Agenda item

The Chair invited the Democratic Services Officer to highlight the salient points contained in the Draft Final Report prior a discussion on the proposed recommendations. The Democratic Service Officer made reference to a number of key points and following discussion Members concluded that based on the evidence presented the Health Scrutiny Panel wished to put forward the following recommendations:-

a) That the public health approach to drug dependence be continued and the benefits of introducing safe spaces in Middlesbrough for people to consume substances (drug consumption rooms) be further explored. Drug consumptions rooms have been successfully used elsewhere in the world (including in Europe and in Canada) for approximately 16 years and no one has ever died of a drug overdose in any of these facilities. Middlesbrough could in the future be a pilot for the adoption of such an approach in the UK.

b) That a new capital funding bid for a 16-18 bedded detox and drug rehabilitation facility at Letitia House be submitted. Public health benefits and financial savings could be achieved when compared to the current costs of funding individual 7-10 day detox programmes out of area.

c) That funding for the Heroin Assisted Treatment (HAT) programme be priortised by partners in South Tees and the current level of investment continued for the foreseeable future. 

d) That the local authority write to the relevant Minister highlighting the success of the Heroin Assisted Treatment Programme (HAT) in Middlesbrough and how it is a demonstrably effective way of treating drug addiction.  

e) That the high quality drug treatment facilities available in Middlesbrough are recognised and that the town further develops as a Recovery Orientated System of Care (ROSC).

f) That in an effort to reduce the stigma associated with drug dependency a proactive approach is undertaken to promote the town’s vibrant recovery community. Middlesbrough is a town where recovery from drug dependency is possible, recognised and celebrated. The town has outstanding substance misuse treatment services and innovative harm reduction initiatives in place. Work needs to be undertaken to ensure Middlesbrough is recognised locally and nationally as a Recovery Town/City.  

g) That in respect of the areas for improvement put forward by Tees, Esk and Wear Valley NHS Foundation Trust it is ensured that a number of measures are implemented including:-

i) That quick and reliable access to specialist Substance Misuse support is made available to the Community Crisis Team, Crisis Assessment Suite and Inpatient wards

ii) That Substance Misuse workers, Social Workers and other colleagues are included in the single point of access in Mental Health for joint triage/joint initial assessment

iii) That Substance Misuse workers attend joint meetings, as arranged by TEWV, including formulation and pre-discharge

iv) That Substance Misuse Services contribute to TEWV’s co-produced Crisis management plans / Wellness Recovery Action Plans (WRAP)

v) That a programme of joint clinics (Mental Health/Substance Misuse) to meet the needs of dual diagnosis patients be established

vi) That the role of peer support workers across all organisations be increased

vii) That prescribers in Substance Misuse services work with TEWV prescribers to ensure enhanced sharing of information

viii) That cross fertilisation in terms of training for Substance Misuse and Mental Health workers be established

h) That pathways for young people at risk of drug dependency be developed and a way for those already dependent to access timely treatment provided.

i) That prescribing substitute treatment for those under 18 years be further explored and the preferred option piloted. 

j) That support for children experiencing parental opiate dependence be commissioned and the, number of children being reached and supported reported.

k) That the best practice approaches adopted elsewhere in the UK in respect of opioid deprescribing for persistent non-cancer pain (for example, those put forward by Nottinghamshire Area Prescribing Committee) be taken up by Tees Valley CCG and promoted amongst Primary Care Networks (PCNs) in Middlesbrough.  

l) That in 2021/22 GP lists in Middlesbrough be screened using the I-WOTCH inclusion and exclusion criteria to establish the number of patients who could benefit from education on opioids and managing chronic pain. Following identification an appropriate initiative be developed to target those patients. In order to ensure that prior to the outcome of the pharmacist led opioid and gabapentinoid reduction proposal early steps are taken to provide people with alternatives approaches to pain management. 

m) That if the opioid and gabapentinoid reduction programme currently being piloted proves successful TVCCG invests sufficient resources to ensure the programme is scaled-up and the number of patients prescribed strong opiates for chronic non-malignant (non-cancer) pain in Middlesbrough is reduced.

AGREED that the Panel’s Final Report on the topic of Opioid Dependency: What happens next? be approved and the recommendations incorporated prior to the report being submitted to the Overview & Scrutiny Board for approval.