Select Committee on Home Affairs Memoranda


Submitted by Lancashire Drug Action Team (LDAT)

  1.  The statutory structures across Lancashire County, and therefore within the Lancashire DATs' jurisdiction, are fairly complex in relation to many other areas—primarily through the existence of four health authorities at present, and twelve district/borough councils. As such, there are highly variable demographics across the country. The Drug Action Team (DAT) has been in place since the first National Drugs Strategy (1995), and has wide representation, of members from all sectors.

  2.  The ability to translate national policy directives with consistency across such a large geography is being achieved through the development of relationships with the twelve local Crime and Disorder Partnerships (CDRPs). In addition, the DAT has an established network of other groups and forums that seek to undertake project development, and advise the DAT in a variety of fields.

  3.  As to the Children and Young People objectives in the National Drugs Strategy, Lancashire DAT contains 596 state maintained primary schools, 109 state maintained secondary schools, and 39 special educational needs (SEN) schools. Implementing a consistent approach to drugs education is therefore challenging. The majority of secondary schools (90 per cent) have both drug education programmes, and drug incident management policies. Primary schools are prioritised according to those that approach the schools advisory team requesting assistance in this work, in addition to which pro-active advocacy work is now undertaken as a direct result of the increase in Standards Funding.

    —  The DAT commended the government targets of all schools developing drug education programmes, and policies by 2004, and the associated revenue increases that have been allocated to support this.

    —  The DAT believe that a distinction should be made between the differing needs of primary, secondary, and SEN schools, within national targets.

    —  the DAT also recommend that a government policy directive for achieving these targets via the larger shire country DATs should take account of the larger number of schools than the smaller unitary authority DATs.

    —  The DAT welcome the increase in standards funding, particularly the ring-fenced funding for drugs education advisors. This increases local capacity for more creative strategies, increasing the number of schools, or clusters of schools with which DAT partners can work, and much valued time to sustain important multi-agency partnerships.

    —  The DAT recognise the need for schools to address a large number of issues within the curriculum, with no statutory obligation for the inclusion of drug policies, or drugs education outside of science programmes. The DAT commend the National Healthy Schools Strategy as a vehicle for raising the profile of substance misuse in context of PHSE in schools. The DAT would also recommend an increased emphasis on drugs-related policies and education programmes through the Office for Standards in Education (OFSTED).

  4.  As to the second target of treatment, the increase in funding, and the correlation between criminal justice, and the health service, are enabling a more targeted, effective approach to treatment across Lancashire. We anticipate significant decreases in both drug specific crime, and drug-related acquisitive crime as a result of offenders responding to treatment interventions. The DAT view the National Strategy Targets for treatment as highly relevant key performance indicators of the effectiveness of the strategy over time. These are practical and measurable targets. The DAT in its developing role as a commissioning organisation is now able to impact directly upon the configuration and development of treatment services via the Joint Commissioning Group (JCG). In order for the objectives of the national strategy to be achieved however, it is vital that DATs are given local flexibilities in target setting. The nature of drug misuse in an area, the geography of the county, and historical patterns of commissioning and investment in treatment services, are all factors that result in the need for locally sensitive service developments. In addition, the majority of treatment services have traditionally been funded from core Health Authority budgets, with the ring-fenced drugs-specific funding being used to enhance those services. These core budgets will be devolved to PCTs as a part of the NHS modernisation agenda. Outside of increased funding, the most significant area of service development that can impact on service effectiveness and efficiency is the level of GPs that participate in the care of problematic drug users. An increase in GPs engaging with treatment services can have a large impact on waiting lists.

    —  The DAT recommend that the Department of Health ensure that PCTs are aware of the commissioning responsibilities of DATs, and that measures are put in place to ensure that treatment service commissioning by PCTs is undertaken as a part of DAT commissioning structures, with provisions to prevent disinvestment.

    —  The changes in commissioning and the general service development environment are significant from the perspective of service providers and existing commissioners. It is important that pressure is put on commissioners, and other professionals, to modify the processes of development in light of these changes, and embrace the multi-agency, cross-cutting nature of commissioning, and development, rather than attempting to manage new responsibilities via existing traditional practice.

    —  The DAT feel that national policy should identify the strategic direction for service development outcomes, but local policy, and target setting, should determine how those outcomes are achieved.

    —  The DAT recommend that nationally, steps be taken to increase the number of GPs prepared to participate in a programme of share care.

