Report to:

 

Lead Member for Adult Social Care and Health

Date of meeting:

21 January 2025

By:

Director of Adult Social Care and Health

Title:

Recommissioning Adult Drug and Alcohol Treatment Services in East Sussex.

 

Purpose:

To seek agreement to commence the recommissioning process for a new adult community drug and alcohol treatment service.

 

 

RECOMMENDATIONS

The Lead Member is recommended to: 

1)    Agree to commence the recommissioning of the adult community drug and alcohol treatment service in East Sussex; and

2)    Delegate authority to the Director of Adult Social Care and Health to agree the award of a contract to the successful bidder, to authorise the Council entering into the contract and to take any other actions necessary to ensure continuity of provision of the adult community drug and alcohol service.

 

1.         Background

1.1.        A key priority for East Sussex County Council is ‘keeping vulnerable people safe’.

1.2.        The County Council is also required to improve outcomes for those who use drugs and alcohol within the following frameworks:

·           The Public Health Outcomes Framework (PHOF);

·           The Government drug strategy ‘From Harm to Hope”’

·           The East Sussex Safer Communities Business Plan;

·           The local Harm to Hope Strategy.

1.3.     The current contract to deliver drug and alcohol treatment services expires in March 2026.

1.4.     A recommissioning process for a service of this size needs to be underway by February 2025.

 

2.            Supporting information

2.1.        The key aim for the service is to reduce drug and alcohol related deaths as well as meeting the requirements outlined in the frameworks listed in paragraph 1.2.

2.2.        In East Sussex, there were 77 drug and alcohol related deaths (DARDs) in 2022 where the inquest has concluded. This figure is made up of 55 deaths attributed to alcohol specific mortality and 22 deaths attributed to drug poisoning.

2.3.        There have been 67 concluded inquests for DARDs that occurred in 2023. A remaining 20 potential DARDs have inquests yet to conclude which could bring the total up to 87, depending on the outcome of the outstanding inquests.

2.4.        In both years, most of these deaths have multiple drugs and/or alcohol recorded in their toxicology reports. Of those who died, 29 or 42% were not active in structured treatment services.  The proportion of those who died, and were not in active treatment, is likely to rise once the outstanding inquests have concluded. This underlines the importance of continued investment into drug and alcohol treatment services.

2.5.        East Sussex faces significant challenges relating to drug and alcohol use, with alcohol related hospital admissions rising steadily since 2009/10. The highest rate of admissions is in Hastings, closely followed by Eastbourne.

2.6.        From 1 October 2023 until 30 September 2024, there were 2,684 individuals receiving structured drug and/or alcohol support in East Sussex. Figures from quarters 1 and 2 of 2024/25 suggest that:

·           26% of those who successfully completed treatment for opiates re-presented to the service within 6 months for further treatment.

·           1.8% of those who successfully completed treatment for non-opiates re-presented to the service within 6 months for further treatment.

·           8.6% of those who successfully completed treatment for alcohol-only re-presented to the service within 6 months for further treatment.

·           9.6% of those who successfully completed treatment for alcohol and non-opiates re-presented to the service within 6 months for further treatment.

2.7.        With the exception of the re-presentation of opiate users, East Sussex is either below or in line with the England average for re-presentations. The opiate figure demonstrates the importance of the service for those who do relapse into opiate use, as they are confident to return to seek further support at an early stage.

2.8.        A measure to illustrate “treatment progress” was introduced in 2023 as an alternative to the re-presentation indicator, as it recognises that completing treatment, especially for opiate users, is not a linear process. “Substantial progress” means those who:

·           have successfully completed treatment;

·           are still in treatment but are no longer using problem substances.

·           are still using but have substantially reduced their use of problem substances.

2.9.        Until the end of September 2024, 57% of those in treatment have shown substantial progress compared to the England figure of 47%.

 

Current Position

2.10.      The contractually allowed-for extension has already been invoked, meaning the contract must end in March 2026. Due to a significant decrease in available funding and emerging drug and alcohol use patterns in the county, it is anticipated there will be better outcomes for service users if the service is redesigned to incorporate all the outcome areas in paragraph 2.12.

2.11.      The proposed new contract value will be £4.8 million, which is lower than the current contract value of £5.1 million, with an initial contract length of 5 years.

2.12.      As well as reducing drug and alcohol related deaths, the new service will need to support the holistic needs of those who use drugs and alcohol. This would be demonstrated by improved outcomes in the following areas:

·           Reductions in drug and alcohol related harm;

·           Reductions in drug and alcohol related harm to children;

·           Improvements in mental and physical wellbeing;

·           Improvements in social, family and community outcomes;

·           Increase in access to and engagement with, education, training and employment;

·           Increase in access to, and retention of, suitable accommodation;

·           Reductions in offending and re-offending.

2.13.      It should also be noted that the stigma attached to problematic drug and alcohol use in East Sussex has reduced as evidenced by feedback received in a public consultation conducted in December 2023. The treatment service is a key part of supporting those who use drugs and alcohol to reintegrate with the wider community as well as addressing needs associated with their problematic drug and alcohol use.

 

3.         Conclusion and reasons for recommendations

3.1.        In order to ensure a service is designed, commissioned and implemented that meets the needs of East Sussex residents who use drugs and alcohol and gives best value for money, a recommissioning process needs to be undertaken.

3.2.        It is therefore recommended that approval is given to commence the recommissioning of the adult community drug and alcohol treatment service in East Sussex. It is also recommended that as part of the recommissioning process, authority be delegated to the Director of Adult Social Care and Health to approve the award of the contract to, and to authorise the Council entering into the contract with, the successful bidder. Finally, it is recommended that the Director of Adult Social Care and Health is delegated authority to take any other actions necessary to ensure continuity of provision of the adult community drug and alcohol service.

 

 

MARK STAINTON  

Director of Adult Social Care and Health  

 

Contact Officer: Caz Kearton-Evans

Email:  caz.kearton-evans@eastsussex.gov.uk

Telephone: 07879 117579

 

LOCAL MEMBERS:

All

 

BACKGROUND DOCUMENTS:

None