Councillors and committees

Agenda item

Substance Misuse Service Report

Purpose of the Report: In July 2018, Surrey County Council implemented changes to the commissioning of Substance Misuse treatment following a review of these services. For the Select Committee to consider the progress made in the changes to the adult substance misuse treatment system.

 

Minutes:

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:

 

  1. 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.
  2. 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.
  3. 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.
  4. 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.

 

  1. 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.
  2. 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.
  3. 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.
  4. 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:

 

  1. noted the progress made in the changes to the adult substance misuse treatment system and positive comments from Healthwatch Surrey;

 

  1. invite the Programme Board to update the Committee on:

 

  1. the Drug and Alcohol Detoxification Service Evaluation scheduled to be published in October 2019.

 

  1. performance of the adult drug and alcohol misuse treatment system.

 

 

Supporting documents: