Dundee Alcohol and Drug Partnership (ADP)
Delivery Plan
2012-2015
All aspects of the Dundee ADP Delivery Plan adhere to the ethos of Recovery
captured in the ADP Statement on Recovery below:
STATEMENT ON RECOVERY
This Recovery Statement Is Underpinned By The Principle That Every Individual Is
Capable Of Recovery.
Recovery is about individuals improving their personal strengths and abilities to help them
“live well” through both the good and hard times.
Within the alcohol and drug field, Recovery is about an individual’s journey beyond a life
that is defined by substance use.
Recovery is driven by the individual but firmly based within their family and community.
Recovery is most effective when families and communities help support this process.
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Dundee Alcohol & Drugs Partnership (ADP)
1.
Introduction
This delivery plan sets out the vision and key priorities for the Dundee Alcohol and Drugs
Partnership (ADP) and the key deliverables in achieving our goals. As part of the Dundee
Community Planning Partnership (CPP), the Dundee ADP will assist in addressing the
root causes of social and economic exclusion by contributing to the creation of a
community that is healthy, safe, confident, educated and empowered. A community
where people are able to gain control over their circumstances, realise their
potential and enhance their wellbeing. .
More specifically, the Dundee ADP will continue to develop a recovery-focused care
pathway based on closer links with generic services and local communities (see further
detail on recovery in Dundee in section 5.2 below). The ADP aims to ensure that high
quality services are available in Dundee to individuals, families and communities affected
by substance misuse. In addition, we aim to ensure that these services are delivered by a
highly qualified and motivated workforce. In recent years, the Dundee ADP has increased
its focus on developing prevention interventions. These interventions include both those
aiming to prevent and delay the onset of substance misuse, and those focusing on early
intervention and the prevention of substance-related problems.
To achieve these aims, the Dundee ADP has already embarked on an extensive research
process to establish the current position in terms of recovery-focused services in Dundee.
This process has involved service users, local communities, staff (from both specialist and
generic services), and strategic leaders. In partnership with the Angus and Perth and
Kinross ADPs, we have developed a Needs Assessment (NA) process, initially focusing on
the needs of individuals affected by homelessness and substance misuse. We will then
focus on the needs of children affected by parental substance misuse (CAPSM). Following
completion of these two projects the NA programme will extend to other priority areas. We
are also in the final stages of the development of the Tayside Substance Misuse
Information System (SUMIT) that will provide real-time information for all the specialist
substance services, as well as systematic information on outcomes.
The Dundee ADP commissioning process involves the active participation of all the
relevant ADP partners. In partnership with Dundee City Council and NHS Tayside, we
have also developed a robust and coherent system to monitor all the services
commissioned to deliver substance misuse interventions.
Dundee has an active and well attended Substance Forum that works very closely with the
ADP. This Forum now includes representation from service users, local communities,
carers groups, as well as a wide range of service providers.
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2. Summary of Key Changes
During the next three years, the key aim for the Dundee ADP is to continue reducing the
problems experienced by individuals, families and communities due to substance misuse.
In order to achieve this aim, the ADP will progress the development of a recovery-based
care pathway involving all specialist substance misuse services and generic services in
the City. Most importantly, this process will also involve changing the culture and the
approach to the provision of interventions to ensure service providers, the individuals who
use services, their families and communities adopt the recovery approach.
In addition, the Dundee ADP will continue to work in partnership to ensure early and
effective interventions are available to families affected by substance misuse. We will
continue to facilitate the joint-working between adult and children services to ensure
children affected by parental substance misuse receive timely and effective interventions.
We will also ensure that families, including Kinship carers, are supported to progress in
their recovery journey. Following a needs assessment study (conducted early 2011) we
will restructure the specialist services for children and young people affected by their own
substance misuse and strengthen the preventative element of these services. We will also
ensure the Strengthening Families Programme 10-14, (working preventatively with families
to delay and prevent the onset of substance misuse amongst young people), is continued
in the long term.
Having developed the Dundee Focus on Alcohol (FOA) project, the ADP will continue to
work in partnership with local communities and other key partners to strengthen the
population-wide approach aiming to bring about a culture-change to alcohol use. Over the
next three years, FOA will run a specific campaign encouraging adults not to buy alcohol
for those underage and will work closely with all off-licences in the City to support them to
take more responsibility. FOA will also do specific work with parents across the City and is
planning an additional campaign targeting older people. We will also continue to provide
free measuring-cups and information booklets.
We have developed an outcomes-reporting frame work which is individually matched to
each service. Over the next three years the ADP aims to develop a Dundee-wide
information system that will allow us to aggregate outcomes information for the whole of
Dundee. We will develop this system in partnership with the two other Tayside ADPs. This
information system will also provide real-time information and monitoring information to
assist future service planning and development.
