Declaration of Interests:
None
Witnesses:
Martyn Munro, Senior Public Health Lead, Surrey County
Council
Helen Atkinson, Executive
Director of Public Health
Sinead Mooney, Cabinet Member for Adults and Public
Health
Katy Matthews, Substance Misuse Service Manager, Surrey and
Borders Partnership
Sue Murphy, CEO, Catalyst
Matthew Parris, Healthwatch Surrey
Key
points raised during the discussion:
- It was
queried what impact out of county services have had on patients
since the closure of Windmill House and what steps were being taken
to ensure these out of county services were being monitored.
The Substance Misuse Service Manager
explained that the model of detoxification had changed from 1 July
2018 and the new model included a mix of ambulatory and out of
county services. Out of county services had been spot purchased
from Bridge House in Kent, which has received an outstanding
grading from the CQC and has a good reputation for providing
outstanding services. It was added that for patients who required
more than an hour’s travel to reach ambulatory services, spot
purchasing from Bridge House could be organised, although this was
considered on a case by case basis.
- A Member of
the Committee queried what lessons the adult substance misuse
treatment team had learnt from the integration of sexual health and
HIV services in Surrey as mentioned in the introduction of the
report. The Executive Director of Public Health stated that a great amount
of work had been done to consult with service users and patients.
Joint work had also been undertaken with NHS commissioners and
Providers. The Cabinet Member added that the work of the sexual
health services task group had a positive impact on the work of the
team, ensuring that discussions with people impacted by the service
took place.
- There was a
discussion around the increased use of opiates in the USA. It was
queried how resilient the service would be if there was an increase
in opiate use in Surrey. The Senior Public
Health Lead explained that locally the medicine management team had
not highlighted any hotspots for opiate use in Surrey. Work was
also being undertaken with local acute teams to understand how best
to work collaboratively to support teams further in the field of
opiate use. Nationally access to opiate treatment was at a decline
but in Surrey there has been an increase in the number of people
accessing opiate treatments. It was added that there were a number
of satellite prescribing services for opiate users in Surrey
although there was an ongoing challenge with recruiting prescribing
staff.
- The
Healthwatch representative explained that a number of positive
comments had been received on the i-access treatment with the needs
of service users being adequately met. There was some concern
around a single point of contact for service users and also some
anxiety around the move of in-patient services, although this was
not deemed to be detrimental. Overall the comments from service
users was very positive.
Dr Bill
Chapman left the meeting at 12.52.
- It was
explained that service user feedback was collated through the
‘Your Views Matter’ survey which was collated
regularly. Feedback was also collated through telephone surveys.
This data was then reported to Public Health quarterly. There were
also peer mentors in the service who delivered smart groups and
were very active in relaying how better to provide services. In
terms of overall performance monitoring, a quarterly contract
review meeting is undertaken which also includes patient feedback.
The service is able to monitor the speed of access to treatments,
with the average being 14 days in Surrey.
- The CEO of
Catalyst explained the benefits of peer mentoring and explained
some positive work had been undertaken with Woking Borough Council.
An accredited programme for those taking part in peer mentoring was
being organised.
- There was a
discussion around recruitment. It was explained that at present
there were no plans to second any employees from the substance
misuse team to the family safeguarding team, although this model
was wholly supported.
-
Concern was expressed around the cost pressures of
Buprenorphine and the impact this will have on patient treatment.
The Substance Misuse Service Manager explained that a number of
alternative manufacturers were offering a rebate on different drugs
that could be used instead of Buprenorphine and were just as
effective. This would be rolled out from April 2019 and would
therefore mitigate some cost pressures. The Senior Public Health
Lead stated that with the new partnership model in place there was
now an open accounting system in place. This has allowed partners
to respond effectively to the £220k cost pressure at year
end.
Actions/further information to be provided:
None
Resolved:
The
Health, Integration and Commissioning Select Committee:
- noted the
progress made in the changes to the adult substance misuse
treatment system and positive comments from Healthwatch
Surrey;
- invite the
Programme Board to update the Committee on:
- the Drug and
Alcohol Detoxification Service Evaluation scheduled to be published
in October 2019.
- performance of
the adult drug and alcohol misuse treatment system.