Transcript Appendix 6 - Community Consultation Paper

Reshaping Drug and Alcohol
Treatment in Westminster
Public Consultation
We want to hear your views
Please respond by March 31st 2009
Introduction
Westminster Drug and Alcohol Action Team (DAAT) is jointly funded by the City
Council and NHS Westminster
The Key Objectives are:
1. Reducing the supply of illegal drugs
2. Preventing young people from becoming drug misusers
3. Reducing drug-related crime
4. Reducing the use of drugs through increased
participation in treatment programmes
Westminster DAAT are one of the top performing DAATs in the Country. It successfully
manages to retain 85% of individuals in treatment for twelve weeks or more. This
measure is regarded as an indicator of effective treatment.
The DAAT is responsible for the commissioning of all treatment services, including
those that sit within the Drugs Intervention Programmed (DIP), and actively monitors
and reports on performance and communicates with stakeholders
Why Provide Substance Misuse Treatment?
•Drug and Alcohol misuse wastes Lives, destroys families and damages communities
•It is estimated that £1 spent on treatment saves £9.50 on cost associated with
drugs such health and crime 1
•Substance Misuse is an issue which has an impact on society as a whole but
disproportionately affects the most deprived communities, disadvantaged
families and vulnerable individuals
•Recent Home Office Study shows providing treatment to drug users has
resulted in a 60% decrease in criminal behaviour 2
•Evidence shows that providing individuals with a counsellor and access to
groups help them to stabilise and reduce their substance use
•Treatment can often be the service that links chaotic individuals to wider
support services such as Debt and Housing Advice, Health Services, Education
and Training
1) Godfrey C, Stewart D, and Gossop M (2004) Economic analysis of costs and consequences of the treatment of drug misuse:
2-year outcome data from National Drug Treatment Outcome Research Study (NTORS). Addiction, 99(6) pp. 697-707
2) Research Briefing RB35 Nov 08 see link http://www.nta.nhs.uk/publications/documents/nta_changes_in_offending_rb35.pdf
The Westminster Picture
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Westminster has approx 3500 Crack and/or Heroin User 3
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Currently 35% of those (1200) attend structured treatment
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The target is to get all into effective treatment
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It is estimated that over 46’000 of Westminster’s population are drinking to
hazardous levels
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It is estimated 6% that (6156) of men in Westminster and 2% (2054) of
women are dependent on Alcohol 4
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Currently there are approximately 400 Alcohol users attending structured
treatment
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Our challenge is to attract more dependent drug and alcohol users into
treatment
Current Treatment Model
•Currently Westminster Commission drug and alcohol services separately. With 5
main providers offering services out of 9 sites across the North and Centre of the
City.
•Services offer Westminster residents treatment such as counselling and group work
as well as substitute prescribing for heroin users. A number of treatment agencies
provide harm reduction services such as needle exchange and health checks.
•Drug and Alcohol services are located separately from one another, with direct
access Alcohol support being provided from a service located in Kensington and
Chelsea called the Alcohol Resource Centre.
•A vast majority of service users accessing treatment are poly users, using a number
of different substances, including mixing alcohol with illicit drugs such as crack and
heroin.
3) Estimates of the prevalence of opiate use and/or crack cocaine use (2006/07) London Region Dr Hay etal
4) Alcohol Needs Assessment Research Project The prevalence of alcohol dependence in England is estimated by the ANARP as 3.6%; 6%
of men and 2% women. Applying this to Westminster would suggest that there are 8,210 dependent drinkers;
1. Substance Misuse Team - 1 Frith
Street
Map of Current
Service Provision
2. Soho Alcohol Team – 1 Frith Street
3. Soho Rapid Access Clinic – 1 Frith
Street
4. Hungerford Drug Project - Wardour
Street
5. Alcohol Resource Centre- Ladbroke
Grove
6. Caravan Project- South Wharf Road
7. WDP – 470 Harrow Road
8. WTC – Hanson Street
9. Family Therapy Centre- Elksotne Road
4
The Proposal

Westminster DAAT are committed to identifying problem substance misusers, get
them into treatment, drive down drug use and the associated costs

We are proposing to retender existing services and commission new treatment
provision

The DAAT have developed this proposal in collaboration with Council Members
and our partners in the Police, Community Protection and Probation

There will be a move from 9 treatment centres across the Centre and North of the
City to 5 with a focus on offering services that are accessible to all
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The Centres will be split into North and South contracts, with Oxford Street/
Bayswater Road being the line that separates the 2 halves
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Drug and Alcohol Treatment will be integrated, offering free expert treatment
regardless of the substance
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Services will be available 7 days a week, with rapid access to the right support
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All Structured Services will be delivered solely to Westminster residents and
verified Westminster rough sleepers
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The Treatment System will be designed with robust enforcement measures in
place for those engaging as part of a community order
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It will offer prompt and direct access to support for individuals to work towards a
substance free life including individual counselling, group work, substitute
prescribing, referral into detox and residential treatment

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There will be a focus on supporting substance misusing parents – breaking the
cycle of problems being transferred between the generations, working alongside
the Family Recovery Project
With an emphasis on working with Employment and Training Organisations and
Job Centre Plus to get Users off benefits
Why Propose a Change?


