In 2012-13, Merton's Safer Merton Team together with Public Health re-tendered and recommissioned a new and fully integrated Recovery-Based Adult Substance Misuse Treatment Service, to meet the needs of those people within the borough’s population, who are alcohol and drug dependent and/or at risk of suffering serious substance-related harm. Services for younger substance misusers locally are currently being re-appraised and will be re-tendered in 2014-15. Together, we are also developing new substance misuse harm prevention frameworks for the borough that focus on whole population issues, public education and earlier identification and intervention methods aimed at stopping or reducing substance misuse before it has escalated into a more serious problem.
Key commissioning recommendations
For the treatment system as a whole:
- Continue to monitor local treatment services against an agreed Performance Assessment Framework and local indicators and outcomes for substance misuse as indicated in the Public Health Performance Dashboard.
- Safer Merton, Public Health and Merton MCG to review current usage of commissioned substance misuse inpatient (tier4) bed nights and further develop community treatment capacity to manage down future demand for inpatient services.
- Safer Merton and Public Health to develop new substance misuse prevention frameworks and reinvestment proposals to complement these.
- Continue to develop assertive outreach capacity to support hard-to-engage populations.
- Further develop local capacity to respond to parents who misuse alcohol and other drugs and to safeguard children.
- Maintain integrity, commitment and future resourcing for integrated substance misuse treatment services.
- Develop an agreed local strategic framework for alcohol partnership work with an alcohol action work plan for 2013-14.
- Stream relevant elements of the alcohol work programme through a new Merton Harm Prevention Forum.
- Target street drinking and anti-social behaviour and effect appropriate responses through the Local Multi-Agency Planning and Problem Solving Groups.
- Work with Trading Standards and the Metropolitan Police Licensing Team to target licensed premises and other alcohol outlets that continue to sell alcohol to children and/or are ‘hubs’ for anti-social behaviour in local communities.
- Have a Merton Alcohol Licensing and Planning Task Group.
- Through training, develop workforce capacity in identifying and responding appropriately to problem alcohol use.
- Have a specific alcohol arrest referral pathway to divert and support problem drinkers at an early point in the criminal justice system.
- Use the Targeted Drug Testing on Arrest programme effectively to identify and treat drug misusing (particularly Class A) offenders.
- Ensure that local treatment services are linked and contribute to effective Integrated Offender Management work locally.
(Writer’s note: a degree of caution should be exercised in the reading of this document as there may be some variance and ‘volatility’ with data presented here. JSNA Support packs for alcohol and drug treatment with refreshed data are due to be released by Public Health England in October 2013 with updated Local Alcohol Profiles England available from January 2014)
‘Drug and alcohol misuse is a complex issue. Whilst the number of people with a serious issue is relatively small, someone’s substance misuse and dependency affects everybody around them...studies including the National Audit Office report show that drug treatment provides value for money and independently verified national statistics show that drug treatment is effective and continually improving. Drug treatment benefits everyone, reducing crime and keeping communities safe’1
The National Drug Strategy 2010 set a new tone and direction for drug treatment, toward a more recovery oriented model that focuses on enabling people to receive treatment, and successfully complete and stay out with appropriate support. For the first time also in this new strategy, the importance of tackling alcohol misuse was duly acknowledged and positioned within an integrated services context.
In March 2012, the Coalition Government launched its Alcohol Strategy with a pledge to
‘tackle binge drinking and support local areas to tackle local problems, reduce alcohol-fuelled crime on our streets and tackle health inequalities.’ In July  and following a period of consultation it was announced that although the proposal for a minimum unit price for alcohol remains under consideration, it will not be introduced at this time.
In April 2013, Public Health England having formally taken ownership of substance misuse, devolved responsibilities for commissioning and monitoring alcohol and drug treatment services down to Public Health Teams in local authorities. In Merton specifically, responsibility is shared between Safer Merton and Public Health and with the Children, Schools and Families Department in relation to young people.
Public Health England has published its priorities for 2013-14, with alcohol included in the first priority
‘Helping people to live longer and more healthy lives’.
Allied with the substantial health impact from substance dependence, alcohol and drug misuse are major causes of crime and disorder, particularly violent (including domestic violence) and acquisitive crimes that seriously harm the lives of individuals and blight the communities in which they live.
In 2012-13, Merton’s Safer Merton Team together with Public Health re-tendered and recommissioned a new and fully integrated Recovery-Based Adult Substance Misuse Treatment Service to meet the needs of those people within the borough’s population who are alcohol and drug dependent and/or at risk of suffering serious substance related harm. Services for younger substance misusers locally are currently being reappraised and will be re-tendered in 2014-15. Together, we are also developing new substance misuse harm prevention frameworks for the borough that focus on whole population issues, public education and earlier identification and intervention methods aimed at stopping or reducing substance misuse before it has escalated into a more serious problem.
1.^ National Treatment Agency for Substance Misuse, as part of Public Health England 2013.