Report of the Executive Director of Adult Social Services and the Director of Public Health

The Health Scrutiny Committee receive an annual update on the delivery of drug and alcohol services in Manchester. This report is in two parts. The first part of the report provides the Committee with a full description of the services provided by the Manchester social work teams, who support adults with complex needs. The second part of the report focuses on efforts to tackle alcohol harm in Manchester and Greater Manchester and the next steps for this important work.

The Committee considered the two-part report of the Executive Director of Adult Social Services and the Director of Public Health. The first report provided a full description of the services provided by the Manchester social work teams, who supported adults with complex needs; the second report focused on efforts to tackle alcohol harm in Manchester and Greater Manchester.

Key points and themes in the report included:

·         Information relating to the Substance Misuse Teams, including a description of their key areas of work;

·         Information relating to the work of the Entrenched Rough Sleepers Social Work Team;

·         Discussion of the approach to the continuous development of services, noting the commitment to research and evidence-based practice;

·         Discussion of the meaning of alcohol harm;

·         Consideration of alcohol harm and inequalities, noting that increased levels of deprivation were associated with increased levels of alcohol related harm;

·         Data relating to the levels of alcohol harm in Manchester;

·         Current activities to tackle alcohol harm in Manchester; and

·         Next steps both at a Manchester and Greater Manchester level.

Some of the key points that arose from the Committee’s discussions were:

·         Noting the proliferation of 24/7 alcohol delivery services and the detrimental impact this had on health outcomes;

·         Noting increased levels of alcohol consumption during the pandemic;

·         A Member described her personal family experience of alcohol harm;

·         In a similar way that the tobacco industry was challenged, Manchester needed to tackle the alcohol industry to reduce alcohol-related harm;

·         What was the process for a family member or carer to access support as a carer;

·         Recognising the need to not demonise or curtail people for enjoying alcohol responsibly;

·         A Member commented that in his ward every application for any new off-licence was vigorously opposed;

·         Public Health should be formally recognised as a licensing objective;

·         Welcoming the reported Family Centred rehabilitation initiative and requesting that a report on this be submitted to the relevant scrutiny committee at an appropriate time;

·         Noting the impact of foetal alcohol spectrum disorder (FASD) and noting the motion on this specific issue at the meeting of Council held 29 November 2023, and requesting that a report on this be submitted to the relevant scrutiny committee at an appropriate time;

·         Noting the challenge presented by grant funding of services; and

·         Requestion an update on the impact of the “Communities in Charge of Alcohol” pilot that had been launched in Miles Platting and Newton Heath in 2017.  

The Director of Public Health welcomed the comments from the Committee and stated that the views expressed in regard to the alcohol industry and the 24/7 availability of alcohol were shared by the Association of Directors of Public Health.

The Registrar in Public Health described the multi-agency approach to consider all licensing applications submitted and where appropriate submit objections for consideration by Licensing Panels. She made reference to conditions and modifications to licences as a result of this approach.

The Director of Public Health stated that a round table discussion would be convened in February 2024 with practitioners and experts participating to develop actions to progress the work on FASD, noting the motion that had been passed by Council.

The Executive Director of Adult Social Services informed the Committee that anyone could refer themselves for an assessment under the Care Act. She acknowledged that consideration needed to be given to promote this more widely.

The Service Manager (Complex Needs), Adult Social Care commented that the Family Centred rehabilitation model had been developed by the staff working within the Alcohol Team. She said that this model utilised a number of therapies, including Trauma Informed Therapy, to best meet the needs of the individual. She commented that the intention was to build upon this model and work with Children’s Services, adding that an update on this work could be provided to the relevant scrutiny committee at the appropriate time.

The Director of Public Health said that NHS England funding for Alcohol Care Teams was due to end in March 2024 and discussions were currently underway to look at transitional funding arrangements so the services could be sustained in 2024/25. He added that Wythenshawe Hospital had mainstreamed this service and options to adopt a similar approach would be explored at the other two hospital sites, noting that this changed its funding status and arrangements.  

The Director of Public Health said that the formal evaluation of the Communities in Charge of Alcohol pilot had not been undertaken due to the pandemic, however the lessons learnt from this pilot would be used, along with the underlying principles to roll this programme out more widely.

The Executive Member for Healthy Manchester and Adult Social Care stated that despite the failure of government to tackle the issue of alcohol harm it remained a priority for Manchester. He paid tribute to the staff working in the Substance Misuse Team. He further commented that FASD was considered by the Children and Young People Scrutiny Committee.

Decision

The Committee recommends that the Executive Member for Healthy Manchester and Adult Social Care and the Chair of the Health Scrutiny Committee engage with the Mayor of Greater Manchester with the view to establishing a Manchester Manifesto to tackle the alcohol industry on the issue of alcohol-related harm.