASK GROUP Jennie Biggs advised that good progress was being maintained in relation to the Alcohol Strategy and a formal launch/sign-up event will take place on 24th November, 2009 (subject to confirmation). The Task Group has been successful in securing a commitment to a significant contribution to the objectives of the Strategy from Children’s Services and there has been increased recognition of alcohol issues being a priority in their own right in addition to being seen as a golden thread running through a number of service Plans. Action The meeting noted the progress report. 8 FINANCIAL ALLOCATION FOR ALCOHOL AND DRUGS MISUSE 2009/10 Richard Carey referred to his letter of 10th July, 2009 sent to the Chairs of the three Partnerships in the North East and pointed out that the meeting referred to which was due to take place on 16th July, 2009 had been postponed. However, there is a commitment to meet with the Chief Executives of the three North East local authorities to agree on the disbursement of funding which makes best use of the available resources. Richard Carey also referred to one of the recommendations in the report from Neil Whyte (Financial Update) and confirmed that the Chief Executives would also be asked to agree on a recommended process that allows for financial issues to be addressed timeously during the financial year. Action Richard Carey will be contacting the three local authority Chief Executives to take forward the actions in his letter of 10th July, 2009 and the broader issue of having an agreed robust process to address financial issues timeously. FINANCE REPORT Neil Whyte referred to his report which sets out overall funding and out-turn information in respect of the Partnership’s budget as at July, 2009. The meeting agreed with his assessment that there is a need for a process to have a more in-depth examination of the use of resources. The meeting was assured that there were sound reasons for the reported underspending of non-recurring funds. Officers explained that problems arising from delays in recruitment and available office accommodation had been overcome. The Partnership was reminded that the Substance Misuse Service has been enhanced and the Scottish Government Minister for Community Safety, Fergus Ewing, recently commended the progress he had noted when he visited Aberdeen. The meeting accepted that the financial constraints served to emphasise the importance of having a strategic commissioning framework in place with agreed Partnership priorities which reflect appropriate involvement of voluntary sector representatives. The Partnership is confident that this can be achieved and any potential conflicts of interest overcome. Action The Partnership approved the recommendations as set out in the Finance Manager’s report but noted the need to await the outcome of the discussions between Richard Carey and the Chief Executives of the three North East local authorities on their proposals for a robust process to address financial issues. PARTNERSHIP MEMBERSHIP The meeting noted the request from the Aberdeen City Civic Forum to have a representative join the Partnership. Sandy Kelman explained that the Civic Forum has representatives on all Challenge Forums and the Partnership is such a Forum for community planning purposes. 9 Action It was agreed to invite the Civic Forum to nominate one representative to serve on the Partnership and to suggest that it may be in their interest to try to ensure that the representative is also their representative on the Aberdeen City Community Health Partnership. POLICE REPORT Andy Imray, Grampian Police, highlighted the main points from the statistical report and advised that the report should include details of an additional significant recovery of controlled drugs as a result of a successful police operation. He pointed out a change in the level of reporting of licensing offences and this is the result of an initiative to focus on these crimes and record them as such rather than treat them as common law offences. Jennie Biggs advised that the refinement in reporting in this respect was welcomed and had already been noted at the Aberdeen Local Licensing Forum. Andy Imray advised that Grampian Police were making ten submissions to the Licensing Board in relation to offences which could lead to the suspension of licences as a result of misconduct by managers or staff within licensed premises. The meeting noted that the Unight Scheme involving licensed clubs was due to be launched later today and that the successful Best Bar None Scheme will recommence in October. The meeting was advised that the Criminal Justice Community Safety Sub-Group of the Partnership will discuss the information contained in this report in more detail. Action Andy Imray was thanked for his informative report and it was noted that future reports will include figures on the number of calls received by the police in respect of drug overdoses. MANDATORY DRUG TESTING – EVALUATION REPORT The meeting noted the main findings of the research into the pilot Mandatory Drug Testing of Arrestees and that there had been a recent announcement by Kenny MacAskill, Justice Secretary, that this approach will not be rolled out as the results of the pilot do not demonstrate sufficiently effective use of resources to have confidence that continuation would impact on vulnerable and at risk drug users. CAMPAIGNS The meeting noted information on Alcohol Awareness Week 2009 and on the campaign in relation to Volatile Substance Abuse. In relation to the evaluation report on the 2008 Alcohol Awareness Week, it was noted the Fraser Hoggan could be contacted if information was required in relation to the local campaign as the circulated evaluation report relates only to the national campaign. 10 Action The information was noted. SAADAT MINUTES Action The meeting noted the minutes of SAADAT meetings held on 21st January and 20th May, 2009. ROAD TO RECOVERY- ONE YEAR ON The members of the Partnership were asked to note the availability of a document on progress which can be accessed at www.scotland.gov.uk/Resource.Doc/273739/ 0081808.pdf. NEXT MEETING It was confirmed that the next Partnership meeting will take place on Monday, 9th November, 2009 at 10.00am at Summerfield House.