Where are we? ADDICTION RECOVERY COMMUNITY HILLINGDON (ARCH) Old Bank House 64 High Street Uxbridge Middlesex UB8 1JP

Meet the partners:

Meet the team Arch staff: Young persons worker Psychology assistants plus honoraria's) Service user & carer volunteers Older persons Pathway Young persons worker A&E Liaison Nurse Criminal Justice Smoking Cessation Arch staff: Consultant psychiatrist Doctors Nurses Social workers Psychologist Occupational therapists Outreach workers Recovery Practitioners Peer support/volunteers

How to refer: Referral letter Fax to: 01895 207 733 Email to: arch.hillingdon@nhs.net Call to discuss possible referrals: 01895 207777 Address to/liaise with: Duty worker Sector Manager – Sue Murphy Consultant Psychiatrist – Dr Jeffrey Fehler Consultant Psychologist – Dr Deepti Shah-Armon Team managers clinical – Debra Davies, Taruna Rampersad Team managers – Jayne Smith, Miriam Jassey & Max Griffiths

Arch- DIAGNOSTICS OUTCOMES MONITORING REPORT ALCOHOL New 253 In treatment 421 2017/18 NON-OPIATE 82 316 OPIATE 159 594 ALCOHOL & NON-OPIATE TOTAL 192 686 1475

How to tackle high rates of alcohol dependency in rough sleepers Demonstrate joint working between adult alcohol services and the wider health and social care providers

Welfare Pathway for Street Homeless Dependent Drinkers ARCH initially set up a welfare pathway to be responsive to high numbers of clients attending the service with alcohol dependence and street homeless. We needed improved access and facilities in which to deliver a package of care for homeless and rough sleeping clients.

Hillingdon LA was awarded a public health grant to implement fibrous scanning on-site at Arch. Early intervention and prevention of liver disease Reduction in inpatient bed days and length of Stay Reduction in hospital admission episodes for alcohol-specific conditions and the mortality rate from alcohol liver disease. Effective implementation of a comprehensive 'welfare, physical and wellbeing' offer for alcohol misuse clients in the borough, providing a ‘health passport ‘. Training programme for all Arch Nurses to provide Fibroscanning. Provision of a wide range of non-stigmatising satellite settings and in -reach arrangements with housing and partner agencies- for this client group. Onsite provision of priority clinics in partnership with Hillingdon LA and the development of the Rough Sleepers Initiative project in 2019/20. Refurbishment of Arch Welfare Room- provision of clothes, food, toiletries and onsite support for housing and health & wellbeing with new pathway . Client access to Information and Communications Technology (ICT) Social Work support & housing clinics. KPIs /outcomes – Increase in clients accessing Fibroscanning with health passports at Arch Increase in street homeless accessing Arch. Increase in access to housing .

Where are we now PHE grants team allocates funding to successful applicants. CNWL works with building contractor on behalf of the LBH to agree project scope. CNWL purchases the FibroScan on behalf of the LA.   Building contractor undertakes work on the welfare room and furniture is purchased. FibroScan machine is delivered to ARCH and staff receive training on usage. Development of a stakeholder engagement plan jointly owned by CNWL and LBH Homeless Prevention Services. LBH and ARCH will link in with the wider health and social care providers in the Borough who come into contact with homeless/rough sleepers who are dependent drinkers. These will include hospitals, GPs, mental health services, CRCs, homeless services, voluntary sector organisations, charities and mutual aid groups. This will ensure that high risk alcohol dependent homeless/rough sleeper adults are targeted through direct engagement (i.e. leaflets, posters, presentations and drop in sessions). The homeless/rough sleeper’s new welfare pathway becomes operational in new space – Provision of weekly clinics in partnership with ARCH and LBH Homeless Prevention Team. The service undertakes FibroScanning, primarily based in ARCH, but also available at alternative locations e.g. GP surgeries. The service collates key performance indicators and carries out a continuous evaluation of the KPIs to identify demographic trends and potential barriers to receiving the service. Monthly update reports will be provided to Public Health on progress of the pathway.

KPIs Outcomes & Quality improvement