Agenda item

The Director of Public Health submits a report to update the commission on Phase 3 of the Leicester City Drug and Alcohol Strategy for 2025-27.

The Director of Public Health submitted a report on Phase 3 of the Leicester City Drug and Alcohol Strategy 2025-2027. The following was noted:

·       The latest phase of the Leicester City Drug and Alcohol Strategy followed a national review of drugs and alcohol services in 2021 and the launch of the Government strategy “From Harm to Hope”. Local areas had been required to review their work and strategies, supported by a refreshed needs assessment which had highlighted the scale of need within the inner city.

·       A comprehensive drug strategy had been developed through the Combating Drugs Partnership. The strategy focused on four cross cutting themes and 32 actions were developed for implementation:

­   A significant increase in the number of adults accessing treatment.

­   A larger proportion of people leaving prison accessing ongoing treatment.

­   An enhancement of harm reduction programmes including carriage of naloxone across multiple organisations and stakeholders.

­   A significant expansion of outreach services across our communities.

• A 1 year progress summary was presented. The number of adults accessing treatment had increased by approximately 500, from around 2087 to 2500. The proportion of prison leavers leaving treatment successfully had increased from 21% to 55.2%.
• A wide range of harm reduction programmes had been expanded, supporting people to use drugs more safely and increasing engagement. The work had received an LGA award in the previous year.
• Police officers had received training to carry naloxone, and outreach services had been expanded with additional specialist staff and programmes.
• It was noted that the programme had started from a relatively low base but had made significant progress within a short period of time and was being recognised as good practice. Reducing inequalities remained central to the strategy.
• A stock take of the strategy had been undertaken during the previous year, leading to a refresh and the commencement of Phase 3. The original 3 year period had concluded and 6 working groups, involving a range of stakeholders and partners, had been established. Each group was developing detailed action plans through a series of workshops.
• Governance arrangements were outlined, including links to city and LLR partnership structures. It was noted that Phase 3 was at an early stage, with action plans now being implemented.

In response to Members comments, the following was noted:

·       Members welcomed the significant progress against key metrics and sought clarification on what constituted “treatment”. It was explained that treatment covered a wide range of interventions, including structured treatment through Turning Point, therapy, management of substance use, harm reduction measures and residential rehabilitation. The reported metrics related to structured treatment programmes.

·       Further clarification was sought regarding the 2500 individuals accessing treatment and how this compared to the wider population. It was acknowledged that this represented a relatively small proportion of the overall population and that there remained a significant level of unmet need. A breakdown of the data was to be shared with members.

·       Members highlighted the importance of evidence, oversight and harm prevention, particularly in relation to alcohol related harm. It was reported that the city had one of the highest rates in the country for alcohol related harm and deaths. The alcohol harm paradox was noted, whereby people living in more deprived areas experienced higher levels of harm despite not necessarily consuming more alcohol, often linked to wider deprivation and long term health inequalities.

·       Questions were raised regarding prison leavers and the support available on release, particularly for women returning from Peterborough prison. It was explained that additional recovery workers were working directly with prisons to build relationships prior to release and to support effective transition planning. It was recognised that women in particular faced challenges on return to the city, including environmental triggers. Work was ongoing through the criminal justice team and in partnership with colleagues focusing on prison health to strengthen pathways and post release support. It was noted that responsibility for some establishments such as Glen Parva and Fosse Way sat with the county, although partnership conversations were taking place.

·       Concerns were raised regarding drug related death rates, reported as 14.7 per 100000, and the availability of drugs, vapes and alcohol across the city, including 24 hour access through some premises. It was noted that public health colleagues were exploring how to provide a more robust input into licensing decisions, working with legal services and Trading Standards within the existing legislative framework. The misuse of substances such as synthetic cannabinoids and THC was also highlighted, and it was confirmed that these issues were considered within the Combating Drugs Partnership and relevant enforcement and partnership networks

·       In response to a question regarding how the strategy addressed health inequalities and access to rehabilitation, it was emphasised that drug and alcohol misuse was a significant driver of reduced life expectancy and ill health. The strategy targeted areas of highest need and sought to improve access to services such as Turning Point. Access to residential rehabilitation involved a structured process, often including detox and at least 3 months preparation, with improved outcomes where appropriate support structures were in place before and after treatment.

·       Members asked about current drug trends and emerging risks, including fentanyl use in the United States. It was reported that alcohol and opioids remained the most common substances locally, although trends were evolving. Nationally there had been an increase in ketamine use, a decline in treatment for some opioid users, and an increase in combined crack and opioid use. Services were described as responsive and data driven, regularly reviewing treatment data and national intelligence to raise awareness and adapt to emerging trends.

AGREED:

1.     The Commission note the report.

2.     A breakdown of the 2500 individuals accessing treatment, including further detail on cohort and demographic profile, to be circulated to members.