Agenda item

Jessica Barclay, Commissioning & Development Manager and Gaby Price, Commissioning Officer were in attendance for this item)

The Committee received a report providing an overview of substance misuse services commissioned by Kent County Council.

(1)     Ms Honey introduced the report.  She welcomed the opportunity to discuss the service with the Committee as it was a particularly significant service for the Council where spending exceeded £19m.  The services are delivered by commissioned organisations; the Council identified the needs relating to drugs and alcohol across the County and commissioned the necessary services to meet those needs, both for adults and for young people. 

(2)     Ms Honey reported that she was the Chairman of the Drug and Alcohol Board, which was a multi-agency board with representation from the key partners including the Police, Probation and Health as well as internal partners, Education and Specialist Children’s Services.  KDAAT was a high performing team and that they were recognised as such nationally.

(3)     Ms Barclay drew the following information to the attention of the committee:

(i)       That investment was predominately from Public Health with contributions from KCC, the Police and Crime Commissioner and Probation and over 30 methods of intervention being delivered by three providers.  Treatment of offenders was also part of the Kent delivery with treatment services for this group being delivered by a fourth provider.

(ii)      That it was hoped that levels of funding would remain at similar levels despite planned changes for the future delivery of such services.

Drug misuse treatment

(iii)     That just under 25% of the drug users currently accessing the service were currently injecting drugs and this was relevant in terms of preventative work related to the health and well being of users, and control of blood borne viruses.

(iv)     That a significant portion of service users had a dual diagnosis, ie they were also referred to mental health services with issues unrelated to their drug use.

(v)      That the largest cohort of the clients in treatment were white British males in their 20s and 30s. 

(vi)     Many clients had further difficulties, in particular in relation to housing.

Alcohol misuse treatment

(vii)   Alcohol misuse clients showed a similar ethnicity make up to those with drug misuse problems, but were significantly older.  In addition there were more people in this group with a dual diagnosis and more living with their children.

          Prison Services

(viii)  Services in prisons mirrored those in the community.  This group of service users was more ethnically diverse than those being treated in the community.

          General

(ix)     Fewer young people were misusing either drugs or alcohol, owing to a successful education programme allowing young people to make more informed decisions.

(x)      Treatment was based on recovery and abstinence models and included not only the user, but their families. 

(xi)     A pilot has been tested in East Kent based on a payment by results model for the provider and incentivisation models were likely to be rolled out further.  Commissioning in this way ensured that outcomes were the focus of service delivery.

(xii)   Performance results were expected to improve further in the next financial year, following a period of disruption and transformation due to two new service contracts, which had affected both results and reporting.  Measured against other DAATs in the country, Kent continued to perform well - 4^th out of 149.

(4)     Officers responded to comments and questions from Members on the Deep Dive and the following points were highlighted:-

·                Successful planned exits meant that users had been abstinent for 12 weeks combined with a clinical judgement that the client was no longer clinically dependent on the substance. 

·                In relation to commissioning and payments for outcomes, Kent was part of the national Payment by Results pilot.  There were 8 pilot sites across the UK testing an outcome based Payment by Results model, these were all very different and were being evaluated as they went on.  The contract for West Kent was £4m.  When the model was chosen it was designed with increasing increments of payment by results each year.

·                That the Drug and Alcohol Board was concerned with the transition period from childhood to adulthood and through careful commissioning it aimed to ensure a seamless service so that young people were not left vulnerable.

That much preventative work was done in partnership with Kent Council on Addiction (KCA), the Council’s main youth service provider, and anti-drug demonstration kits such as a training model and toolkit called RisKit.   All adult service providers worked in partnership with KCA to further strengthen the transition work from child to adulthood.  The adult provider for East Kent is Turning Point and for West Kent it is the Crime Reduction Initiative (CRI).

(5)     RESOLVED that the information on KDAAT and Members’ comments be noted.