There are currently no Drug or Alcohol Treatment facilities In the South of the City
More Drug treatment than Alcohol – The proposal will provide an opportunity to
Integrate the two

Equal Access to treatment across the City

There is currently no Open Access Service for Alcohol Users in WestminsterService Users have to go to Kensington And Chelsea

Changing Trends in Drug Use with Increased Crack and Alcohol prevalence

There has been a change in National focus toward getting people through
treatment and into work- Need for clearer pathways through the system

There a re currently 35% of Westminster’s Problem Drug Users (heroin and/or
crack cocaine) in treatment. New and improved services are needed to attract
more
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The current system is too complicated; Service Users Drop Out Before
Completion
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A 3 year needs analysis has been carried out, outlining where needs are not
being met
The New Model – Location
Westminster Drug and Alcohol Action Team (WDAAT) are proposing to redesign
treatment services with 2 centres in the North, 2 in the South and a small referral
service based in Soho. The 2 centres are:
“Neighbourhood Centres”, providing the first port of call for all dependent drug
and alcohol users wanting treatment
“Structured Intervention Centres” where those stable and ready to move into
education and/or employment will access support to do this.
“West End Referral Centre” will be a signposting service offering brief advice and
information of where to get help
The sites are not yet known. Organisations bidding for the contracts will be putting
forward properties that fit the design specification developed by the Council. All
properties will be subject to Planning consent and consultation with the relevant
neighbourhoods.
Visual Outline of New Model
Structured
Intervention
Centre
Neighbourhood
Centre
West End Referral Centre
Structured
Intervention
Centre
Neighbourhood
Centre
The Commissioning Process

Following consultation we plan to go to open tender for new services during
2009
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Detailed service Specifications are being developed and will be available to
anyone who wishes to view them
•
Expert providers to bid for new service and they will be required to propose
location

Invite representatives from key partners and service users to be part of
interview process

DAAT Partners including Community Protection and Met Police to consult
residents and work in partnership to address the concerns raised throughout
the process

Service Specifications request centres offer space to accommodate Local
Community Groups

Bidding Providers will need to demonstrate how they will communicate with
the community, offering regular liaison meetings

New service due to open 1st Sept 2010
Reshaping The
Westminster Drug
and Alcohol
Treatment System
How we can learn from you?



Westminster Council is committed to consulting it’s
residents on all changes, particularly those that will affect
their healthcare. Westminster Drug and Alcohol Action
Team are proposing this change on the basis that it will
improve the quality and accessibility of treatment to those
who need it most.
By enhancing the treatment on offer more substance
misusers will access and benefit from the support available,
making positive changes in their lives that will impact not
only on themselves but on the community as a whole.
Whilst consultation with current service users’ is taking
place around how they would improve current service
provision, we would like to ask residents of Westminster for
their input on this proposal, taking on board any concerns
and addressing them throughout the development of the
model and tender process
Question 1
We feel that Westminster requires a Treatment System where Substance Misusers
can get the help they need easily and without delay. To achieve this we propose
that drug and alcohol services be moved to the neighbourhoods that need it most?
Do you support the rationale behind this proposal? (Please tick one box)
 Yes
 No
 Don't know
Question 2
In your opinion what would constitute good management of the treatment service
and its surrounding areas for local people? Please give your opinion on a scale of
1-10, 10 being to strongly agree (please circle as appropriate)
Regular City Guardian Patrols in locality of Service
1
2
3
4
5
6
7
8
9
10
Premises to be designed with community safety in mind (appropriate lighting etc)
1
2
3
4
5
6
7
8
9
10
Develop a Street Management policy in partnership with local residents
1
2
3
4
5
6
7
8
9
10
No external advertising on the building itself
1
2
3
4
5
6
7
8
9
10
Open Days for residents to visit the services
1
2
3
4
5
6
7
8
9
10
Duty Manager’s contact details made available for each of the Centres
1
2
3
4
5
6
7
8
9
10
Service Providers to host regular neighbourhood involvement groups
1
2
3
4
5
6
7
8
9
10
Residents’ complaints to be responded to in one day
1
2
3
4
5
6
7
8
9
10
Any other suggestions? Please detail below
Any other comments on the Management of the service?
Question 3. How would you like to be consulted on this proposal in the
future?
 Local Area forums
 Newsletter (if yes please provide email address)
__________
Safer Neighbourhood Forums
 Other (please specify)
Police Consultation Group
Question 4.
Do you have any comments on the proposal?
(Please write your comments in the box below)
Thank you for taking the time to fill out this questionnaire.
Your views are valued greatly. Please return your completed
questionnaire to us using the pre paid envelope provided by
31st March 2009.
You are not required to fill out the following section, but we
would be grateful if you could in order for us to ensure we get
responses from a variety of people.
Which of the following are you?
I am a Resident in Westminster
I work in the area
Male
 If yes what is your postcode?


I am visiting the area
Female

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How old are you? 16-24 
25-34 
35-44 
44-55 
56-65 
65+ 
To which of these groups do you consider you belong? (please circle)
British White
Irish White
Other white
Mixed - White and Black Caribbean
Mixed - White and Black African
Mixed - White and Asian
Any other mixed background
Asian or Asian British – Indian
Asian or Asian British – Pakistani
Asian or Asian British – Bangladeshi
Any other Asian background
Black or Black British – Caribbean
Black or Black British – African
Any other Black background
Chinese
Any other background