West Berkshire Council

Start date: 2018-11-12
End date: 2018-12-23
Results: 2019-03-05

Budget Proposal 2019/20: Adult Substance Misuse Service (Swanswell)

Background

This is one of 14 budget proposals for 2019/20. You can view the full list online.

You can also view budget consultations from previous years


Alcohol consumption is a contributing factor to hospital admissions and deaths from a diverse range of conditions, including liver failure, liver cirrhosis, many cancers, cardiovascular disease, high blood pressure, falls and accidents. Alcohol misuse is estimated to cost the NHS about £3.5 billion per year and society as a whole £21 billion annually.

Our overall budget for Substance Misuse Services provided to adults and young people is currently £1,059,000. The services provided are:

  • Needle exchange through pharmacies
  • Alcohol Users Disorder Identification Test - Consumption (AUDIT-C) carried out by GPs
  • Shared care in GP surgeries (where the GP's and the specialist service (Swanswell) work together to plan and meet the health needs of the individual)
  • Prescribing and supervised consumption of opiate substitute medications
  • Raising awareness through giving advice and information about the risks to health around alcohol and drugs

The specialist services for adults with drug and alcohol problems are delivered by a voluntary and charitable organisation called Swanswell. They support those who use drugs; helping them through treatment to become drug free. They also support those who are dependent upon alcohol to stop drinking, and those whose drinking is damaging their health to cut down.

Swanswell supports approximately 400 residents who are in treatment for drug and alcohol use each year. Individuals who stop using opiates have improved health and well-being. They live longer with improved physical and mental health, and are less likely to have family problems. Additional support services, including supervised consumption of methadone for those who use heroin and provision of a needle exchange service, are also available through GPs and community pharmacists. 

Swanswell employ twelve members of staff including a manager, team leader, two administration workers, an apprentice recovery worker, a part time nurse and six recovery workers. The six recovery workers employed have average caseloads of 65 service users each. This number varies depending on the complexity of cases and the numbers of service users in treatment.

Between April 2017 and June 2018, there were 389 service users accessing substance misuse treatment, of whom 50 were new to the service. In 2017 9.3% of opiate clients, 44% non-opiate clients, and 39.9% alcohol clients in treatment, completed their treatment successfully and did not return to the service within 6 months. West Berkshire ranks better, for two out of three of these outcomes, than the national average (7%, 39% and 40% respectively).

We currently provide Swanswell with annual funding of £585,940. There have been no cost reductions to the service since it was commissioned in 2015.


Legislation requirements

Under the Health and Social Care Act 2012, local authorities have the duty to reduce health inequalities and improve the health of their local population by ensuring that there are public health services aimed at reducing drug and alcohol misuse.


What are we proposing?

To reduce the annual funding to Swanswell from £585,940 to £540,940 (a proposed saving of £45,000 or 8%) from 1 April 2019.


What do we think the impact will be?

The proposal may impact on the numbers of service users who can be supported in treatment, and the level of support that each individual receives as part of their treatment package. However, it is likely we could achieve greater value for money by offering group interventions and less individual support sessions.

Group interventions and peer support can be effective in supporting people to change, as it provides an opportunity to share experiences (Tracy, 2016). However, group interventions are not always favoured or suitable for individuals seeking support for substance misuse issues, and can sometimes lead to individuals refusing treatment. If this is the case then, users will continue to be provided with one to one support.

It is likely that the number of staff employed by the service will be reduced. This could increase workers caseloads or extend waiting lists for individuals wishing to access the service.

Please refer to the pdf icon Equality Impact Assessment (EqIA) Stage One [334kb] for more details.


What else have we considered in arriving at our proposal?

As part of the 2019/20 Budget Proposals we're also proposing to cease funding the Alcohol Screening and Brief Advice Service.

We've considered re-tendering the Adult Substance Misuse Service jointly with other local authorities, which could potentially produce a financial saving. However, this can disrupt the services provided, leading to a loss of qualified and experienced staff and causing uncertainty to service users.

Re-commissioning is also a process which takes up a lot of resources and time for the staff involved, with no guarantee that the required savings will be achieved.


Why we want your views

We would like to know how this proposal might impact you and the wider community, and any views you have on how we can minimise the impact of this proposed change.

All feedback will be considered at the Executive Committee on 14 February 2019. Following this, a final decision will be made at the Full Council meeting on 5 March 2019. The recommendations and your anonymised response will be posted on this page.

Please note: Social media discussions will not be monitored/considered as a valid response. Please use the link below to take part in the consultation.

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