DUMFRIES AND GALLOWAY ALCOHOL AND DRUG PARTNERSHIP (ADP)

DELIVERY PLAN

2015-18

INTRODUCTION

This Dumfries and Galloway Alcohol and Drug Partnership (ADP) Delivery Plan (the ADP Delivery Plan) 2015-18 complements the Dumfries and Galloway Alcohol and Drug Partnership Substance Misuse Strategy (the Strategy) 2015-18 and should be read with reference to that strategy. These are designed to be working documents which will form the basis for investment in service development and delivery over the next three years as we strive to meet the aspirations of our service users and their families and carers and achieve the local and national outcomes described in the strategy.

OUR PARTNERSHIP APPROACH

Dumfries and Galloway ADP is a strategic partnership which reports directly to the Dumfries and Galloway Community Planning Executive Group. Specific aspects of the ADP business will also be reported through the governance structures of individual partners, in particular NHS Dumfries and Galloway and Dumfries and Galloway Council. As our structures supporting Health and Social Care Integration are developed our relationship with the Integrated Joint Board will be defined and governance arrangements confirmed.

Our partnership strives to be inclusive and this is reflected in our membership, which includes the following representation:

  • NHS Dumfries and Galloway
  • Dumfries and Galloway Council

- Social Work Services

- Criminal Justice Services

- Licensing Services

- Strategic Housing Services

  • Police Scotland
  • South West Scotland Community Justice Authority
  • Crown Office Procurator Fiscal Service
  • Scottish Prison Service
  • Third Sector Dumfries and Galloway

Each of our partners have signed up to the current strategy and implementation plan.

In addition to the above, the ADP employs a Community Engagement Officer within its Support Team to ensure that service users and patients, their families and carers are integral to the development and delivery of their services.

GOVERNANCE AND FINANCIAL ACCOUNTABILITY

Our ADP receives regular and ongoing support from a Finance Manager within NHS Dumfries and Galloway. The ADP meets quarterly and has ‘Finance and Budgets’ as a standing item on its agenda. Decisions on investment of both earmarked funds and partners core funds for drug and alcohol services have been delegated to the partnership. Annual allocation decisions and end of year sign off is vested in the partnership.

Since 2013, available resources and allocations have been identified as utilised for treatment, prevention or recovery and a year on year transfer of allocation of 2% has been achieved from treatment to prevention and recovery services.

PRIORITIES

During the lifetime of this Delivery Plan we are committed to addressing the following national and local priorities:

  • Develop our current reporting mechanisms and relationship with the Community Planning Executive Group and the Integration Joint Board of the Health and Social Care Partnership.
  • Comply with the demands of the Scottish Drug Misuse Database (SDMD), the Drug and Alcohol Treatment Waiting Times Database (DATWTD) and the evolving DAISy data collection system.
  • Develop our systems to ensure that patients, service users, their families and carers are embedded within the commissioning, delivery and ongoing review of services.
  • Continue the development of our Recovery Orientated System of Care (ROSC) within the Dumfries and Galloway Recovery Plan.
  • Develop and implement a comprehensive Workforce Development Plan.
  • Further develop our Performance Management Framework.
  • Continue to comply with the Alcohol Brief Interventions (ABI) H4 HEAT Standard.
  • Continue to comply with the Drug and Alcohol Waiting Times A11 HEAT Standard.
  • Develop a local Drugs Death Prevention Strategy which will include a commitment to annual increases in the reach and coverage of the national Naloxone programme.
  • Development of our data collection systems in respect of the use of ORT in Dumfries and Galloway.
  • Ongoing review of our Shared Care for Drug Misusers Service.
  • Implementation in full of our local NPS Strategy and compliance with national initiatives concerning NPS.
  • Development of effective throughcare arrangements for prisoners affected by drug and alcohol use.
  • Compliance with the evolving GIRFEC and CAPSM agendas.

HOW WILL WE DO THIS?

The following section describes in detail the national (core) and local indicators that we will use to demonstrate how we are addressing the identified priorities. This section also describes the activities that are planned in pursuit of our priorities and the ways by which we are measuring our performance.

The ADP will receive a six monthly-performance update with highlighted exception reporting. This report will be available to the Community Safety Executive Group and the Integration Joint Board of our Health and Social Care Partnership.

