Casting light on a dark problem

By Ann McGauran | 25 November 2020

Blackpool has a long history of problems with drug use. The town has a higher rate of deaths related to drug misuse than any other local authority in England and Wales since 2009. There were 38 drug-related deaths in 2018 alone. Despite this, the drug misuse treatment budget for adults in Blackpool fell by 72% between 2015/16 and 2018/19 – double the average fall across England in that period.

It became obvious that a new integrated approach was needed. Spearheaded by the local public health team and the Lancashire Constabulary, a multi-service group was created.

The Drugs-Related Death and Non-Fatal Overdose (DRDNFO) Review Panel was set up using initial funding from the Home Office,and is chaired by the public health co-ordinator at Blackpool Council Emily Davis and detective chief inspector John Clegg at Lancashire Constabulary.

The panel’s core members include representatives from North West Ambulance Service, Horizon Treatment Service and its lead provider Delphi Medical, HM Coroner, Blackpool & Fylde CCG and Lancashire & South Cumbria NHS Foundation Trust.

The aim is to meet regularly to collaborate closely and pool knowledge as they review cases of drug-related deaths and non-fatal overdoses. The panel is also able to identify the ‘top 20’ most at-risk individuals as identified by key workers with ‘on the ground’ knowledge and set up a support plan, drawing on help from across the health and social care spectrum. The panel also ensures that information sharing on these individuals across all services is prioritised and that key workers are informed about the high risk nature of these particular clients.

The progress of the panel so far is summarised in a new report informed by detailed interviews with members of the DRDNFO review panel and its partners held between May and June this year.

This report focuses on three key areas of activity in Blackpool; the DRDNFO review panel, efforts to offer a full range of evidence-based treatments for drug dependence through Blackpool’s Horizon Drug and Alcohol Service, and the reconfiguration of drug treatment and related services during the COVID-19 pandemic. The report is funded by Camurus Ltd, with editorial control by Camurus and Delphi. Camurus is a biotechnology company committed to improving outcomes in opioid dependency, and Delphi are a lead provider of the Horizon support service.

The arrival of COVID-19 presented the further challenge of adapting services to ensure ongoing support for vulnerable people accessing drug treatment and support services, while minimising risks to support staff. They took an innovative approach to managing the crisis, using virtual support meetings and offering mobile phones to support telephone-based outreach.

In terms of outcomes, early results are promising, according to the panel, with the risk of drug-related deaths having been reduced for service users. Four individuals have been removed from the high risk category following a co-ordinated outreach effort. More broadly, the panel says it has ‘successfully transformed the previously siloed approach to combatting drug-related harm in Blackpool’.

According to the report, while the panel has made significant progress since it was set up, it is in the process of addressing some remaining challenges on funding, commissioning cycles and data and information sharing as priorities to improve its efficiency and the effectiveness of its work.

Although significant effort has been made to continue operating with limited resources, panel members ‘consistently cite budget cuts as having a directly negative impact on how services can operate both individually and collectively’.

The report says interviewees acknowledged that service users could be supported in a more consistent way if councils were able to award longer-term contracts.

The panel has been working towards enabling all data to be shared on a single database and has set up information-sharing agreements between all members. Despite this, technical barriers have meant ‘not all panel members are able to access the system to date’.

The ambition of the panel is to enable all the services to cross-check each other’s patient records in real-time, rather than needing to wait until each panel meeting, as this would ‘enable them to respond more quickly to high-risk individuals’. However, achieving the necessary system requires ‘both time and resource, at a time when there is considerable uncertainty over funding’.

Responding to the report, public health co-ordinator at Blackpool Council Emily Davis said: ‘With support from all members of the panel, we are collectively attempting to prevent untimely and unnecessary deaths of people living in Blackpool. We have good people working in this town and we need to continue this good partnership work for the benefit of those at risk.

‘We have started something really positive and I hope that we continue to make things better for those stuck in a cycle of addiction because there is a way out and I want us all to be ready for when that window of opportunity arises.’

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