3.
Partners
The ADP is a crosscutting theme group responsible for providing the strategic direction
across the whole of the Dundee CPP and enabling all theme groups to follow a coherent
response to substance misuse. The ADP is involved in the implementation and monitoring
of the Dundee Single Outcome Agreement (SOA) Framework and works closely with a
range of both strategic and crosscutting themes, including the Children & Young People
Protection Committee (CYPPC), Integrated Children Services and the Community Safety
Partnership. The ADP has commissioning responsibilities, initially in respect of ring-fenced
alcohol and drug funding, and aims to ensure its commissioning process reflects the needs
and interests of the Dundee CPP. In addition, the ADP is responsible for the
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implementation of national policy in relation to substance misuse at a local level and for
measuring HEAT Targets for access to substance misuse treatment and care services.
For a list of ADP membership see Appendix 1.
4.
Core and local outcomes to be achieved
Dundee ADP will ensure that progress in the City with respect to substance use and
misuse addresses the key themes outlined in Government Strategic priorities The National
Core Outcomes to be addressed are:
1.
HEALTH: People are healthier and experience fewer risks as a result of
alcohol and drug use
2.
PREVALENCE: Fewer adults and children are drinking or using drugs at
levels or patterns that are damaging to themselves or others
3.
RECOVERY: Individuals are improving their health, well-being and lifechances by recovering from problematic drug and alcohol use
4.
FAMILIES: Children and family members of people misusing alcohol and
drugs are safe, well-supported and have improved life-chances
5.
COMMUNITY SAFETY: Communities and individuals are safe from alcohol
and drug related offending and anti-social behaviour
6.
LOCAL ENVIRONMENT: People live in positive, health-promoting local
environments where alcohol and drugs are less readily available
7.
SERVICES: Alcohol and drugs prevention, treatment and support services are
high quality, continually improving, efficient, evidence-based and responsive,
ensuring people move through treatment into sustained recovery
To help achieve the core outcomes locally, the Dundee ADP has developed a list of
specific local outcome. These outcomes were developed in consultation with service
providers and service users – (see full list of local outcomes in the page below)
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Local outcomes for Dundee
Category
Outcomes
Access to services
•
Making appropriate referrals
(specifically in the context of the Arrest
Referral service)
Substance misuse behaviour
•
•
•
•
•
•
•
Not using illicit drugs
Reduction in the use of illicit drugs
Client becomes drug free
Reduction in risk-taking behaviour
Changes in the method of use
Not consuming alcohol
Reduction in the consumption of alcohol
Physical and psychological health
•
•
•
Improvement in physical health
No deterioration in physical health
Improvement in psychological health/
emotional wellbeing
No deterioration in psychological health
•
Social functioning and life context
•
•
•
•
•
•
•
•
•
•
•
Reduction in criminal activity
Improved personal safety
Improved employability skills
Moved into employment
Improved parenting
Improved personal relationships
Improved accommodation status
Improved financial situation
Improved independent living skills
Improved supportive living environment
Improved engagement with
education/training
Personal Development
•
•
Increased motivation
Increased feeling of appropriate
personal responsibility
Increased confidence and self-esteem
Higher personal and career aspirations
•
•
Prevention & Education
•
•
•
Reduce the prevalence of substance
use amongst young people in Dundee
Reduce the problems associated with
substance misuse
Improve the effectiveness of substance
misuse education
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5.
Priority actions & interventions to improve outcomes
5.1
Children and Families affected by substance misuse
•
•
•
•
5.2
The ADP will continue to drive the implementation of and oversee the evaluation of the
Supporting Vulnerable Families projects and the New Beginnings service
Secure the long term delivery of the Strengthening Families Program (SFP) 10-14
The ADP will ensure it has clear links to the Early Years Framework, Being A parent in
Dundee sub group
The ADP will continue to redesign and reshape services in line with the
recommendations contained in the young people’s needs assessment report.
Promoting Recovery
The concept of Recovery as an overall philosophy of care focuses on developing personal
strength and resilience (see Dundee Statement on Recovery). The focus on strengths
rather than problems is widely accepted as a more effective model than the more
traditional models based around stabilisation, harm reduction and abstinence.
There are however, a variety of challenges to the Recovery agenda becoming embedded
in service delivery and in individual worker’s practice. These challenges are predominately
centred on the creation of a genuine partnership with service users, carers and community
members and ownership of the Recovery ethos. Nonetheless, embracing the principles of
Recovery also offer professionals, communities and users of services a framework within
which service delivery and improvement can be monitored alongside an individual’s
progress through services.
