The Chair welcomed to the meeting, Ms Ros Jervis, Director of Public Health and Ms Joanna Dainton, Head of Commissioning and Partnership Strategy Development (Drug and Alcohol Misuse) of the Hywel Dda University Health Board.
The Committee considered the Area Planning Board’s annual report on Drug and Alcohol Misuse for 2018-19 which covered a range of areas, serving to inform members and provide and update on current commissioning arrangements and the provision of substance misuse services. Information was included on:
· The strategic objectives regarding the provision of such services, the funding arrangements and services/projects commissioned.
· Local developments and confirmation of the governance and planning arrangements in place on a regional basis.
· Performance indicators, service user feedback and case studies.
The following queries were raised on the report:-
· Officers were asked their thoughts on Naloxone kits being made more publicly available and what support was available to service users following the use of Naloxone.
The Director of Public Health stated that she supported Naloxone kits being widely distributed and that Naloxone had saved lives since being made available. Following use of Naloxone, the service provided a structured treatment and recovery path for individuals. The Head of Commissioning and Partnership Strategy Development (Drug & Alcohol Misuse) added that although Naloxone was already distributed widely, distribution was still a key priority for the Area Planning Board. Distribution could only be managed through agreed local services.
· Concern was raised in relation to the increase of addiction to prescribed drugs and over the counter drugs such as codeine. The Director of Public Health acknowledged the complexity of drug abuse was a concern and that statistics showed that many were using secondary drugs. Details of the top five drugs used was available on the WEDINOS website. DDAS have a caseload of codeine dependent clients and packages of treatment were provided. The Director of Public Health advised that outreach work within the pharmacies could be organised to facilitate discussions with individuals affected with drug dependency.
· It was asked, if the service provided by drop in centres was audited? The Director of Public Health advised that the Health Board had a robust assurance framework and if an agency was not providing value for money, or was under-performing against agreed SLA’s the Board would intervene and could decommission the service.
· Reference was made to the emphasis on prevention. It was commended that as prevention was better than cure this was the way forward.
· It was suggested that “strict presentations” should be provided to children in schools and that they should not have a “choice” regarding drug taking. The Director of Public Health highlighted that children habits were mainly due to inter-generational cycles. The cross organisational / multi agency work that was being undertaken promoted education and awareness within schools. The Head of Commissioning and Partnership Strategy Development added that continuous discussions were held with Welsh Government highlighting the importance of maintaining multi-agency support especially within Police and Crime.
· Reference was made to AUDIT C screening tool and ABI (alcohol brief intervention). The Director of Public Health explained that AUDIT C was a series of questions that immediately help identify individuals that have alcohol dependency issues. It was now used in the A&E environment and those identified would receive an alcohol brief intervention which could be effective in 5 minutes. It was reported that 1 in 8 people who receive ABI take further positive steps to reduce alcohol intake.
· In response to a query raised as to why substance misuse services referrals in Hywel Dda during 2018-19 had increased from last year, the Director of Public Health advised that essentially this was attributed to alcohol related referrals via the Alcohol Liaison Service and mainly for the 50+ age group.
· Concern was expressed that due to Brexit, funding could cease for services such as Cyfle Cymru. The Head of Commissioning and Partnership Strategy Development acknowledged that Brexit carried an element of uncertainty with regard to future funding, however she had received indications that funding would be protected for the next two years.
The Chair expressed an appreciation to both the Director of Public Health and the Head of Commissioning and Partnership Strategy Development for attending the meeting and further stated that the detailed report was beneficial.
UNAMIMOUSLY RESOLVED that the report be received.