Public Consultation

1. Public Consultation Reshaping Drug and Alcohol Treatment in Westminster We want to hear your views Please respond by March 31st 2009

2. Introduction • Westminster Drug and Alcohol Action Team (DAAT)is jointly funded by the City Council and NHS Westminster • The Key Objectives are: • 1. Reducing the supply of illegal drugs • 2. Preventing young people from becoming drug misusers • 3. Reducing drug-related crime • 4. Reducing the use of drugs through increased participation in treatment programmes • Westminster DAAT are one of the top performing DAATs in the Country. It successfully manages to retain 85% of individuals in treatment for twelve weeks or more. This measure is regarded as an indicator of effective treatment. • The DAAT is responsible for the commissioning of all treatment services, including those that sit within the Drugs Intervention Programmed (DIP), and actively monitors and reports on performance and communicates with stakeholders Why Provide Substance Misuse Treatment? • Drug and Alcohol misuse wastes Lives, destroys families and damages communities • It is estimated that £1 spent on treatment saves £9.50 on cost associated with drugs such health and crime 1 • Substance Misuse is an issue which has an impact on society as a whole but disproportionately affects the most deprived communities, disadvantaged families and vulnerable individuals • Recent Home Office Study shows providing treatment to drug users has resulted in a 60% decrease in criminal behaviour 2 • Evidence shows that providing individuals with a counsellor and access to groups help them to stabilise and reduce their substance use • Treatment can often be the service that links chaotic individuals to wider support services such as Debt and Housing Advice, Health Services, Education and Training 1) Godfrey C, Stewart D, and Gossop M (2004) Economic analysis of costs and consequences of the treatment of drug misuse: 2-year outcome data from National Drug Treatment Outcome Research Study (NTORS). Addiction, 99(6) pp. 697-707 2) Research Briefing RB35 Nov 08 see linkhttp://www.nta.nhs.uk/publications/documents/nta_changes_in_offending_rb35.pdf

3. The Westminster Picture • Westminster has approx 3500 Crack and/or Heroin User 3 • Currently 35% of those (1200) attend structured treatment • The target is to get all into effective treatment • It is estimated that over 46’000 of Westminster’s population are drinking to hazardous levels • It is estimated 6% that (6156) of men in Westminster and 2% (2054) of women are dependent on Alcohol 4 • Currently there are approximately 400 Alcohol users attending structured treatment • Our challenge is to attract more dependent drug and alcohol users into treatment Current Treatment Model • Currently Westminster Commission drug and alcohol services separately. With 5 main providers offering services out of 9 sites across the North and Centre of the City. • Services offer Westminster residents treatment such as counselling and group work as well as substitute prescribing for heroin users. A number of treatment agencies provide harm reduction services such as needle exchange and health checks. • Drug and Alcohol services are located separately from one another, with direct access Alcohol support being provided from a service located in Kensington and Chelsea called the Alcohol Resource Centre. • A vast majority of service users accessing treatment are poly users, using a number of different substances, including mixing alcohol with illicit drugs such as crack and heroin. 3) Estimates of the prevalence of opiate use and/or crack cocaine use (2006/07) London Region Dr Hay etal 4) Alcohol Needs Assessment Research Project The prevalence of alcohol dependence in England is estimated by the ANARP as 3.6%; 6% of men and 2% women. Applying this to Westminster would suggest that there are 8,210 dependent drinkers;

4. 1. Substance Misuse Team - 1 Frith Street 2. Soho Alcohol Team – 1 Frith Street 3. Soho Rapid Access Clinic – 1 Frith Street 4. Hungerford Drug Project - Wardour Street 5. Alcohol Resource Centre- Ladbroke Grove 6. Caravan Project- South Wharf Road 7. WDP – 470 Harrow Road 8. WTC – Hanson Street 9. Family Therapy Centre- Elksotne Road Map of Current Service Provision 4

5. The Proposal • Westminster DAAT are committed to identifying problem substance misusers, get them into treatment, drive down drug use and the associated costs • We are proposing to retender existing services and commission new treatment provision • The DAAT have developed this proposal in collaboration with Council Members and our partners in the Police, Community Protection and Probation • There will be a move from 9 treatment centres across the Centre and North of the City to 5 with a focus on offering services that are accessible to all • The Centres will be split into North and South contracts, with Oxford Street/ Bayswater Road being the line that separates the 2 halves • Drug and Alcohol Treatment will be integrated, offering free expert treatment regardless of the substance • Services will be available 7 days a week, with rapid access to the right support • All Structured Services will be delivered solely to Westminster residents and verified Westminster rough sleepers • The Treatment System will be designed with robust enforcement measures in place for those engaging as part of a community order • It will offer prompt and direct access to support for individuals to work towards a substance free life including individual counselling, group work, substitute prescribing, referral into detox and residential treatment • There will be a focus on supporting substance misusing parents – breaking the cycle of problems being transferred between the generations, working alongside the Family Recovery Project • With an emphasis on working with Employment and Training Organisations and Job Centre Plus to get Users off benefits

