Agenda item

Report CS14072

Approval was sought to extend from January 2015 to December 2015 three existing contracts with Crime Reductions Initiatives (CRI) for the provision of an integrated drug and alcohol service covering Stabilisation and Assessment, Recovery, and Intensive Prescribing. Approval was also sought to extend from January 2015 to December 2015 the contract with Kent Council on Alcohol (KCA) to provide an integrated drug and alcohol service for children and young people.

The matter was previously considered by the Executive at its meeting on

16^th July 2014. Given the sums involved Members wanted a full understanding of this area and for the Care Services PDS Committee to give the matter further consideration before a final decision is taken. Accordingly Report CS14072 provided further details.

It was proposed to tender for a new substance misuse service to take effect following any contract extensions. The service would be re-specified with the aim of combining individual service elements into a single contract. It was intended to deliver further value for money. In providing for the treatment of patients with alcohol and/or drug dependence, the service formed part of the Authority’s statutory obligation for public health provision. 

A number of views were outlined in discussion. The number of adults in Bromley drinking at levels which increase the risk of harm to health would, it was suggested, need correction (first bullet point at paragraph 3.2.1 of Report CS14072). It was felt the report focused on the extent of alcohol and drug dependency nationally and locally rather than on offering options to effectively address the problem. As a local initiative, it was necessary to be assured on value for money and it was questioned whether resources might be better targeted at prevention/early intervention with a possible increased role for local police enforcement. Increased medical evidence would also be helpful.

As the contract was originally tendered by the former Bromley PCT as part of a pan-London contract, a more “Bromley centric” approach was suggested with a re-negotiated contract based on local needs. The Deputy Leader proposed a six month rather than 12 month extension of the contracts during which time further (medical) evidence and information could be obtained. If more time was needed a further three month extension could be considered. Noting the mandatory Public Health outcome for successfully completing treatment, i.e. being free from the substance of choice and not re-presenting within six months, the Leader questioned whether there might be those leaving treatment re-presenting after six months. He suggested a greater role for intervention, with the Better Care Fund possibly funding some of the issues in conjunction with a possible role for primary care. 

In further comment, it was suggested that effective treatment can positively reduce crime levels. Treatment had been successfully completed in a number of cases and those requiring clinical intervention needed ongoing support and help. The Portfolio Holder for Care Services supported an extension of the contracts suggesting there would be much more focus in considering a new contract. He supported early intervention but suggested that some aspects of service outcomes were difficult to quantify.

It was highlighted that 20% of patients completed drug dependency treatment i.e. not presenting back to services within six months. This compared favourably with treatment for a number of other conditions. After six months there is a reasonable prospect of the patient not relapsing. The Public Health grant covered both acute and preventative elements, and with contracts extended, both savings and a revised policy approach could be considered in a new contract e.g. increased early intervention. A full 12 month extension would be necessary to develop a new policy, tender new requirements, and complete decision making. Revised specifications for a new contract could be brought to Members at an early stage e.g. April/May 2015 with further reports provided at subsequent key stages to enable Member input. It might be possible to direct some funds towards further prevention measures if savings could be made in a new contract. 

Taking account of comments made, the Portfolio Holder for Resources offered his support to extend the contracts by 12 months, subject to interim reports at three and six months. However, it was important for Members to be provided with appropriate information.

The Leader put the recommendation at 2.2. of Report CS14072 to a vote alongside the wish for a policy review of the service and both were agreed by a majority. The Deputy Leader asked that his vote against be recorded.

The Leader emphasised the importance of providing clarity to Members on outcomes that can be expected from the service.

RESOLVED that:

(1) in line with the Council’s Contract Procedure Rules (CPR) –

·  the three existing contracts with CRI for the (a) Stabilisation and Assessment Service, (b) Recovery Service, and (c) the Intensive Prescribing Service, be extended for a period of one year from January 2015 until December 2015 and

·  the contract with KCA for the children and young people’s substance misuse service (BYPASS) be extended for a period of one year from January 2015 until December 2015; and

(2) a policy review be undertaken to develop a revised approach to counter substance misuse in preparation for the procurement of a new contract effective from January 2016 and progress reports be brought back to the Executive after three and six months.