Agenda item

Emma Stubbs, Senior Commissioning Officer, Public Health was present, together with Barney McGee, Lisa Luhman and Liz McGrath of Better Lives, and outlined the presentation and report (copies interleaved)

During discussion the following main points were made –

·         Islington experiences some of the greatest levels of substance misuse related harm in London, with detrimental impacts on health services, crime and community safety and social care needs

·         Better Lives the adult drug and alcohol recovery service has been operation since April 2018 and during COVID lockdown the focus was on ensuring residents could access or continue to access the critical elements of their care. Post lockdown other types of remote support was offered however it has been difficult to sustain progress due to changing nature of the pandemic

·         Increasing numbers in treatment – COVID gave an opportunity to draw people into treatment, particularly opiate users, who may have chosen to decline previous treatment

·         Support has been extended to rough sleepers with better outreach, training other frontline staff, partnership working, rapid access, establishing a single point of contact, harm reduction

·         Issues identified throughout the COVID – feedback from Better Lives – residential rehab and inpatient detox closures or access severely restricted which limited available treatment options, pressure on local pharmacies, reduction in availability of other services, staffing resources,  safeguarding issues

·         Increase in reported cases of domestic violence and abuse and safeguarding

·         Opportunities identified as a result of COVID – rapid expansion of virtual and remote interventions, use of MS Teams/Zoom, more flexible approach to services, review traditional ways of working, different approaches to care, building on improved partnership working, continuation of Family Support Service

·         Borough performance – numbers seeking support for their opiate use is increased as a consequence of the reduced availability of street purchased drugs. During lockdown marked reduction in numbers of people presenting for support around their alcohol, and whilst these numbers are increasing, commissioners are working with the service to encourage greater numbers into treatment

·         Next steps – planning for future waves of COVID, delivering flu vaccinations to staff and vulnerable service users, ensuring critical face to face interventions are reinstated safely, provider led work streams, commissioning the new support  funded programme to provide drug and alcohol support to rough sleepers, equality impact assessments for any new approaches to delivering support

·         85% of service users in June 2020 indicated experience of service as good or very good during first lockdown. Increase in number of people remaining in treatment for 12 months or more, and a decrease in number of service users leaving treatment. Challenges – support services outside of drug and alcohol services, closing or moving online, and a significant number of service users do not have equipment or desire to access online support

·         Borough Performance – Contract management – during initial stages of COVID formal contract monitoring was suspended to allow the service to focus on delivering the critical elements of care, but these have now been reinstated and efforts are being made to develop a post COVID way of working. The service is able to report a relatively low number of COVID deaths amongst their current population

·         In response to a question it was stated that COVID had presented opportunities to engage users and to work with partners in a collective way to support users of the service

·         In response to a question as to whether additional staff could be employed in order to cope with additional users of the service, it was stated that there were limited resources but the service model did allow tiered support

·         Noted that there had been a reduction in staff available during COVID, and work had taken place with service users to provide alternative options, and there had been an increase in the number of volunteers who could assist with collection of medication and prescriptions

·         It was stated that the illegal supply of street drugs had started to increase back towards pre COVID levels, however it is hoped that lessons learnt would enable the service to continue to increase service users, and in particular address rough sleeping. Statistics showed that at present the service only engaged with 40% of opiate users and the challenge is to find the remaining 60% and encourage them into treatment

The Chair thanked Emma Stubbs, Lisa  Luhman, Liz McGrath and Barney McGee for attending