[To receive the outcomes of the Licensing Policy Consultation and endorse the system approach to tackling substance related harm.]
Michelle Smith, Principal Public Health Specialist presented the Substance Misuse Partnership Update report and highlighted salient points. The report provided an outline to Health and Wellbeing Together of the intended approach to tackling substance related harm, which built upon the Board’s previous commitment to the alcohol harm reduction agenda.
It was noted that alcohol misuse had been agreed as a priority within the Living Well theme of Wolverhampton’s Joint Health and Wellbeing Strategy (JHWBS) 2018 – 2023.
A short presentation was also delivered which provided an overview of the substance related hospital admissions and mortality rates as well as drug prevalence in a local context and outlined the proposed priorities for the City.
It was noted that alcohol dependence within the City was higher than the national average however it was highlighted that, in terms of the recovery of people receiving support, Wolverhampton had been placed in the top quartile nationally.
It had been noted that the sizable and complex issues of alcohol and drug dependency could not be tackled without a joined-up approach, therefore the Substance Misuse Partnership had been established in July 2019 with a view to developing a new Substance Misuse Strategy. It was highlighted that an alcohol misuse strategy had previously been in place in 2012, however the proposed strategy was the first to include drug misuse as well. It was suggested that an update be provided to Health and Wellbeing Together in future.
Of the priorities listed for the City, four key areas were touched upon and a number of points and statistics were highlighted.
To improve Outcomes in Housing, Employment and Mental Health:
It was highlighted that whilst successfully undergoing treatment, 85 residents had been supported into gaining employment and 129 had been assisted in resolving housing problems.
To reduce Drug-related Deaths:
It was reported there were plans to widen the availability of the synthetic drug naloxone, used to counter the effects of overdose. It was noted that work was being undertaken to introduce an early warning system to raise the alert to bad batches of drugs entering the market. It was reported that the concept of establishing an inquiry panel to investigate and learn from drug-related deaths was being explored.
To reduce the impact of parental substance misuse
It was reported that, in Wolverhampton over a three-year period, 1450 children had a parent receiving treatment for alcohol dependence. Based on prevalence data there was an 82% unmet need for alcohol dependence. On this basis there were many more people to engage into treatment, many of whom would be parents. It was reported that 1159 children had a parent in treatment for an opiate dependency, given an unmet need of 55% there were many people and families who should be engaged with treatment and recovery services. It was noted that these figures appeared stark however they were in line with UK national figures.
To reduce the density of alcohol licensed premises
Work was being undertaken in partnership with responsible authorities in terms of representations to new premises licence applications as well as an update in the Wolverhampton Statement of Licensing Policy.
Michelle James, Licensing Policy Manager delivered a presentation on the revised Statement of Licensing Policy which had been approved at Statutory Licensing Committee on the morning of 22 January 2020. It was reported that the density of licensed premises was significantly higher than the national average and five Cumulative Impact Zones (CIZs), where the combined impact of outlets was highest around Wolverhampton, had been implemented.
Applications for premises licences within these zones relied upon responsible authorities or other individuals making representations against an application or variation applications based on the premises likelihood of undermining one of the licensing objectives.
It was noted that one of the changes to the Policy included a matrix approach to licensing decision-making within the City. This matrix outlined the types of premises which would be less likely to have an impact upon the existing premises located within the CIZs.
The refreshed Policy also introduced a Special Consideration Area for premises which fell around the curtilage of the CIZs, but may still impact upon these areas, with fewer restrictions on premises types than within the CIZs.
Applications for non-alcohol-led premises or premises considered more beneficial for certain areas, such as restaurants, theatres or cafés, were considered more favourably than those that were considered to cause harm, such as off-licences and takeaways.
It was noted that many of these restrictions were not applicable within the heart of the City Centre as a diverse offer of venues would be expected in this area.
The application of the matrix approach relies upon relevant representations being received for applications and variations.
It was agreed that the risks associated with substance misuse could potentially affect everyone and the extensive work undertaken was commended. The positive effect of working within a partnership was highlighted as well as the importance of working with premises licence holders in respect of reducing alcohol-related harm.
A concern was raised around the length of time taken for GPs to refer individuals to other services following a visit to seek treatment for a substance dependency. It was thought that the associated problems could continue or escalate during the wait period, possibly resulting in a risk to the individual and there were concerns around the impact on their family as well. Reassurance was offered that treatment could be accessed direct through Recovery Near You (treatment and recovery service). It was agreed that support around the family was equally important as the support around the individual. It was noted that there was a potential to include a pathway through Primary Care. It was agreed that these suggestions be taken on board.
It was added that work was being done in the Wolverhampton CCG around specialist workforce being introduced and there was potential with the introduction of social prescribing and signposting individuals to support networks and services.
It was suggested that work could also be done following alcohol or substance related hospital admissions.
It was clarified that responsible authorities would be mindful not to appear to be influencing residents to make representations however it was equally important that extensive engagement was carried out to enable communities to make decisions around the types of premises licenses granted in the area.
In respect of county line issues and drug use, it was noted that it had been a challenge to understand the direction of travel of drugs. It had been noted that many problems with drug misuse had occurred within affluent areas.
It was reported that a monitoring scheme had been implemented by Michelle Smith, Principal Public Health Specialist and her team, which provided colour-coded needles to pharmacies offering free needle and syringe programmes in Wolverhampton. Each colour represented a different quadrant of the City to identify which areas discarded needles had originated from. It was noted that it would be interesting to see how the journey of these needles was plotted out.
It was noted that West Midlands Fire Service regularly came across needle litter, which posed a risk to crewmembers and it was agreed that a map showing the colour-coded quadrants would be shared with the service representative to cascade to crewmembers.
4. That the quadrant map for the colour-coded needles be provided to West Midlands Fire Service.