An Annual Review of our Delivery Plan and progress being made towards the targets therein will be prepared for Scottish Government. This will include benchmarking comparisons with both Scotland as a whole and selected comparator ADP areas.

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Core and Local Indicators 2015-18

Blue – core indicator; Purple – Local indicator; Green- Ministerial priority

Core Outcome 1: Health: Peopleare healthier and experience fewer risks as a result of alcohol and drug use

National Health and Wellbeing Outcome 1: People are able to look after and improve their own health and wellbeing and live in good health for longer

Indicators / Baseline / Improvement Goal/Target
Rate of drug-related hospital staysEASR per 100,000 population / 2009 / 2010 / 2011 / 2012 / 2013 / Reduce drug-related hospital stays to 120 by April 2018
Dumfries and Galloway / 119.8 / 116.4 / 119.4 / 121.7 / 145.5
Scotland / 107.6 / 116.6 / 117.6 / 107.9 / 124.6
Rate of alcohol-related hospital stays EASR per 100,000 population / 2009 / 2010 / 2011 / 2012 / 2013 / Reduce alcohol related stays to 450 by April 2018
Dumfries and Galloway / 524.1 / 522.8 / 498.5 / 486.4 / 520.8
Scotland / 771.6 / 759.6 / 749.8 / 697.0 / 696.9
Drug- related mortality (EASR per 100,000) population) / 2009 / 2010 / 2011 / 2012 / 2013 / Reduce to 4.0 by 2018
Dumfries and Galloway / 6.5 / 4.1 / 9.6 / 4.7 / 7.1
Scotland
Alcohol–related mortality (EASR per 100,000 population) / 2009 / 2010 / 2011 / 2012 / 2013 / Reduce to 8.0 by 2018
Dumfries and Galloway / 22.2 / 20.6 / 11.8 / 8.9 / 13.7
Scotland / 25.7 / 26.1 / 24.6 / 21.2 / 21.4
Percentage of injecting drug users testing positive for HCV antibody (% is based on all IDUs tested) / 2008/09 / 2010 / 2011 / Reduce percentage of IDUs testing positive for HCV to 40% by 2018
Dumfries and Galloway / 65.2 / 54.5 / 66.0
Scotland / 54.6 / 56.4 / 53.0
Number of non fatal overdoses reported to Police Scotland (over past 5 years)– (Dumfries and Galloway Division) / 2009 / 2010 / 2011 / 2012 / 2013 / 2014 / Reduce the number of NFODs to 40 by 2018
Dumfries and Galloway / 75 / 64 / 65 / 50 / 58 / 42*
Planned Activities:
  • Continued delivery of ABIs in the key settings
  • A drug death prevention strategy and action plan will be produced by December 2015.
  • Link in with Public Health’s Health Protection Nurses to ensure regionwidedistribution of leaflets to IDUs around Better Hygiene; Sharing Water risks to reduce risk of bacterial infections and distribution of foil.
  • Development Peer Educators project during 2015 to include education on health issues, overdose awareness and Naloxone training
  • Non Fatal Overdoses has been devolved to The Naloxone Working Group which has developed an Information Sharing Protocol to allow the group to discuss persons who have repeated non fatal overdoses.
  • Work in partnership with NHS D&G Health and Wellbeing unit to establish a suicide review group and link processes/ data collection with the Drug Related deaths group.
  • Naloxone training for pharmacists and their staff.
How we are measuring performance:
  • The Drug Deaths Group reviews each death and actions established to address any issues
  • Quarterly monitoring of ABIs
  • NEO web based data collection system will provide IEP data regarding numbers of items including needles, syringes,water and foils supplied to IDUs
  • The Naloxone working group will continue to monitor the numbers of non fatal overdoses and will establish a baseline for numbers of repeated non fatal overdoses.
* The reporting of non fatal overdoses has been impacted on by the changes within Police Scotland and we are cautious that the numbers may actually have been higher than this. Indications for 2015 suggest that the reporting has improved again.

