Agenda item

The ongoing need for substance misuse treatment services was addressed, as estimates from the Office of Health Improvement and Disparities (OHID) for 2019/20 indicated 3,869 residents used opiates and/or crack cocaine, and 3,147 had dependent alcohol consumption. The Public Health directorate within the Council remained responsible for commissioning effective services to meet these needs, which included:

-          Lot 1: Grove drug service (run by BEH)

-          Lot 2: HAGA alcohol service (run by Humankind charity)

-          Lot 3: Haringey Recovery Service (HRS, run by Humankind charity)

These core services were supported by the peer-led Bringing Unity Back into the Community (BUBIC) program and funded through the Council’s Public Health Grant. The Council set annual performance targets for these services in agreement with OHID. By the end of Quarter 2 in 2024/25, Haringey had surpassed its target of 1,803 residents in treatment, with 1,811 residents participating, reflecting a 17% increase from the 2023 baseline.

The Grove drug service reported higher numbers of opiate users accessing treatment, partly due to its co-location with Mulberry Junction and collaboration with criminal justice services. This increase was particularly critical amid the UK’s synthetic opioid crisis, which posed significant overdose risks. Additionally, the Grove’s non-opiate service achieved a 30% growth, with 333 residents receiving support for substances such as cannabis, cocaine, ketamine, and prescription drugs through partnerships with GPs, mental health services, hospitals, and a new digital platform.

HAGA, Haringey’s standalone alcohol service, was rated “GOOD” by the Care Quality Commission in 2023, with “OUTSTANDING” ratings in responsiveness and leadership. HAGA met its target of treating 475 primary alcohol users.

HRS played a significant role in relapse prevention and social reintegration, serving 1,500 residents in 2023/24 through self-help groups, social activities, counseling, welfare rights, and employment support. Notably, 160 residents attended the Recovery Pride event celebrating addiction recovery.

Recognizing that 72% of those in treatment were men, services ensured women had access to female-only sessions, reflecting their preference. Trauma-informed care and collaborations with domestic violence and sexual health services were also prioritized. Women contributed to co-producing services, which enhanced empowerment and recovery. In 2023, women in the program organized the first International Women’s Day event to address and celebrate issues affecting women in Haringey.

The Cabinet Member stated that all the good work that had been produced by the team should be echoed to residents. It was queried whether lot 3 was humankind charity, in response to query the officer confirmed lot 3 was humankind charity.

RESOLVED:

Recommendations

3.1. For the Cabinet Member for Health, Social Care and Well-being to approve extension of the contracts for the provision of integrated adult substance misuse treatment and recovery services across all 3 service lots, as listed below, for a period of two years commencing on 1st February 2025:

-          The Lot 1 Specialist Drug Treatment Service is provided by Barnet Enfield and Haringey Mental Health Trust and the estimated cost of the service for duration of extension period will be £4,592,898.00. The aggregated value of the contract will be £19,662,024 including proposed extension

-          The Lot 2 Specialist Alcohol Treatment Service and Lot 3 Drug and Alcohol Recovery Service are both delivered by Humankind Charity. The estimated costs for the extension period will be £1,799,814.56 for Lot 2 and £1,025,582.78 for Lot 3, respectively. Aggregated value of the contract for Lot 2 will be £8,146,631 and Lot 3 will be £4,064,933 including proposed extension

The above extension is in accordance with the terms outlined in the existing contracts and is permitted under Contract Standing Orders (CSO) 16.02 and 10.02.1(b).

Reasons for decision

4.1. In October 2018, following an open tender process, Cabinet awarded contracts for Integrated Adult Substance Misuse treatment and recovery in three lots. The contracts were awarded for four years, with an option to extend for two further periods of 2 years (total 8 years). These contracts have reached year 6, they can therefore within the terms of the original contract be extended for a further period of 2 years. The grant funding for these contracts is available, local need remains high, and the contracts are performing well for our residents. By extending the contracts the Council will continue to receive good value for money, as the service providers offered competitive prices when they tendered, and the price of the contract remains at 2018 prices. It is therefore not in our residents or the Council’s interest to go out to the market for a new provider at this stage.

Alternative options considered

5.1. Do nothing – the Council could decide not to extend the current service contracts. There are good reasons as to why this is not advisable. Haringey council is responsible for commissioning drug and alcohol services for its residents. Funding for these services is ring fenced within the public health grant and a condition of receiving the grant. Drug and alcohol treatment needs are high in Haringey. It is not only those with an addiction problem that benefit from access to effective treatment, illegal drug use fuels crime and both drug and alcohol use can create antisocial behaviour and disturbance to residents, making the borough feel unsafe. Families’ wellbeing and especially children’s, can be damaged by other members problematic use of substances.

5.2. Tendering process – The Council could decide that the contracts should go to market. However, this was rejected for the following reasons. The existing service providers deliver well against key performance indicators and have exceeded Government targets. They have a stable workforce and work effectively with residents to shape the service to meet immerging need, evidenced through CQC reviews. There is a possibility that if the council went to market currently, there could be significant inflationary costs related to staffing. This is due to the Government substantially increasing grant funding for substance misuse services to all local authorities, without warning for the market to develop an appropriate workforce. Extending the contracts will synchronise retendering with the Government’s Comprehensive Spending Review, meaning any ongoing additional grant funding to Haringey council, can be consolidated into a service redesign to maximise delivery value to residents.