6. There are currently no Drug or Alcohol Treatment facilities In the South of the City • More Drug treatment than Alcohol – The proposal will provide an opportunity to Integrate the two • Equal Access to treatment across the City • There is currently no Open Access Service for Alcohol Users in Westminster- Service Users have to go to Kensington And Chelsea • Changing Trends in Drug Use with Increased Crack and Alcohol prevalence • There has been a change in National focus toward getting people through treatment and into work- Need for clearer pathways through the system • There a re currently 35% of Westminster’s Problem Drug Users (heroin and/or crack cocaine) in treatment. New and improved services are needed to attract more • The current system is too complicated; Service Users Drop Out Before Completion • A 3 year needs analysis has been carried out, outlining where needs are not being met Why Propose a Change? The New Model – Location Westminster Drug and Alcohol Action Team (WDAAT) are proposing to redesign treatment services with 2 centres in the North, 2 in the South and a small referral service based in Soho. The 2 centres are: “Neighbourhood Centres”, providing the first port of call for all dependent drug and alcohol users wanting treatment “Structured Intervention Centres” where those stable and ready to move into education and/or employment will access support to do this. “West End Referral Centre” will be a signposting service offering brief advice and information of where to get help The sites are not yet known. Organisations bidding for the contracts will be putting forward properties that fit the design specification developed by the Council. All properties will be subject to Planning consent and consultation with the relevant neighbourhoods.

7. Visual Outline of New Model Structured Intervention Centre Neighbourhood Centre West End Referral Centre Structured Intervention Centre Neighbourhood Centre

8. The Commissioning Process • Following consultation we plan to go to open tender for new services during 2009 • Detailed service Specifications are being developed and will be available to anyone who wishes to view them • Expert providers to bid for new service and they will be required to propose location • Invite representatives from key partners and service users to be part of interview process • DAAT Partners including Community Protection and Met Police to consult residents and work in partnership to address the concerns raised throughout the process • Service Specifications request centres offer space to accommodate Local Community Groups • Bidding Providers will need to demonstrate how they will communicate with the community, offering regular liaison meetings • New service due to open 1st Sept 2010

9. Reshaping The Westminster Drug and Alcohol Treatment System • Westminster Council is committed to consulting it’s residents on all changes, particularly those that will affect their healthcare. Westminster Drug and Alcohol Action Team are proposing this change on the basis that it will improve the quality and accessibility of treatment to those who need it most. • By enhancing the treatment on offer more substance misusers will access and benefit from the support available, making positive changes in their lives that will impact not only on themselves but on the community as a whole. • Whilst consultation with current service users’ is taking place around how they would improve current service provision, we would like to ask residents of Westminster for their input on this proposal, taking on board any concerns and addressing them throughout the development of the model and tender process How we can learn from you?

10. Question 1 We feel that Westminster requires a Treatment System where Substance Misusers can get the help they need easily and without delay. To achieve this we propose that drug and alcohol services be moved to the neighbourhoods that need it most? Do you support the rationale behind this proposal? (Please tick one box)  Yes  No  Don't know Question 2 In your opinion what would constitute good management of the treatment service and its surrounding areas for local people? Please give your opinion on a scale of 1-10, 10 being to strongly agree (please circle as appropriate) Regular City Guardian Patrols in locality of Service 1 2 3 4 5 6 7 8 9 10 Premises to be designed with community safety in mind (appropriate lighting etc) 1 2 3 4 5 6 7 8 9 10 Develop a Street Management policy in partnership with local residents 1 2 3 4 5 6 7 8 9 10 No external advertising on the building itself 1 2 3 4 5 6 7 8 9 10 Open Days for residents to visit the services 1 2 3 4 5 6 7 8 9 10 Duty Manager’s contact details made available for each of the Centres 1 2 3 4 5 6 7 8 9 10 Service Providers to host regular neighbourhood involvement groups 1 2 3 4 5 6 7 8 9 10 Residents’ complaints to be responded to in one day 1 2 3 4 5 6 7 8 9 10 Any other suggestions? Please detail below Any other comments on the Management of the service?

11. Question 3. How would you like to be consulted on this proposal in the future? Local Area forums Newsletter (if yes please provide email address) Safer Neighbourhood Forums Police Consultation Group  Other (please specify) __________ Question 4. Do you have any comments on the proposal? (Please write your comments in the box below)

12. Thank you for taking the time to fill out this questionnaire. Your views are valued greatly. Please return your completed questionnaire to us using the pre paid envelope provided by 31st March 2009. You are not required to fill out the following section, but we would be grateful if you could in order for us to ensure we get responses from a variety of people. Which of the following are you? I am a Resident in Westminster  If yes what is your postcode? I work in the area  I am visiting the area  Male  Female  How old are you?16-24 25-34  35-44  44-55  56-65  65+  To which of these groups do you consider you belong?   (please circle) British White Irish White Other white Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Any other mixed background Asian or Asian British – Indian Asian or Asian British – Pakistani Asian or Asian British – Bangladeshi Any other Asian background Black or Black British – Caribbean Black or Black British – African Any other Black background Chinese Any other background