Core Outcome 2. Prevalence: fewer adults and children are drinking or using drugs at levels or patterns that are damaging to themselves or others

National Health and Wellbeing Outcome 1: People are able to look after and improve their own health and wellbeing and live in good health for longer

Indicators / Baseline / Improvement Goal/Target
Estimated prevalence of problem drug use amongst 15-64 year olds in Scotland, by age group / 2006 / 2009 / 2012 / Reduce the percentage rate to 1.0 by 2018
Dumfries and Galloway / 1.6 / 1.4 / 1.13
Scotland / 1.6 / 1.7 / 1.63
Estimated prevalence of problem drug use amongst 15-64 year olds in Scotland, (Males) / 2006 / 2009 / 2012 / Reduce to 1.5 by 2018
Dumfries and Galloway / 2.2 / 2.1 / 1.96
Scotand / 2.3 / 2.5 / 2.43
Estimated prevalence of problem drug use amongst 15-64 year olds in Scotland, (Females) / 2006 / 2009 / 2012 / Reduce to 0.5 by 2018
Dumfries and Galloway / 0.9 / 0.8 / 0.81
Scotland / 1.0 / 1.0 / 0.96
Percentage of 15 year old pupils who used illicit drugs in the last month / 2006 / 2010 / 2013 / Reduce to 5% by 2018
Dumfries and Galloway / 11.0 / 6.9 / 10
Scotland / 14.0 / 11.4 / 9
Percentage of 15 year old pupils who used illicit drugs in the last year / 2006 / 2010 / 2013 / Reduce to 10% by 2018
Dumfries and Galloway / 16.0 / 13.3 / 14
Scotland / 23.0 / 18.5 / 16
Indicators / Baseline / Improvement Goal/Target
Males exceeding daily/weekly drinking limits (SHS data) / 2008-11 / Reduce to 40% by 2018
Dumfries and Galloway / 45.8%
Scotland / 48.7%
Females exceeding daily/weekly drinking limits / 2008-11 / Reduce to 30% by 2018
Dumfries and Galloway / 35.5%
Scotland / 38.6%
Individuals exceeding daily/weekly drinking limits / 2008-11 / Reduce to 35% by 2018
Dumfries and Galloway / 40.5%
Scotland / 43.4%
Males binge drinking / 2008-11 / Reduce to 15% by 2018
Dumfries and Galloway / 19.8%
Scotland / 26.0%
Females binge drinking / 2008-11 / Reduce to 8% by 2018
Dumfries and Galloway / 11.2%
Scotland / 16.7%
Individuals binge drinking / 2008-11 / Reduce to 12% by 2018
Dumfries and Galloway / 15.3%
Scotland / 21.1%
Indicators / Baseline / Improvement Goal/Target
Males problem drinking / 2008-11 / Reduce to 8% by 2018
Dumfries and Galloway / 11.2%
Scotland / 13.9%
Females problem drinking / 2008-11 / Reduce to 4% by 2018
Dumfries and Galloway / 6.7%
Scotland / 9.5%
Individuals problem drinking / 2008-11 / Reduce to 6% by 2018
Dumfries and Galloway / 9.0%
Scotland / 11.7%
The proportion of 15 year olds drinking on a weekly basis (and their mean weekly consumption level) / 2006 / 2010 / 2013 / Reduce to 8.0 by 2018
Dumfries and Galloway / 31.0 / 21.7 / 11.6
Scotland / 30.0 / 20.4 / 11.6
Service users reduce drug use (Adults) / March 2012 / March 2013 / March 2014 / March 2015 / Increase the % of drug users in service who reduce their drug use to 50% by 2018
28% / 42% / 43% / 39%
Service users reduce the amount of alcohol drunk (Adults) / 49% / 39% / 46% / 47% / Increase the % of alcohol users in treatment service who reduce their alcohol use to 50% by 2018
Indicators / Baseline / Improvement Goal/Target
Local understanding of the prevalence and impact of new psychoactive substances / Percentage of 16 – 25 year olds* who reported using NPS
*85 questionnaires / April 14 / Reduce percentage to 20% by 2018
32%
Planned Activities:
  • Work with colleagues in Community Learning and Development with local campaigns delivering drug and alcohol education to Children and Young People
  • Work with partner agencies in the Health and Wellbeing forums to develop local alcohol campaigns
  • Development of Service User Groups in the East and West of the region will assist with local alcohol and drug initiatives
  • Develop links with A&E and psychiatric inpatient unit to collect NPS data
  • Develop an Information Sharing network to distribute health information and NPS alerts.
  • NPS conference for service staff to ensure information and advice is available
  • Working with Police Scotland and D&G council licensing boards to ensure licences for festivals are granted on condition that all festival traders are prohibited from selling NPS
How we are measuring performance.
  • SALSUS reports
  • Outcome Star Data analysed on a six monthly basis with reports provided to ADP and ADP Partners meetings.
  • Evaluation of campaigns