The nature of the Recovery process demands that services offer greater openness to and
input from, users of services, carers, and local communities. It is therefore crucial that
users of services, carers, and communities are placed at the centre of the process.
•
•
•
•
•
•
The ADP will continue to develop the Recovery care pathway for all service provision in
the City
The ADP will work with Tayside colleagues to progress the ongoing needs assessment
program
We will develop the research program designed to identify the position Recovery holds
with service providers, service users, carers and communities in the City
We will increase the range and level of support for young people affected by alcohol/
substance misuse
We will continue to improve the outcomes-reporting framework for substance misuse
services
We will improve the engagement on Recovery through the strengthening of existing
links with community groups, family support groups and Community Planning
Partnership structures.
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5.3
•
•
•
•
Increase the focus on prevention interventions
We will reduce the prevalence of substance use amongst young people in Dundee
We will improve the effectiveness of substance misuse education at schools including
the support of peer-led education and prevention interventions
We will provide support and extend to other settings the future delivery of Alcohol
Screening and Brief Intervention
We will ensure the “Writing to Reach You” resource is fully utilised in all appropriate
settings across the City.
5.4
•
•
•
•
•
Prevention of overdose, drug deaths and support for the Naloxone Program
Work with the Tayside DRD group to develop a care pathway and information sharing
pathway for responding to non-fatal overdoses that allows information from police and
ambulance services to be passed on to other agencies that can offer an appropriate
intervention to reduce the risk of future deaths
Continue to provide Overdose Prevention training and continue to extend the
programme to service users, carers and community members, keeping under review
the issue of incorporating the use of take-home naloxone in this provision
Continue to extend the take home Naloxone Program to include all key partners
ensuring wide availability in all communities in the City
Ensure the availability of accessible and appropriate harm reduction and treatment
services that provide a range of evidence based recovery focussed options
Work in partnership to improve our ability to meet the needs of substance misusers
within the criminal justice system
5.5
•
•
•
•
•
Increase and improve community engagement
Strengthen the engagement with local communities that enhances the overarching
Dundee Partnership and Community engagement model
Expand the Focus On Alcohol project in Dundee through :
o Developing a body of evidence and recommendations in relation to
overprovision of alcohol in Dundee.
o Responding to adults buying alcohol for young people through an awareness
raising campaign
o The development and delivery of alcohol resources and interventions for young
people in Dundee
Continue to support the Community Café in Lochee and expand this model across the
City
Continue to develop the role of the Dundee Substance Forum ensuring the Forum
represents the views and experiences of service users, their families, community
groups and service providers
Through Local Community Planning Partnerships (LCPP) involve communities in
o Developing local solutions in relation to their concerns regarding substance
misuse
o Enhancing local skills and knowledge to enable communities to deliver local
services
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o Improving mental wellbeing through increasing the resilience of residents in
dealing with the negative impact of substance misuse
o Engaging and involving young people in substance related planning processes
o Creating opportunities to build capacity in individuals and community groups
5.6
•
•
•
5.7
•
•
•
5.8
•
•
•
Safer Communities, Enforcement and Availability
Work with partners to increase youth diversionary activities for young people engaging
in substance misuse
Continue to support the Dundee Licensing Forum in its role of promoting responsible
drinking in the City
Support enforcement activity in respect of individuals and groups concerned in the
supply of illegal drugs, in particular Class ‘A’ Drugs
Staff Development / Training
Develop a Program utilising the information obtained from the Recovery based
research.
The ADP will continue to co-ordinate and support the multi-agency substance misusetraining programme delivered by STRADA to a wide-range of professionals in Dundee
The ADP will continue to work in partnership with the Dundee CYPPC and the Violence
Against Women Partnership (VAWP) to identify training needs and develop training
programmes around issues of child protection and neglect.
Performance Measurement
Work with key partners (including Tayside Health Advisory Forum and Dundee
University) to complete the SUMIT information system for substance misuse
Work in partnership with all substance misuse agencies to improve the quality of the
outcomes reporting structure
Continue to improve structures to ensure accurate information is available to measure
HEAT Target for access to services.
6.