  5.  The "Communities" related targets in the National Strategy are difficult to quantify. However, it is in this area of development that the greatest level of new activity is evolving, and within which the broadest range of organisations is involved. There is a lack of central guidance on the nature of developments that should be undertaken at a community level with regard to the National Strategy. On the positive side, this has lead to a number of innovative and productive project developments. However it leaves the DAT with difficulties in assessing which communities are achieving the requirements of the National Strategy, and which require further support.

    —  The DAT would recommend the development of community models that highlight the characteristics of local communities to which the DAT should aim.

    —  the DAT suggest national consolidation of good practice at a Home Office level, that relates to community interventions, and which can be subsequently recommended to DATs and CDRPs for implementation.

    —  The DAT advise the development, and specification, of achievable outcomes at a national level such as the provision of family and parent support, development of community consultation networks, and the equitable provision of advice and information.

  6.  The targets relating to availability are the most difficult for the DAT to assess. There is no methodology yet agreed for the assessment of the level of drug availability. Without baseline data regarding current levels of availability, it is difficult to establish targets. It is also the most problematic area of the strategy to take forward at a DAT level, as much of the activity as identified in the National Strategy is a matter for constabularies, and relies on a degree of covertness to be effective. Rather than identifying a reduction of availability as a target, it would seem at this stage, a more appropriate method would be to target an increase in the level of activities that are known to reduce availability, and for which quantitative impact can be measured, such as street lighting, neighbourhood warden schemes, intelligence network development, and drug-specific police operations.

    —  The DAT acknowledge the need for much of the activity in the area of reducing availability to be developed without the DAT arena.

    —  The DAT would welcome measurable target setting in relation to availability.

    —  The DAT would highlight a potential paradox within the strategy, in that effective enforcement is proved to result in increased street prices of illegal drugs, which is therefore likely to result in increased acquisitive crime in order to fund drug use. The DAT endorse the approach that effective treatment services within the criminal justice system (ie arrest referral, DTTOs and prison-based treatment regimes) are an appropriate method of breaking this cycle.

  7.  Summary:

    —  The principles that drive the National Strategy, and the overall aims and objectives are commended by the DAT; however, in order to determine the effectiveness of the strategy, we would recommend the development of measurable performance indicators in the areas of communities, and availability, and the recognition at a national policy level of the relative advantages/disadvantages in strategic implementation by a shire county DAT as opposed to a unitary Authority DAT.

    —  The level of activity undertaken by DATs, and the progress achieved as a result against the National Strategy is significant. However, the DAT, without statutory status is limited in the range of responsibilities it can assume. We recommend that central government departments be increasingly charged with developing and implementing policy change in support of the national strategy. DATs cannot independently achieve the outcomes that the current National Strategy requires—this must be done in an environment of supportive policy developments undertaken by all government departments.

    —  The DAT would support the identification of an increasing level of autonomy. This is due (at least in part) to the DAT membership being based on seniority—presumably because strategic thinking is required. If national strategy is too prescriptive, opportunities for imaginative and strategic thinking are greatly reduced. This can result in the risk of decreasing ownership and commitment among members who may view the role of the DAT as administrative rather than innovative.

    —  The National Strategy is likely to have the greatest impact on communities via local DATs in their new role as purchasing organisations. Treatment service purchasing, providing a strategic overview of the "Communities against Drugs" funding, and management of DTTOs will all directly influence services, waiting times, attitudes to substance misuse, and levels of drug-related crime. It is vital that central government communicates this new role of DATs in all arenas, and at all levels.

    —  The activity of the DAT since the inception of the new strategy in 1998 has been increasingly determined both centrally and regionally. The DAT recognise the need for consistency of approach at a national level, but it is equally important that DATs are provided with the capacity to respond to local issues. It is important to remember that DAT members can only dedicate a percentage of their time to substance misuse related issues, and that it is the supporting administrative staff that are tasked with many of the nationally driven developments. Any increase in activity that DAT support staff are asked to undertake nationally will result in a corresponding decrease in their capacity to respond to local issues, and act upon local needs.

    —  In summary, therefore, the DAT sees the National Strategy as an effective tool with which to combat substance misuse. However, the DAT advocate an increase in the integration of these strategic objectives across all government departments, the development of measurable performance indicators, and increased capacity building among Drug Action Teams as the vehicles to co-ordinate implementation of the strategy at a local level.

September 2001

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