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Core Outcome 3.RECOVERY: Individuals are improving their health, well-being and life-chances by recovering from problematic drug and alcohol us

National Health and Wellbeing Outcome 5: Health and social care services contribute to reducing health inequalities

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Indicators / Baseline / Improvement Goal/Target
Number of individuals in receipt of ORT / At the end of Dec 2013 / NHS Specialist Drug and Alcohol Service / GP Shared Care / Increase the proportion of clients in Shared Care to 50% by 2018
Dumfries and Galloway / 377 (59%) / 260 (41%)
Service users have improved/nodeteriorationin physicalhealth(Adults) / March 2012 / March 2013 / March 2014 / March 2015 / Increase to90%andmaintainasaminimumstandardby 2016*
85% / 88% / 80% / 79%
Service users have improved/nodeteriorationinemotionalhealth(Adults) / March 2012 / March 2013 / March 2014 / March 2015 / Increase to90%andmaintainasaminimumstandardby 2016*
86% / 79% / 82% / 78%
Service users have improved/nodeteriorationin Wellbeing (Children and Young People) / March 2012 / March 2013 / March 2014 / March 2015 / Increase to90%andmaintainasaminimumstandardby 2016*
86% / 88% / 80% / 81%
Service users have improved/nodeteriorationin structure/education (Children and Young People) / March 2012 / March 2013 / March 2014 / March 2015 / Increase to90%andmaintainasaminimumstandardby 2016*
N/A / 79% / 81% / 81%
Indicators / Baseline / Improvement Goal/Target
Service Users improve their social skills for work (Adults – Work Star) / March 2012 / March 2013 / March 2014 / March 2015 / Increase to90%andmaintainasaminimumstandardby 2016
N/A / N/A / 80% / 87%
Service Users have improved aspiration and motivation(Adults – Work Star) / March 2012 / March 2013 / March 2014 / March 2015 / Increase to90%andmaintainasaminimumstandardby 2016
N/A / N/A / 80% / 82%
Planned Activities:
  • Establish systems to allow quarterly reporting of clients in receipt of ORT
  • Evaluation of Family Support Pilot
  • Evaluation of regionwide Third Sector service
  • Link drug and alcohol service providers with NHS/D&G Council’s Health and Wellbeing social prescribing initiative
  • Support D&G Recovery college to train peer mentors
How we are measuring performance
  • Pharmacy Information System will provide quarterly data to ADP
  • Waiting Times HEAT standard, SDMD compliance and data quality, relevant Outcomes Star compliance and quality
  • Number of trained peer mentors
*refer to annual reporting template 2013/14

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Core Outcome 4 CAPSM / FAMILIES: Children and family members of people misusing alcohol and drugs are safe, well-supported and have improved life-chances

National Health and Wellbeing Outcome 6: People who provide unpaid care are supported to look after their own health and wellbeing, including to reduce any negative impact of their caring role on their own health and wellbeing

