Agenda item

Report ACH22-015

The LBB Public Health Registrar delivered a presentation providing a summary of the Substance Misuse Needs Assessment, which is attached at Appendix C.

Substance Misuse treatment and recovery services for Bromley residents were commissioned by the London Borough of Bromley, and the service was due to be recommissioned in 2023. As part of the recommissioning, a needs assessment/analysis of needs was carried out to ensure the new service adequately met the needs of the local population.

The LBB Public Health Registrar noted that 27 recommendations had been made on the basis of Needs Assessment, and were categorised into:

1. Improving data collection
2. Improved partnerships
3. Targeting risk and vulnerable groups
4. Drug use in Young People
5. Harm Reduction
6. Bromley Drug and Alcohol Service (BDAS)

The Health and Wellbeing Board were asked to consider:

-  How can better partnerships be fostered with the organisations mentioned? – these organisations knew the individuals well and were trusted. A way to capitalise on this to reduce drug related harm and death to the individual, their family and beyond needed to be sought. This was highlighted in the Dame Carol Black review, and echoed in national policy.

-  How can inequalities in access to services, as well as drug-related harm and deaths, be tackled? – inequalities in access and harm/deaths were clearly evidenced. With the levelling up agenda, as well as national drugs policy and the aims of health groups, this would be an important consideration.

-  How can substance misuse and addiction be shifted  to become a health issue rather than a criminal justice issue, thereby reducing stigma? – the evidence from both the Dame Carol Black review and literature was clear that substance misuse treatment and recovery works for both the individual and society, reducing harms and costs.

The LBB Public Health Registrar advised that a copy of the full Substance Misuse Needs Assessment could be circulated to Board Members following the meeting.

The Chairman enquired as to where overall ownership of the Substance Misuse Needs Assessment lay. The Director of Public Health said that Public Health had a role in commissioning services and developing programmes around early intervention and prevention. Lots of work was undertaken with GPs and hospital services and programmes were also commissioned jointly with the CCG – it was a multiagency approach with the involvement of community groups, charities, Police and criminal justice system.

In response to questions from Members, the LBB Public Health Registrar advised that a separate Alcohol Misuse Needs Assessment was underway and could be presented to a future meeting of the Health and Wellbeing Board. It was highlighted that lots of good prevention work was being undertaken for both young people and adults, and there was a need to ensure that this was integrated. The Director of Public Health noted that the initial focus had been on substance misuse as the contract with the service provider was coming to an end the following year. An in-depth piece of work had been undertaken to look at the needs, and identify any gaps, to ensure an effective evidence-based service was provided. The Alcohol Misuse Needs Assessment would provide similar information and would be used to recommission the service.

In response to a question, the LBB Public Health Registrar said that Bromley had a higher rate of hospital admissions related to drugs, compared to the national average, but a lower death rate, and this was something that they were “trying to unpick”.

A Member enquired if any policy interventions would be introduced following this work. The LBB Public Health Registrar advised that there was lots of existing literature and that the Dame Carol Black review focussed on recovery. In the past, there had been quick detox programmes followed by reintegration, however it was considered that longer term recovery was needed. It was noted that the literature suggested having members of mental health staff at substance misuse clinics helped with the recovery of individuals with co-occurring mental health and substance misuse needs. Another Member highlighted the issue of unrecognised drug use and the need for more to be done in helping to train those working in primary care to get this issue out in the open and help individuals understand its implications. The LBB Public Health Registrar said that the biggest gap identified during the needs assessment was recreational or ‘before crisis’ users as little evidence could be gathered. Some recommendations had been made in terms of how partners could work together to recognise those in crisis, but many individuals were unaware of the services available to them.

RESOLVED that the presentation on the Substance Misuse Needs Assessment be noted.