6.1
•
Core indicators
The national indicators used by Dundee ADP include
Rate of drug-related hospital discharges (three year rolling average over last 5 years)
General acute inpatient & day case discharges with a diagnosis of drug misuse in any
position (2004/07 - 2007/10)
2004/07
2005/08
2006/09
2007/10
3 year rolling average rates per 100,000 population
56.3
89.9
129.6
175.0
Source: ISD, SMR01 Admissions from non-obstetric and non-psychiatric hospitals
•
Rate of alcohol-related hospital discharge rates (three year rolling average over last 5
years
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General acute inpatient and day case discharges with an alcohol-related diagnosis in any
position (2004/07 - 2007/10)
2004/07
2005/08
2006/09
2007/10
3 year rolling average rates per 100,000 population
640.7
661.8
656.2
681.2
Source: ISD, SMR01 Admissions from non-obstetric and non-psychiatric hospitals
•
Rate of alcohol-related mortality (three year rolling average over last 5 years
Alcohol related deaths (underlying cause) 2005/07-2008/10
2005/07
2006/08
2007/09
2008/10
3 year rolling average rates per 100,000 population
33.4
35.4
35.6
35.7
Source: ISD (NRS)
•
Prevalence of hepatitis C among injecting drug users
Percentage of injecting drug users testing positive for HVC antibody (% is based on all injecting
drug users tested)
ADP
2008/09
Dundee City
62.1%
Scotland
53.5%
Source: HPS, HCV antibody prevalence: data from the Needle Exchange Surveillance Initiative (NESI),
2008/09
6.2
Local indicators
Following a comprehensive consultation process, each individual agency in Dundee has
developed specific indicators to reflect the interventions they deliver. Below is a list
providing examples of the indicators currently in use (please note, these indicators are
used individually by each service to provide information to the ADP. However, we are not,
at this point, able to provide Dundee-wide information. Once the SUMIT project has been
completed (see details above) this information will be available):
•
•
•
•
•
•
•
•
•
•
•
Client stopped injecting
Client appears less chaotic
Client turning up to meetings sober
Client no longer involved in criminal activities
Client engages with the project/with staff members
Parents able to recognise and respond to children’s needs
Parents setting boundaries, and guidance for children
Improved budgeting skills
Improved school/nursery attendance
Improvement in basic interpersonal and communication skills
Improvement in literacy and numerical skills
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•
•
•
•
•
•
•
•
•
•
•
7.
Higher personal and career aspirations
Improved ability to plan and prioritise
Client has acquired paid employment
Client successfully engaging in voluntary work, training or educational programme.
Improvements to client’s eating or sleeping patterns
Improved timekeeping, attendance & reliability
Client takes more responsibility over own actions.
Client shows greater ability to work on own initiative
Increased feelings of personal responsibility
Client is more confident in a group work situation
Client is able to better express personal views
Governance and financial accountability
The ADP is committed to ensure that drug and alcohol services in Dundee are
based on an assessment of local needs and that services are evaluated to ensure
value for money. Through its partner agencies, the ADP will ensure that service
specifications are in place for all drug and alcohol services and that requirements relating
to service activity and quality are clearly set out. In order to establish clear criteria of
effectiveness and expected outcomes, the ADP will continue to engage with all drug and
alcohol services and with the relevant CPP theme groups. Where services are contracted
on behalf of the ADP, the ADP will ensure the above specifications are part of the formal
contract.
Regular monitoring of drug and alcohol services in Dundee takes place through the
Dundee SOA Delivery Framework, as well as through the collation and reporting
information in respect of HEAT Targets A11 (access to services) and H4 (Alcohol Brief
Interventions). The ADP will continue to use the Audit Scotland Self-Assessment checklist
to identify gaps in its performance and shape the delivery and actions plan to address
these gaps.
8.
National support requirements
•
We already receive support from Stephen Malloy (SDF) to deliver overdose and
naloxone training. This support has been very valuable and we would like to continue
working with SDF to deliver our overdose and naloxone training programme.
•
The Dundee ADP has worked closely with STRADA to deliver a range of basic training
courses. STRADA has also worked with us to develop and deliver courses responding
to the specific need of agencies in the City. Again, we would like to continue with this
joint working.
In addition to the above the Dundee ADP is committed to work within the Dundee
CPP to tackle deprivation in the City and ensure health inequalities are reduced.
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APPENDIX 1: ADP MEMBERS
David Lynch, (ADP Chair) General Manager, Dundee CHP
Stewart Murdoch, (Vice Chair) Director, DCC, Leisure & Communities Department
Alan Baird, Chair, Children and Young Persons Protection Committee
Chris Johnston, Tayside Community Justice Authority
Superintendent Athol Aitken, Tayside Police
Dr Brian Kidd, Tayside Substance Misuse Service
Dr Kirsty Licence, NHS Tayside Public Health
Elaine Zwirlein, Director, DCC, Housing Department
Michael Wood, Director, DCC, Education Department
Laura Bannerman, DCC, Social Work Department
Morna Wilson, Chief Officer, Dundee Voluntary Action
Neil Fraser, Strategy & Performance Manager, NHS Tayside
Peter Allan, DCC, Community Planning Manager
Mike Inglis, Governor, HMP Perth
Martin Tait, Tayside Fire and Rescue Service
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