August 2017- Fulfilling Lives NECG 2017 Drug Strategy August 2017- Fulfilling Lives NECG

2017 Drug Strategy, NECG August 2017

Overview Key components New and enhanced measures Reducing demand Building recovery Key things you influenced Some reaction Next? 2017 Drug Strategy, NECG August 2017

Published on Friday 14th July 2017 Involved targeted consultation with key partners including practitioners and commissioners, academics & service users. Government Strategy, as opposed to departmental. Public Health England’s 2017 drug treatment outcomes evidence review informed the strategy’s development. 2017 Drug Strategy, NECG August 2017

Develops the three strands of 2010 strategy and adds a fourth Reducing Demand Building confidence and resilience among children, young people and others, with a more targeted approach for vulnerable individuals. Restricting Supply Ensuring the legal framework remains effective, while tackling the production and distribution of drugs. Taking a smarter approach to drug-related offending. Building Recovery Achieving better outcomes for those in recovery, through increased transparency, better structures, a more integrated system and stronger governance Global Action Shaping international policy and practice by providing global leadership and working with our international partners 2017 Drug Strategy, NECG August 2017

Key Components Builds on the 2010 strategy, aiming to do more to address the complex and evolving challenges of drug misuse. Including changing drugs markets and patterns of use, the recent increases in the rate of drug-related deaths and the needs of an ageing cohort of heroin and crack users with increasingly poor physical and mental health. The importance of joined-up action on alcohol and drugs. Many areas of the strategy apply to both alcohol and drugs. Alcohol treatment services should be commissioned to meet the relevant ambitions. The importance of local quality governance structures for drug treatment, workforce development and compliance with relevant clinical guidelines are all highlighted. Stronger governance and accountability for delivering the strategy, including a Home Secretary-chaired Board, increased transparency of local performance and the appointment of a national recovery champion. 2017 Drug Strategy, NECG August 2017

The new enhanced set of overarching aims and measures include: 1. Reduce illicit and other harmful drug use Currently measured by last year’s drug use in the Crime Survey for England and Wales. The 2017 Drug Strategy will: go further and measure/publish the frequency (e.g. monthly) and type of drug use (e.g. opiates and crack) Government will work to improve estimates of heroin and crack use provide this data both at national and local level 2017 Drug Strategy, NECG August 2017

The second primary aim 2. Increase the rates recovering from their dependence Currently measured by the proportion of clients leaving treatment free from dependence and sustaining this for 6 months The 2017 Drug Strategy will: expand the measure, by supplementing it with the proportion who sustain freedom from dependence for 12 months (reporting TBC) segment this data (e.g. newer/entrenched opiate users and non-opiate users) provide a breakdown of local penetration/access rates and waiting times to access treatment 2017 Drug Strategy, NECG August 2017

A new set of jointly owned measures to sit underneath the two main aims Needed to better reflect: wide range of social and health harms drugs misuse is both cause and consequence of wider factors [physical and mental health, employment, housing and crime issues] the joint responsibility a range of partners have alongside Local Authorities and the drug treatment services they commission to meet these shared ambitions, including health, housing services, employment support providers and criminal justice partners Integrated recovery system measures: Treatment measures: crime and re-offending [joint] outcomes for parents employment [joint] prison through-care housing [joint] outcomes for individuals with co-existing mental health problems Heath & social care system measures: hospital admissions For local process monitoring: drug related deaths post treatment recovery support blood borne viruses facilitated access to mutual aid 2017 Drug Strategy, NECG August 2017

