Minutes:
The Chairperson welcomed Ms. Frances Dowds, Belfast and South East Area Manager, Health and Social Care (HSC). She commenced by explaining that her remit was specifically over drugs, alcohol, and mental health issues. Ms. Dowds then introduced her colleagues Mr. J. Brogan, Assistant Director of Integrated Care and Ms. K. Turner, Medicines Management Lead for Integrated Care, along with associates from the Public Health Authority (PHA), Ms. L. Wylie, Senior Health and Social Well Being Improvement Officer and Mr. M. Owen, Health and Social Well Being Improvement Manager.ea;t.
Ms. Dowds thanked the Members for the opportunity to present and apologised for the delay in attending, which she explained had been a direct result of the Covid-19 pandemic and ongoing work pressures. She advised that she and her colleagues would be presenting in regard to the ongoing work to try and reduce alcohol and drug related harm in Northern Ireland within the context of the New Strategic Direction for Alcohol and Drugs Strategy (2011-2016) and Draft Programme for Government Framework (2016 – 2021).
Mr. Rogan advised that the Department of Health (DoH) was currently leading on the development of a new Substance Use Strategy – ‘Preventing Harm and Empowering Recovery – A Strategic Framework to Tackle Substance Use’. This strategy had been co-produced with a wide range of stakeholders and the public consultation had closed on 5th February 2021. He advised that the co-production writing group had been reconvened and was currently discussing the responses received, once complete, the final strategy would then be forwarded to the Minister for Health for his consideration and then to the Executive for final approval.
He highlighted that most of the responsibility for illegal substances had not been devolved and was still the responsibility of the Home Office, therefore, it was important for the Members to understand that the PHA did not have the lead in this area and it was trying to deliver within the parameters of the existing legislation. He then provided an overview of the remits of both the Health and Social Care Board (HSCB) and the Public Health Agency (PHA).
The Committee was advised that, in addition to the new Substance Use Strategy, the following would also be key policy considerations going forward in 2021:
· New Liquor Licensing Bill being progressed by Department for Communities (DfC);
· Consultation on Minimum Unit Pricing for Alcohol; and
· Consultation regarding the new Mental Health Strategy.
Ms. Dowds then provided the Committee with an overview of the PHA Health Improvement – Regional and Local Level Approach. She advised that statistics showed that 1 in 14 adults with a mental illness also suffered with a substance abuse disorder, therefore in terms of drugs and alcohol and mental health and suicide prevention it was essential that there was a coordinated multi-agency approach to ensure the sharing of good practice. She also referred to the high drug related deaths in areas of deprivation and stated that they were committed to focusing on addressing these inequalities.
The representative referred to the current treatment and crisis response and she outlined the proposed next steps for Belfast, as follows:
· the strategic alignment of Belfast Drug and Alcohol Coordination Team (BDACT) and Belfast Protect Life Implementation Group (BPLIG);
· a ‘whole system’ approach to supporting vulnerable with ‘complex lives’;
· a Commitment to develop integrated, neighbourhood-based care supported by strong partnership with communities
· establishing a integrated and multi-agency teams - fuelled by diverse skills and experience
· progressing Joint Commissioning Agreement - underpinning partnership arrangements
· Belfast has many of the foundations/elements – these need to be brought together; and
· ‘Integrated and resourced plan ‘Doncaster Model’ as a driver for integrating, for example, Health, Social Care and Housing.
The representative referred to the Strategic Leadership Group, of which Belfast City Council was a Member, along with the Belfast Health and Social Care Trust (BHSCT), the PHA, the Police Service of Northern Ireland (PSNI), the Northern Ireland Housing Executive (NIHE), the Northern Ireland Ambulance Service (NIAS), Translink and the Belfast Drug and Alcohol Addition Team (BDACT). She referred to the linkages that it had with the Community Planning Partnership and the Living Here Board and provided an overview of its strategic vision to adopt a Complex Lives Model – whole system approach, as follows:
· The formation of a Multi-Agency Delivery Group – aligned with the BDACT priorities/action plan;
· to Develop a SMART action plan and roadmap (short/medium/longer-term);
· utilise support from the Doncaster Complex Lives Alliance;
· identify the potential co-location of teams and/or support (for example, community support hubs); and
· to identifying vulnerable/at-risk people and mobilise the required support.
The representative then referred to the PHA funded Needle Exchange Service. She explained that community pharmacies and non-pharmacy providers throughout Northern Ireland strived to provide a high quality and safe service for all clients, this included the provision of sterile injecting equipment and harm reduction advice. The delivery of this service had been maintained throughout the pandemic. She referred to the figures in respect of visits to the service and advised that, year on year, these had increased which was a positive outcome for the service and stressed that the PHA were keen to increase and promote the benefits of this service to local communities. She reported that, unfortunately, two NSES providers within Belfast had withdrawn from the scheme within the last 20 months due to a mixture of antisocial behaviour issues and community protests. She highlighted that not all people were in favour of these services being offered within their local communities.
She also referred to the Take Home Naloxone (THN) programme which was another important lifesaving intervention also funded by the PHA. This programme aimed to supply THN packs to those at risk of opioid overdose as well as opioid overdose responses training.
Regarding the Drug and Alcohol Monitoring Information System (DAMIS), the representative advised that this programme was funded by the DoH, with support from lead partners and was coordinated by the PHA, it currently had over 400 network members. She explained that this was an e-mail based ‘early warning system’, aimed at identifying possible emerging trends in drug and alcohol misuse.
The Members welcomed the comprehensive update regarding the wide raging programmes that were already in existence and that the focus was on joined up working and multi-agency initiatives.
During discussion, the representatives answered a range of questions in relation to the possible establishment of a Citizens’ Assembly, Safe Injection Facilities (Drug Consumption Rooms) and the closure of the HSC in March 2022.
The importance of both the Community Planning Partnership and the Belfast Open Spaces Strategy were both discussed in terms of further progressing many of the issues/discussion further. It was also noted that many of the concerns raised were difficult to resolve as they were working within the parameters of the existing legislation.
The representatives advised that more information was available at www.drugsandalcoholni.info, this site provided information regarding the services and supports systems that were available throughout Northern Ireland.
The Chairperson thanked the representatives for their comprehensive presentation following which they left the meeting.