Agenda item

Report CS14134

Approval was sought to tender for substance misuse services.

For the procurement of a new contract to take effect from January 2016, Members had previously requested a policy review to develop a revised approach to counter substance misuse - information was to be provided on outcomes that could be expected from the serviceand the effectiveness of treatments.

Work since undertaken included:

• clarification of the legal basis for providing substance misuse services;
• assessment of the local population need for substance misuse services, including a review of the effectiveness of treatments; and
• commissioning options in relation to the above points.

Copies of the full needs assessment for alcohol and drugs misuse were provided online and copied to the Members’ room at the Civic Centre. Key points from each assessment were presented in Report CS14134.

There were a number of risks should services not be commissioned for people misusing drugs or alcohol. It was recommended that substance misuse services continue to be funded to provide a full range of treatments outlined in guidance. The report outlined how commissioning arrangements for the services could be more efficient with an opportunity provided to revise service specifications and create greater efficiencies.

On success and outcomes, officers were aware of the proportion of patients not returning for treatment. Successful completion of treatment was defined as leaving treatment free from the substance of choice and not re-presenting to services within six months. This was a Public Health Outcome Framework indicator – accepted nationally - against which the local authority was measured. Although the proportion in effective treatment in L B Bromley was a little lower than for England, successful completion rates were higher, suggesting that Bromley services were working effectively and meeting statutory requirements. Some 20% of patients were considered to have successfully completed treatment and to have been cured. It was agreed to provide an indication of the number of people this percentage represented.

It was intended to realign contracts for the main services and tender those services as one contract. As such the Leader supported the recommendation to grant a waiver to extend the shared care contract from October to December 2015 so aligning it for inclusion with the other services to be tendered as one contract. Noting the recommendation from the Executive and Resources PDS Committee, the Leader agreed that further work (and information) was needed before the tender process could begin. It was important that relevant Members had a part in the process for defining the tender specifications. The Portfolio Holder for Resources suggested that the views of residents be considered along with desired outcomes from the NHS Bromley Clinical Commissioning Group (CCG) - it was necessary to work closely with the CCG in this area. Successful outcomes could then be built into the tender process.

In merging the current contracts, it was explained that the services would be re-specified in a different way. More was known about the adult population, those who use the service, and what was needed, and it would be possible to specify a better service. Effectiveness of substance misuse services in L B Bromley was in line with national expectations and the authority was in the top quartile of performance. 

The Portfolio Holder for Renewal and Recreation suggested that an easier strategy to counter drug misuse might be to reduce numbers starting to take drugs. Some of the Public Health Grant funding for substance misuse services might be better invested in preventative measures such as education at schools, improving parenting, targeting families where parents are drug users, and supporting the police in targeting venues where illegal drugs are sold.

Councillor Fawthrop (Executive and Resources PDS Chairman) advocated moving quickly so as to achieve savings in the new contract earlier. He suggested an approach where elements of the contract could be taken forward/released in tranches. One part of the contract would come into force earlier than other parts to achieve savings. With negotiations in advance, savings could be achieved in contract tranches for release in October and January. The Leader indicated that it might not be possible at this stage to change the contract approach and questioned how it might be possible to take savings earlier. The approach also appeared similar to submitting individual services to tender.

Having considered the issues and Member views, the Leader was minded to support the recommendations in the report subject to Members being involved early in formulating the tender specifications and how a contract might eventually look. Officers could take account of the suggestions from Councillor Fawthrop but it was necessary to have a formal contract from

1^st January 2016 where performance could be determined against outcomes through KPIs etc. It was necessary to consider this in the next few months. Councillor Fawthrop agreed that the matter be looked at, understanding that it was best to take savings as soon as possible; also, in principle, to look at rolling forward the contracts into one contract, and assessing how different a contract might look if rolled over to a third year.

RESOLVED that:

(1)  the following substance misuse services be tendered in line with the Council’s Contract Procedure Rules (CPR):

·    Stabilisation and Assessment Service

·    Recovery Service

·    Intensive Prescribing

·    Children and Young People Substance Misuse Service

(2)  relevant Members be involved at an early stage with the formulation of tender specifications and how a contract might eventually look; and

(3)  the grant of a waiver be agreed to extend the Shared care contract for three months (October to December 2015) in order to align it and incorporate it within the contracts at (1) above.