Indicators / Baseline / Improvement Goal/Target
Maternities with drug use (3 year rolling average) / 2007/10 / 2008/11 / 2009/12 / 2010/2013 / Reduce 3 year rolling average to 8 (per 1000 maternities) by 2018
Dumfries and Galloway / 12.2 / 12.8 / 11.0 / 10.3
Scotland / 11.9 / 15.8 / 18.8 / 19.7
Maternities with alcohol use – rate per 1000 maternities / 2011/12 / 2012/13 / Reduce rate of maternities with alcohol use to 2 per 1000 maternities by 2018
Dumfries and Galloway / 2.9 / 2.5
Scotland / 30.2 / 33
Child protection with parental alcohol or drug use per 10,000 population <18yrs / 2012 / 2013 / 2014 / Reduce to 15 per 10,000 by 2018
Dumfries and Galloway / 18.8 / 11.2 / 17.9
Scotland / 8.8 / 9.6 / 10.9
Child protection with parental drug misuse per 10,000 population<18yrs / 2012 / 2013 / 2014 / Reduce to 10 per 10.000 by 2018
Dumfries and Galloway / 8.8 / 9.4 / 12.4
Scotland / 5.6 / 6.4 / 6.7
Child protection with parental alcohol misuse per 10,000 population <18yrs / 2012 / 2013 / 2014 / Reduce to 10 per 10,000 by 2018
Dumfries and Galloway / 14.2 / 5.0 / 11.0
Scotland / 5.0 / 5.1 / 6.2
Proportion of positive ABI screening in ante-natal settings / 2011 / 2012 / 2013 / 2014 / Reduce percentage to 15% by 2018
Dumfries and Galloway / 22.9% / 28% / 29% / 19%
Scotland / No data available / No data available / No data available / No data available
Indicators / Baseline / Improvement Goal/Target
Young Carers have improved education and learning / 2014 / 2015 / Increase to 50%by 2018
Dumfries and Galloway / 25% / 44%
Young Carers have improved confidence and selfesteem / 2014 / 2015 / Increase to 50% by 2018
Dumfries and Galloway / 25% / 44%
Young carers feel safe
(improved/no deterioration) / 2014 / 2015 / Increase to 90% by 2018
Dumfries and Galloway / 0%* / 83%
Planned Activities:
  • Continue to deliver ABIs to all pregnant women
  • Further GOPR training for drug and alcohol service providers in Autumn 2015
  • Continue to fund Dumfries Carers centre to work with Young Carers
How we are measuring performance
  • Quarterly ABI reports from ante-natal settings
  • My Star outcomes data for Young Carers
* Numbers werevery small.0% means there was no increase between initial and second review for all 4 clients

Core Outcome 5. COMMUNITY SAFETY: Communities and individuals live their lives safe from alcohol and drug related offending and anti-social behaviour

National Health and Wellbeing Outcome– no match available

Indicators / Baseline / Improvement Goal/Target
Percentage of new clients at specialist drug services who report funding their drug use through crime / 2009 / 2010 / 2011 / Reduce to 12% by 2018
Dumfries and Galloway / 15.6% / 23.4% / 17.5%
Scotland / 17.8 / 22.3 / 20.9
One year reconviction frequencies rate (per 100 offenders) given a DTTO / 2007/08 / 2008/09 / 2009/10 / Reduce to 80 by 2018
Dumfries and Galloway / 133.3 / 144.4 / 100.0
Scotland / 194.5 / 175.6 / 149.6
Alcohol related offences D&G per 1000 population
Serious Assault
Common assault
Vandalism
Breach of the Peace / 2009/10 / 2010/11 / 2011/12 / By 2018
Reduce to 0.3
Reduce to7.0
Reduce to8.0
Reduce to6.0
0.4 / 0.5 / 0.5
10 / 9.7 / 8.9
13.8 / 12.1 / 10.2
- / - / 7.1
CPOs with alcohol/drug treatment / 2011 / 3 year average decrease to 8 by 2018
Dumfries and Galloway / 11
Alcohol/drug influenced offences D&G
Alcohol
Drugs / 2009/10 / 2010/11 / Reduce 3 year average for alcohol influenced offences to 20% by 2018
Reduce3 years average for drug influenced offences to 20% by 2018
29% / 31%
13% / 26%
Indicators / Baseline / Improvement Goal/Target
Number of CPOs issued where alcohol and drug treatment is required and proportion that is successfully completed. / 2011/12 / 2012/13 / Reduce numbers issued to 10 by 2018
No data available for successful completed
Dumfries and Galloway
(Issued) / 11 / 15
Scotland / 772 / 575
Proportions of victims of a crime who reported that the offender was under the influence of alcohol/drugs / No data available
Number of discarded needles seized by community safety officers / Dumfries and Galloway / 2011 / 2012 / 2013 / 2014 / Reduce the number of discarded needles by 25% by 2018
301 / 276 / 427 / 514
Planned Activities:
  • Meetings with relevant partner agencies have been arranged to discuss further measures to reduce the numbers of discarded needles.
  • Peer Educators will be used within IEP services to encourage clients to return needles and provide health advice
How we are measuring performance:
  • Data collected by Community Safety Officers recorded on a monthly basis and shared with ADP
  • IEP needle returns monitored on a quarterly basis

Core Outcome 6. ENVIRONMENT: People live in positive, health-promoting local environments where alcohol and drugs are less readily available