Agenda item

Prior to consideration of the report, the Chair of the Overview and Scrutiny Board sought Members’ approval in respect of some submitted amendments that had been circulated; this was agreed.

The Chair of the Health Scrutiny Panel presented the Panel’s Final Report in relation to Opioid Dependency: What Happens Next?

The recommendations to be submitted to the Executive were:

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 consumption 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 the local authority writes to the government to request that it reconsiders national policy in respect of Drug Consumption Rooms (DCRs).  Given that DCRs are a provable harm reduction tool that reduces the risk of overdose, improves people health and lessens the damage and costs to society.

c)     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.

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

e)     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.

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

g)     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.

h)     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:-

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

-        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.

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

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

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

-        That the role of peer support workers across all organisations be increased.

-        That prescribers in Substance Misuse services work with TEWV prescribers to ensure enhanced sharing of information.

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

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

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

k)     That the Personal, Social, Health and Economic (PSHE) education delivered in Middlesbrough schools in respect of drugs and alcohol be reviewed by public health professionals to ensure our teachers and school leaders are equipped with the local knowledge they need to deliver an enhanced educational offer to our children and young people.

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

m)   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.

n)     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 38 pharmacist led opioid and gabapentinoid reduction proposal early steps are taken to provide people with alternatives approaches to pain management.

o)     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.

A Member made reference to the recommendations and commented on the ground-breaking approach that would be undertaken to support those affected by opioid dependency within Middlesbrough.

AGREED that the findings and recommendations of the Health Scrutiny Panel be endorsed and referred to the Executive.