Agenda item

Presentation by Joe Benmore and Sarah Hart.

A presentation on this item was introduced by Will Maimaris, Director for Public Health, Joe Benmore, Lead on Community Safety & Offender Management and Sarah Hart, Senior Commissioner for Substance Misuse, Sexual Health & Health Improvement.

Will Maimaris explained that there had been a policy shift in this area with the introduction of a National Drugs Strategy and some additional investment had been received to support the implementation of this strategy, particularly around the treatment of people with substance misuse issues.

Joe Benmore, Sarah Hart and Will Maimaris highlighted some key points from the slides including:

• That there were clear benefits in combating illegal drug use. Parental drug use was a risk factor in 29% of all Serious Case Reviews, while heroin and crack cocaine addiction was a significant cause of crime and disrupted community safety. A typical heroin user spent around £1,400 per month on drugs.
• Statistics on the prevalence of drug and alcohol use from 2010 to 2017 demonstrated that Haringey had higher rates of opiate and crack cocaine users than both the London and national rates.
• Statistics on drug offences resulting from stop and search showed substantial reductions in almost all parts of the Borough from 2020 to 2021, but this was as a result of large reduction in the use of stop and search caused by the Covid-19 pandemic.
• The National Drugs Strategy had led from the Independent Review by Dame Carol Black and covered a number of issues that she wanted to address including the previous disinvestment in substance misuse treatment (particularly for young people), the shortage of the workforce and high caseloads. She had also highlighted a breakdown in joined-up systems and the gaps in health, mental health, housing and employment support for those in recovery from substance misuse issues.
• The Government’s 10-year National Drugs Strategy had three main elements:

o   Breaking drug supply chains;

o   Delivering a world-class treatment and recovery system;

o   Reducing the demand for recreational drugs.

• On breaking drug supply chains, it was noted that the UK was Europe’s largest heroin market, worth around £6billion per year. The Ministry of Justice plans included targeting the middle market, breaking the ability of gangs to supply wholesale to neighbourhood dealers and dealing with county lines distribution chains and local retail markets. It also included the recruitment of more police officers and increased use of technology.
• On the delivery of a treatment and recovery system, the plans included more treatment for young people, better integration of mental health, employment and housing providers and better continuity of care for people in treatment when they leave prison.
• On reducing the demand for recreational drugs, the plans included prevention programmes in schools and for young people and families most at risk of substance misuse.
• With regards to the funding, the new supplementary grant amounted to approximately:

o   £795k in 2022/23

o   £1.3m in 2023/24

o   £2.5m in 2024/25

There was also separate money for inpatient detox but there was an issue about capacity and rebuilding the sector so it may be necessary to work London-wide with that pool of funding.

• The new funding came with an expectation to increase the number of adults in treatment in Haringey by 23%. Another locally-set target was to increase the amount of treatment places for young people by 43%.
• The local implementation plan for the first year had been developed with co-producers as part of some events held in May. The first year was about building back stronger and fairer. There were peer-led projects including night outreach and a new recovery project, there had been investment in a Haringey Works employment worker and there were links with primary care, Connected Communities and HfH. The second year would have more of a focus on workforce development.
• Commitment was being sought from partners such as Probation, to screen and refer into treatment, and Housing, to identify housing options for those in recovery, in order to develop a whole system public health approach.
• In terms of governance, there was a requirement for local areas to set up a new Combating Drugs Partnership locally to implement the asks of the national strategy and to nominate a senior responsible officer for local delivery. The initial recommendation was that the senior responsible officer would be Will Maimaris as Director for Public Health but there would also need to be strong leadership from all partners. The Partnership would feed into the Community Safety Partnership and Health & Wellbeing Board and there would also be opportunities for cross-Borough partnership working.
• Work had already started on the treatment aspects of the program and this would be supported by a needs assessment, a delivery plan and a reporting infrastructure on the key indicators.

Joe Benmore, Sarah Hart and Will Maimaris then responded to questions:

• Cllr das Neves asked how the local work would link in at a London-wide level. Sarah Hart said that the Office for Health Improvement and Disparities had been looking at a workforce strategy at both national and London levels which would be needed as broadening the workforce in Haringey was so important, including by attracting social workers.
• Asked by Beverley Tarka about the transitional safeguarding approach to support vulnerable young people, Sarah Hart agreed that this was an important consideration and that the young adults service went up to 23 years of age and that a new vulnerable young adults post being created would work with people up to the age of 25.
• Beverley Tarka commented that supporting people with lived experience through skills development and gaining qualifications needed to be a central focus of the workforce strategy and added that equalities would be an important consideration given the links between drug use and other factors, such as mental health and social deprivation. Sarah Hart agreed with this and noted that protected characteristics were part of the data sharing set that was looked at in every monitoring meeting and that specialist services were developed where required.
• Cassie Williams from the NCL ICB commented on the partnership approach and suggested that it would be critical to find a way of ensuring that there was buy in from the full range of NHS organisations and not just the ICB. She added that there could be further opportunities to strengthen these links via the Borough Partnership and the Live Well Board. Cllr das Neves agreed that the ICB was quite broad and that it was important to make sure that there was understanding at ICB level about the local activity and priorities. Beverley Tarka agreed with the role of the Live Well Board and said that there was a question about how to develop the flow of partnership working upwards as well as across the system so that they could have influence on what happened at ICB level as well as at place level.
• Cllr Hakata commented that he was in favour of decriminalisation as the threat of punishment could deter people from seeking treatment and asked what communications existed between the Police and treatment services to ensure that people were not diverted away from treatment in this way. Sarah Hart said that her team was passionate about diverting people into treatment as this was the opportunity for harm reduction and that local police had been doing ‘test on arrest’ even when not mandated to do so. She felt that there was an intention both locally and London-wide to provide alternatives to custody, particularly because short custodial sentences were often ineffective. Shirley Kennerson from Enfield & Haringey Probation Service commented that the enforcement side of criminal justice could sometimes be what makes drug treatment a success because it could motivate people to remain engaged with treatment services. Seb Adjei-Addoh from the Metropolitan Police said that he couldn’t comment directly on police intervention and that Detective Superintendent Marco Bardetti would be the person to speak to on this. However, he noted that the Police also had a violence reduction plan and so it would be necessary to ensure that the two plans complemented one another as drugs were known to be a driver for violence.
• Shirley Kennerson suggested considering Integrated Offender Management which relating to offenders who often caused the most nuisance and disturbance locally and that investing in this approach could prevent them coming back to services again and again, as with the ‘revolving door’ issue around drug use. Joe Benmore added that these interventions would also include offenders who had been convicted on violent offences as well as domestic violence offences.
• Asked by Cllr Hakata whether the additional funding would be sufficient to establish a sustainable programme, Sarah Hart said that there had been less and less money available over the past 15 years and so the new funding was very welcome.
• Susan Otiti, Assistant Director for Public Health, commented that there was less than £60k available each year through the inpatient detox grant and said that the Council would be better to have a collective London-wide approach as this would lead to better access to services.
• Beverley Hendricks, Assistant Director for Safeguarding & Social Care, welcomed the support for young people going up to the age of 25 but suggested that this was still a cliff edge for care leavers where vulnerability could be most acute between the ages of 26 and 28 so a further extension could be beneficial.

·         Beverley Hendricks commented that the earlier work started with parents around substance misuse the better and suggested a conversation around early year children’s centres and helping parents to be confident about having those conversations with children. Sarah Hart said that secondary schools in Haringey were now talking more about substance misuse with their pupils but that very little was coming through the parents so this was a valid point. Cllr das Neves said that adding primary schools to this was something that could be considered. Susan Otiti commented that this could be incorporated into the healthy schools programme along with PSHE coordinators but agreed that more could be done to reach out to parents. Joe Benmore added that there were new designer drugs coming onto the market that were attractive to young people which would make this work particularly relevant. Sarah Hart said that a survey had been put out to all social workers asking about their conversations with young people about drugs. Beverley Hendricks added that there was a role for primary care as part of the multi-disciplinary approach.

·         Geoffrey Ocen from the Bridge Renewal Trust asked how the plans would be developed in the longer-term. Sarah Hart said that the world class treatment strand of the strategy would continue to be co-produced beyond the first year but that there was only three years of funding in place for this so far. A criminal justice treatment steering group was also in place where partners discuss the pathways and continuity of care between criminal justice and treatment.

·         In response to a suggestion from Eubert Malcolm, Director of Environment & Neighbourhoods, to consider the links between the local approach on drugs and the Young People at Risk Strategy, Sarah Hart said that the approach on drugs was largely about adults and that there needed to be a plan to link to the Young People at Risk Strategy and Children’s Services though this still needed to be explored further.

·         Cllr Brabazon expressed the view that it was important to consider the housing allocations provided to drug users, such as when leaving prison for example, as she was concerned that congregating large number of people together who have serious problems as this could exacerbate social problems in the community. Sarah Hart said that the investment in BUBIC (Bringing Unity Back Into the Community) was making a real impact in hotspot areas by talking to people, seeing if support could be provided and feeding back to enforcement where necessary. She also agreed that Housing needed to be part of the partnership working. Beverley Tarka added that she shared the concerns about placing people with significant issues together and had already had conversations with Denise Gandy about allocations policy so this was being considered.

Cllr das Neves thanked everyone for their contributions and for the efforts of the team leading on this important piece of work.