To review the quality and performance of the substance misuse service commissioned by Herefordshire Council and delivered by Addaction.

Alex Crawford, service manager for Addaction Herefordshire, gave a presentation on (appendix 1 to the report), the key points included:

a.       100% completion of treatment outcome profiles (TOPs), used to monitor substance misuse and overall progress of clients.

b.       100% completion of risk and recovery plans, used to assess risks that clients might present to themselves or others and to inform individual care plans.

c.       Re-presentation rates to treatment services following successful discharge remained low, demonstrating that treatment was effective and sustainable.

d.       The ‘maintaining change’ group provided support and skills development for clients for twelve weeks following successful completions.  Arising from this, two independent peer led groups had formed to continue the work of this initiative in the community.

e.       Addaction Herefordshire had been awarded an ‘overall good’ rating from the Care Quality Commission (CQC) and clients had spoken positively about the service.

f.       There had been a ‘slight dip’ in opiate and non-opiate successful completions.  This was due to tackling more complex service users who had been in treatment for an extended period of time; Herefordshire had a larger number of older opiate users in treatment for 6 years or more (43.2%) compared to the national average (32.4%).

g.       A recovery mentor, who had come through treatment, had been appointed recently and was helping to dispel myths and encourage people to engage with the service.

h.       Alcohol and non-opiate rates had improved, reflecting high levels of participation in the new group offering.

i.        To build upon the good rating and summary from the CQC, Addaction Herefordshire was working to streamline its assessment process and would run a pilot scheme to obtain feedback from clients.

j.        Attention was drawn to the CQC’s positive comments about staff and their approach, the recovery-oriented care plans, the active involvement of clients in care planning, and how records and procedures demonstrated good practice in a number of areas.

k.       An overview was provided of the group provision and wide range of activities in Leominster, Ross and Ledbury, and Hereford.

l.        Funding had been received for a new lead role to provide a specialist service for veterans.

m.     An overview was also provided of the young persons’ service which involved young people taking the lead and encouraging their peers to come forward and seek support.

The chairperson commented that Addaction Herefordshire had improved dramatically in three years.  Alex Crawford acknowledged the initial difficulties but, with significant progress already made, there was excellent potential for people to make successful recovery journeys in Herefordshire.

In response to a question about interactions with partner agencies, the committee was advised that Addaction Herefordshire and 2gether NHS Foundation Trust were working holistically in the interests of clients with substance misuse and mental health issues.  Professor Jane Melton added that colleagues in adults’ and children’s services had also commented on the positive working relationships.

The senior commissioning officer public health said that the aging population had to be taken into account, both nationally and locally, in terms of commissioning strategy going forward.

In response questions, Alex Crawford said that: Addaction Herefordshire did not have a dedicated outreach worker for rough sleepers currently but there had been contact with a support group and this could be explored further as part of future commissioning options; and the organisation had worked closely with street pastors in the past.

A committee member commended Addaction Herefordshire on the extent of the transformation that had been delivered and asked about the position in rural areas of the county.  The senior commissioning officer public health agreed that the turnaround of this service was to be commended and provision in rural areas would be revisited as part of the commissioning strategy.

The vice-chairperson said that the update was most encouraging and, noting that group activities included art therapy, suggested that the achievements of clients could be showcased in local exhibitions, such as h.Art.

On behalf of the committee, the chairperson congratulated everyone involved in the quality and performance improvements.  Committee members suggested that the communications team be invited to issue a press release about the service, including the positive outcomes of group provision and working with young people.

Resolved: That

a.       The performance update be noted; and

b.      The ambition of including rural outreach in future commissioning strategy be endorsed.