Agenda item



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 & Alcohol Misuse) of the Hywel Dda University Health Board.


The Committee considered the Area Planning Board report on Drug and Alcohol Misuse Annual Report 2017 which covered a range of areas, serving to inform members and update them 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.


The following queries were raised on the report:-


·       Reference was made to the achievements made during 2017 which included the distribution of 397 Naloxone kits.  It was asked who the naloxone kits had been provided to.  Furthermore, it was commented that it could be beneficial to raise the awareness of naloxone and its purpose this could be achieved by rolling out the Naloxone roadshow throughout the county and providing training to door supervisors of pubs/clubs. The Director of Public Health explained that Naloxone was a medication used to block the effects of opioids, especially in cases of an overdose and that kits had been distributed widely.  She acknowledged that raising awareness would be beneficial and would consider widening the training programme in the future. The Head of Commissioning and Partnership Strategy Development (Drug & Alcohol Misuse) added that Naloxone is already distributed widely throughout the Hywel Dda area.  


·       Strong concern was raised in relation to the increasing number of young people that have issues in connection with alcohol and drugs and it was hoped that the direction of travel was to try to eradicate issues not just ‘paper over the cracks’.  The Director of Public Health acknowledged that this was a challenging area and that continuous research was being undertaken to ensure the right services were being commissioned.  The Area Planning Board comprised of multi-agencies, all of which have a responsibility to tackle the complexity of issues that is presented.  This incorporated treatment services which provide a holistic approach and a dual group which supports and navigates challenging issues in relation to mental health and addiction.

Furthermore, the Director of Public Health explained to the Committee that intelligence has revealed that alcohol dependency was not just limited to young persons, it was found to affect a wide range of ages including older age groups. Education, prevention and early intervention work were key areas of focus for the Board which was essential in order to reduce alcohol dependencies.  The Head of Commissioning and Partnership Strategy Development added that the Area Planning Board would be undertaking exercises to commission services within education sector in schools and colleges.


·       With regard to the Well-being of Future Generations Act 2015 and the 5 ways of working, it was asked, if there any collaborative working with the third sector and communities?  The Head of Commissioning and Partnership Strategy Development stated DDAS which was an Adult Drug and Alcohol Service works in partnership with Dan 24/7, Barod (formerly known as Drugaid Cymru) and Kaleidoscope, all of which have close links with the local communities and businesses.  In addition, the Area Planning Board was structured around priority areas of the Welsh Government Strategy and included a delivery plan which focused on treatment and recovery.

·       Reference was made to Children in Need with Parental Substance Misuse problems. A query was raised regarding the definition of Children in Need.  The Senior Manager-Complex Needs and Transition explained that children in need represented children in care and support and which included children who were known to social services and those children/families how were identified as needing additional support.

·       It was asked, how do we know if services are successful? The Head of Commissioning and Partnership Strategy Development stated that the Area Planning Board receive and scrutinise a report on all services on a quarterly basis, highlighting areas of concern to the Chair of the Area Planning Board. In addition, the structure of the Board allowed for tight assurance and robust monitoring.


·       Officers were asked how the service provided by drop in centres is measured and the Head of Commissioning and Partnership Strategy Development
(Drug & Alcohol Misuse) explained that on a quarterly basis all drop in centres have to provide information and if any issues are raised then they are reported to the Board.  The Health Board has a very tight assurance framework and if an agency is not providing value for money for the service user then the Board will intervene. 

·       It was asked, if a review of the Annual Planning Board’s effectiveness was planned?  The Director of Public Health stated that the Health Inspectorate Wales had earlier this year commissioned a review into all the Area Planning Board’s throughout Wales. The outcomes of the review was due to be published July/August 2018.

·       Reference was made to the 5000 bed days that had been taken up by patients with alcohol related conditions within the Hywel Dda Health board.  It was commented that it was interesting to note that the cost to the Health Board was over £5.2million per day with regard to the inpatient treatment alone.


The Chair thanked both the Director of Public Health and the Head of Commissioning and Partnership Strategy Development for the detailed report and presentation.


UNANIMOUSLY RESOLVED that the report be received.



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