Action to reduce the demand for drugs (prevention onset/escalation) includes: A universal approach across the life course PHE & wider government action - early years help & Best Start in Life programme; Early Intervention Foundation & wider youth policy action, through to PHE support to local areas to build health and wellbeing across life course Confidence and resilience and risk management: supporting schools to support enhanced PSHE education, PHE commissioning ADEPIS (Alcohol & Drug Education & Prevention Information Service) Update Talk to Frank service. Targeting most vulnerable Identifying vulnerable groups and patterns of use (e.g. young people at risk, range of vulnerabilities; image and performance enhancing drug (IPED) use; LGBT and chemsex; homeless; young offenders) New central government action (e.g. Liaison and Diversion for offenders; ACMD reviews, Troubled Families; toolkits + comms, inc on new psychoactive drugs & RIDR) as well as support to local areas. Local action supported by: Gov to share evidence of what works, and what doesn’t, including monitoring existing pilots; PHE toolkits to support local action; enhanced provision of data on prevalence and local need 2017 Drug Strategy, NECG August 2017

Action to ensure individuals have the best chance of recovery includes: Improving treatment quality and outcomes for different groups Sending clear message on ambition through enhanced range of measures PHE review of the treatment system and how its performance can be enhanced New UK Guidelines (‘Orange Book’) on clinical management. Promoting joined up commissioning and service integration Encourage integrated commissioning - through jointly owned measures across mental health, employment, housing, criminal justice etc. Action on Dame Carol Black Review employment recommendations Enhance access to mental health provision-Mental Health Taskforce, new guidance Supported by stronger governance Enhanced transparency on LA spend, and publication of outcomes Stronger inspection and regulation through the Care Quality Commission Progress reports into a cross-gov Home Secretary chaired Board A National Recovery Champion 2017 Drug Strategy, NECG August 2017

Key things you influenced “Commissioning and contracting should be informed by robust service user involvement’ “Service user involvement in the design and delivery of services and recovery systems can contribute significantly to the evolution of effective drug and alcohol treatment systems. It is important that service users have a full stake in the decision-making process about how their needs are met. Local areas, with PHE support where needed, should engage service users in the implementation of this Strategy at both system and service levels.” “Peer support is an essential component of effective recovery and should be easily accessible before, during and after formal structured treatment. Evidence for the efficacy of mutual aid is well-documented and peer support is highly valued; both can increase and sustain the gains achieved by formal treatment, in addition to challenging stigmatising views of people who use drugs.’” “We will also appoint a national Recovery Champion………seek to address the stigma faced by people with drug or alcohol dependency issues” 2017 Drug Strategy, NECG August 2017

More things you directly influenced “We know recovery is only achievable through a partnership-based approach with action taken across a range of services, particularly housing, employment and mental health. There are clear expectations for partners at both a national and local level set out throughout this chapter.’” “We will support local partners to measure outcomes from key processes which promote recovery, including: …recovery support interventions, such as housing, employment or parenting support...provided after treatment.’” “Where supported housing is commissioned, they should assure themselves that the quality and type of support and accommodation provided is appropriate to client needs.’” “…….expand the measure, by supplementing it with the proportion who sustain freedom from dependence for 12 months.’” “Strategy, we will also develop a range of measures which will deliver greater transparency on local performance, outcomes and spend.” 2017 Drug Strategy, NECG August 2017

Some reaction BBC: ‘…there is a sense that the Home Office is more focused on the issue than before, prompted perhaps by the recent rise in drug deaths and the need to prevent a new generation of drug users sparking a fresh crime-wave.’ Collective Voice: ‘…..pleased to welcome the strategy as a serious and realistic platform which, if delivered, will improve society’s collective efforts to minimise the various harms flowing from illegal drug use. Our optimism is driven by four key aspects of the strategy…..Vulnerability; leadership; evidence; accountability.’ LGA: ‘We have long argued that reductions by central government to the public health grant in local government that is used to fund drug and alcohol prevention and treatment services is a short-term approach and one that will only compound acute pressures for criminal justice and NHS services further down the line….. Leaving councils to pick up the bill for new national policies while being handed further spending reductions cannot be an option.’ 2017 Drug Strategy, NECG August 2017

Next? How can we work together in the future Meet with recovery champion? Support dissemination/implemention? Involvement in events? 2017 Drug Strategy, NECG August 2017