Open Event : Reconfiguration of Substance Misuse Services in Westminster July 2009
Westminster City Council Open Event for interested parties regarding the reconfiguration of substance misuse services in Westminster Introduction Objectives � To Excite and Inspire � To Inform � To network with other providers � To answer your questions Outcomes Gain and Understanding of : � Westminster and its substance misuse issues � The basic rationale behind the change � The new treatment model � Outcome based commissioning � Areas of focus and the challenges ahead
Westminster City Council Open Event for interested parties regarding the reconfiguration of substance misuse services in Westminster An Unique Opportunity In a Unique City Westminster “A City within a City” � One of the busiest Cities in the world � 500’000 people – nightlife � 3400 licensed premises � Busier at 3am than 3pm � Home to Parliament Media Attention A Unique Opportunity � Whole scale redesign of services � Integrating Drug and Alcohol Services � Comprehensive Service User Consultation
Westminster City Council Open Event for interested parties regarding the reconfiguration of substance misuse services in Westminster Most affluent wards in the country found next to some of the 8th Most deprived most deprived Local Authority in England A City of Contrasts Hazardous and harmful levels of drinking Queens Park, Westbourne, amongst higher socio Church Street – Top economic 20% of most deprived wards in the country NHS Westminster Public Health Data 2008 Westminster City Council Ward Profile Data Index of Multiple Deprivation 2007, national deprivation quintile
Westminster City Council Open Event for interested parties regarding the reconfiguration of substance misuse services in Westminster Estimated 1’000’000 73.9% of working age frequent the city 20’000 Claiming some kind of on a daily basis worklessness benefit 1/3 of Westminster’s Population of approx population will Demographics 230’000 residents leave 1/3 replace in any given year 29% of the Population BME 50.1% Male 52% of the Population 49.9% Female Born outside of the UK Figures have been taken from Neighbourhood Statistics Mid Year Estimate for Jun 2007 Westminster Joint Strategic Needs Assessment Aug 2008 Westminster Public Health Annual Report 2007/08
Westminster City Council Open Event for interested parties regarding the reconfiguration of substance misuse services in Westminster Proportion of Westminster Population in each Proportion of Westminster children and ethnic group young people in each ethnic group Chinese Chinese 3% 2% Asian 11% Asian 19% Black 8% Other 7% White 53% Black 14% White 71% Other 12% Source: GLA 2007 round population projections (PLP low)
Westminster City Council Open Event for interested parties regarding the reconfiguration of substance misuse services in Westminster � Problem Drug Users 3,627 Opiate and Crack users – Smoothed estimate � Opiate Misusers 2,801 � Crack cocaine Misusers 2179 Alcohol Use � Hazardous 6,257 Prevalence of Substance � Harmful 12,659 Misuse � Binge Drinking 31,552 � Dependent 8210 (ANARP) Capacity of Treatment System � 70% PDU Penetration = 2,476 � Minimum 10% of dependent drinkers = 821 (ANARP) Figures have been taken from Westminster LARP Data a, Glasgow Estimate and Alcohol Needs Assessment Research Project 2005
Westminster City Council Open Event for interested parties regarding the reconfiguration of substance misuse services in Westminster 84% of PDUs accessing structured Just over half of clients accessing structured treatment in 2008 were there for treatment receive either specialist or GP 12 weeks. prescribing Women remain under represented in the treatment population Around two thirds are Westminster’s Treatment from a white background Population Approx 60% of new presentations are either NFA or present with Approximately 60% of the treatment a housing problem population are aged 35 or older 85% of the treatment population misuse either opiates or crack cocaine Westminster Performance Management Data/ NTDMS 2007/08
Westminster City Council Open Event for interested parties regarding the reconfiguration of substance misuse services in Westminster Nationally, 50% of child protection cases reference parental alcohol misuse 37% of domestic violence cases involve alcohol (Home Office Stats) Parental alcohol misuse – around 2,447 children in Westminster impacted Approx 230 people in structured Alcohol by parental drinking treatment at any given time 2,752 alcohol related hospital admissions in 45% of all violent incidents, victims for Westminster residents believed offenders to be under the influence of alcohol (Home Office Stats) National Service Framework for Children, Young People and Maternity Services Department of Health (2004). http://www.nwph.net/alcohol/lape/index.htm
Westminster City Council Open Event for interested parties regarding the reconfiguration of substance misuse services in Westminster 12 GP Practices participating in Shared Care 12 pharmacies offering needle exchange services 74% Male, 26% Female (Comparable to overall treatment Approximately 51% using population) substances on top of their script Primary Care 13% of clients employed Older population Delivery of brief interventions for Approximately 600 Westminster alcohol misusers residents prescribed in a primary care setting Provisional findings from Westminster DAAT GP Shared Care Audit 2009
Westminster City Council Open Event for interested parties regarding the reconfiguration of substance misuse services in Westminster Understanding the differences Nearly one quarter of all rough 57% new to the streets sleepers nationally are in Westminster 9% will be returners 34% entrenched ongoing 41% of rough sleepers have a problem with drugs Homeless Population 40% of rough sleepers have a 49% of rough sleepers have mental health problem a problem with alcohol Approx 15 hostel providers 1,820 individuals were verified accommodating approx rough sleepers in 1200 individuals Westminster in 06/07 HM Government NO ONE LEFT OUT Communities ending rough sleeping Westminster City Council Rough Sleeping Strategy 2007–2010
Westminster City Council Open Event for interested parties regarding the reconfiguration of substance misuse services in Westminster Approx 50% on caseload are NFA Drug Rehabilitation 43 % of Dip caseload engaged in Requirements; structured treatment in 100 New Orders in 08/09 with a 2008 49% success rate Drug Intervention Programme Arrests 550 ‐650 drug tests per month 32% Testing Positive 76% Out of borough 319 DIP Care Plans agreed in 2008 In 2008 Over 600 ROB 150 DIP referrals to specialist Assessments at court with treatment approx 150 receiving ROB Home Office Dashboard/ Performance Indicators 2008
Westminster City Council Open Event for interested parties regarding the reconfiguration of substance misuse services in Westminster The Future Of Drug and Alcohol Treatment Provision In Westminster � User Focused Treatment System � Developed in collaboration with key partners � Significant input from Drug and Alcohol users � Improving the experience and outcomes of service users � Integration of drug and alcohol treatment into broader work of NHS Westminster, Community Protection, Police and Probation Service
8 Key Features of the Westminster’s Vision For Substance Misuse Services are: Positive Outcomes: Health and Well Being, Reduction in Criminal Behaviour Increase range, quality and accessibility of alcohol treatment Improved care pathways – the right treatment at a time they need and want it Increase number of women and BME communities accessing treatment Focus on social reintegration‐ accommodation, training, education Emphasis of meeting needs of children and families of substance misusers Service users at the centre‐ developing service user advocacy and support Treatment rooted in local community, need to engage to ensure meeting their needs July 2009
Westminster City Council Open Event for interested parties regarding the reconfiguration of substance misuse services in Westminster The Model � Hub and Spoke Design � 2 mini treatment systems North and South � Range of services on offer as detailed in specification � Delivered from 3 key settings: Neighbourhood Centres Direct access service offering Tier 2 and 3 interventions Structured Intervention Centres offering appointment based tier 3 interventions West End Referral Centre Offering harm reduction interventions and referral on In reach services at a range of community based settings
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