Report of the Director of Public Health

The report provides the Committee with an overview of the Drug and Alcohol Treatment and Support and Tobacco Addiction Treatment Services commissioned by the Manchester Population Health/Public Health Team.

The Committee considered the report of the Director of Public Health that provided the Committee with an overview of the Drug and Alcohol Treatment and Support and Tobacco Addiction Treatment Services commissioned by the Manchester Population Health/Public Health Team. 

To accompany the report a video was played that articulated the voice of the service user.

Key points and themes in the report included:

·         The Manchester Drug and Alcohol Treatment and Support Service and Tobacco Addiction Treatment Service is provided by Change, Grow, Live (CGL);

·         Providing a strategic context both at a local and national level;

·         Key statistics;

·         A description of the service offer for each service;

·         An outline of the performance and an overview of the successes and challenges;

·         The impact of COVID-19; and

·         Next steps.

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

·         Recognising the valuable and important role that the services provided;

·         Had there been a reduction in the numbers of clients seen due to the impact of COVID-19 and the move to online consultations;

·         The need to recognise and address the correlation between socio-economic deprivation and smoking and drug consumption;

·         Was there any evidence to suggest that the increased cost of tobacco had any impact on the numbers of smokers;

·         Was there any evidence to indicate if the historic reduction and closure of services had any impact on the numbers of people seen or being supported by the drug and alcohol service;

·         Noting the prevalence in specific areas of needles being disposed of irresponsibly and what was being done to address this; and

·         Was there any evidence currently available to identify the number of COVID-19 related deaths amongst drug users.

In presenting the report, the Strategic Commissioning Manager advised the Committee that there was a correction at sections 4.2.1 and 5.5.1 of the paper. She reported that the service is specified to supply Varenicline, commonly known by its trade name Champix, which was an important stop smoking medication, often used alongside Nicotine Replacement Therapy, but because of a national issue, this currently cannot be sourced or provided at the moment. She reported that there was no end date for this situation currently and it was likely that it would impact on quit rates.

In response to the question on the issue of historic reduction and closure of services and the impact on the numbers of people seen or being supported by the drug and alcohol service, the Strategic Commissioning Manager advised that any data available would be circulated for information following the meeting.

The Greater Manchester Head of Services for Change, Grow, Live discussed the impact that COVID-19 had placed on the delivery of services, in particular the planned launch of the Be Smoke Free programme that coincided with the beginning of the pandemic. She said staff had responded quickly and effectively to deliver these sessions online and commented that the numbers of people seen had not reduced as a result, adding that some people who might otherwise not have attended an in-person appointment had accessed services online. She commented that where appropriate medication had been delivered to people’s doors.

The Be Smoke Free, Team Manager for Change, Grow, Live supported the comments previously given as to the challenge presented by COVID-19. She said that the intention was to continue to deliver a hybrid model of service delivery and to raise the profile of the service amongst communities going forward.

The Greater Manchester Head of Services for Change, Grow, Live discussed the successful response to bring homeless people indoors at the start of the pandemic. She described the wrap around support that had been provided to both homeless people, including providing vaping devices for smokers, and support for the staff working in those sites. She stated this had been very successful and had provided an opportunity to engage with and assist homeless people around often complex issues to achieve long term positive outcomes.

In response to the question asked relating to the number of COVID-19 related deaths amongst drug users, the Director of Public Health stated this data was not currently available. He further responded to an earlier comment regarding the figures provided within the report relating to alcohol dependency by advising that these were compiled using Public Health England National Data.

The Greater Manchester Head of Services for Change, Grow, Live responded to the issue of the disposal of needles and needle exchanges by commenting that there was no need for people to use dirty needles and there were provisions across a range of locations to dispose of needles safely. She described that there were outreach workers, that included ex-users with lived experience, who would attend specific sites at the appropriate times to engage with users and offer advice and signpost to help and support. She further described the locations around the city as to where advice and information could be obtained, in addition to their social media presence. Noting the positive comments from the Members she extended an invitation to any Member wishing to visit the teams and accompany them when they were out and engaging with users to further understand the work of the service and witness the impact this had.

The Programme Lead stated that the prevalence of smoking in Manchester was high, noting that it was recognised that the incidents of smoking was related to deprivation. She stated that a Tobacco Control Programme had been developed at a Greater Manchester level, based on the World Health Organisation framework. She said this had an emphasis on prevention and de-normalisation of tobacco in addition to treatment services. In reply to the question relating to the pricing of tobacco as an incentive to quit smoking she stated that whilst the cost of tobacco was high it was important to acknowledge that there was a significant presence of organised crime that flooded communities across the city with illicit tobacco. She described that e-cigarettes and similar devices were not licensed medication and as such were regulated by Trading Standards legislation. In response to a question relating to the smoking of shisha she said that the Licensing Out Of Hours Team had been proactive in monitoring and visiting those establishments where this activity was undertaken across the city to ensure they were compliant with the relevant legislation.

Decision

The Committee note the report and thanked all of the invited representatives for attending the meeting and contributing to the Members’ discussion.