1. Substance Misuse in Cardiff An Overview
Conrad Eydmann
Head of Substance Misuse Strategy and Development
December 12th 2012

2. Background
Current position
Achievements
Outstanding priorities
Route map for 2013 and beyond

3. Background
In 2003/4 when Welsh Government grant funding first became available, Cardiff received an allocation of approximately £400,000
In 2007 there were 600 treatment places for the city
In 2008 there were over 7000 violence against the person crimes recorded
In 2009, waiting times to access prescribing services were approaching 2 years
In 2010/11, over 70% of a £330,000 new budget for children and young people’s substance misuse services was allocated on non-recurrent, short-term interventions, despite the absence of any dedicated structured support services for the city.

4. And things have changed…
In 2013/14 (Budget settlements allowing) Cardiff is set to receive a substance misuse funding grant of £2,834,000
There are nearly 2000 treatment places across the city
2012/13 has a projected violence against the person crime rate of less than 6000
The waiting list for prescribed treatment has reduced to a maximum of 6 weeks
On December 6th a £250,000 per annum contract was confirmed with Barnardos to provide an open access substance misuse support service for children and young people

5. The ingredients
Substance Misuse Action Funding (SMAF) Revenue - Cardiff and the Vale will see a 12.8% one-off increase in their funding from 2013/14 onwards
Capital - the same 12.8% increase will apply, meaning the APB will have approximately £890,000 per annum to develop premises, secure hardware and undertake other capital developments
Partner agency core funding for services, and third sector charitable funding sources
The Area Planning Board is the senior partnership that delivers the substance misuse work-stream to both the Cardiff Partnership Board, and the Vale LSB
The APB delivery group undertakes all operational responsibilities, including commissioning, performance management, financial management and service development and delivery.
The APB Support Team undertakes day-to-day programme delivery

6. Achievements Alcohol Treatment Centre Alcohol Brief Interventions
School support programme
EDAS single point of entry
Alcohol awareness week
Breaking Free Online
IOIS Service
Increased clinical services for under 18s
New multi-agency premises on Neville St. Riverside
New interventions to prevent substance use among individuals who are NEET
National project piloting a new Dual Diagnosis care pathway
Permanent resourcing for alcohol test purchasing

7. Outstanding priorities
New commissioning strategy required by Welsh Government
Full service review completed, including service managers, staff and service users
Need to consolidate 50+ separate lines of expenditure – has resulted in a fragmented picture of service delivery
Significant duplication, with no clear definitions around services.

8. GAPS Aftercare and through-care – the last piece of the jigsaw
Services for vulnerable and marginalised groups such as homeless and roofless service users, sex workers, individuals from a variety of ethnic backgrounds, and looked after children.
Long term support for recovery
Service user-led services

9. Direction of Travel
Disestablish the current multiple lines of expenditure, to be replaced by strategically commissioned packages of services
Encourage inter-agency collaboration, and eliminate duplication, by creating a necessity for provider consortiums to delivery packages of services
Tendering new resources as service packages, including pooled budget arrangements where appropriate.

10. Future landscape of services
Packages of care to include:
Education, prevention and health promotion
Reduction of supply and enforcement
Tier 2 support, engagement and preparatory services for adults
Tier 2 services for CYP
Tier 3&4 services for adults
Tier 3&4 services for CYP
Through-care, aftercare and recovery
Harm reduction
Supporting vulnerable and marginalised groups
Supporting service users, carers and families
Developing the substance misuse workforce

11. Next steps
Commissioning strategy ( ) circulated in draft by 18th January 2012, with a development day on February 8th, and final consultation on March 26th
Performance management framework for substance misuse incorporated into the commissioning strategy
Due to UHB funding timescales, the commissioning process for the Adult tier 2 service package, and the through-care, aftercare and recovery package will commence as soon as possible in the new calendar year.
All other services will be transferred into the new packages during the first 18 months of the commissioning strategy

12. And finally…. a sample of the outcomes we are aiming to achieve
More school-age children and young people have accurate knowledge and awareness of substance use and its risks
The capacity of treatment and support services meets demand
Services are increasingly able to appropriately retain service users in treatment and support
Service users achieve improvements in their health and wellbeing
Service users are able to recover from substance dependence
Multiple needs of young people and their families are effectively addressed
Fewer young people are at risk as a result of parental substance misuse
Fewer children and young people are drinking alcohol, and drinking alcohol unsafely
Substance related crime is decreasing
Adult alcohol consumption is at decreasing levels of harm
Substance misuse is a decreasing local concern among residents
Service users feel that treatment and support meets their needs
Services are accessible and appropriate to the needs of vulnerable and “at risk” groups