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ITEM CM5(a)
Report of: Oxford Health Overview & Scrutiny Sub – Committee
To: Oxfordshire
Joint Health Overview & Scrutiny Committee
Date:
25th May 2006
Title of Report:
Alcohol misuse in young people
Summary
and Recommendations
Purpose of report:
To report the findings of the Alcohol Misuse Review Group. The group looked
at the prevalence of alcohol misuse amongst young people in Oxford and
treatment / prevention services targeted towards hazardous and heavy drinking
levels.
Recommendation(s):
The Joint Committee is asked to:
Background papers:
1. Introduction
The review group
looked at hazardous / heavy drinking behaviour amongst 16 – 25 year olds.
The group decided to focus its research work on screening and early intervention
for alcohol misuse, recognising that this was an area under development
locally / nationally, matched with preliminary evidence showing sharp
rises in heavy drinking patterns within young people.
The review group
focused on screening and early intervention work in Community, Primary
care and Acute Trust settings, gathering local evidence and best practice
evidence. The best practice evidence has been looked at pragmatically,
noting local differences and recognising current funding constraints.
Professional opinion
strongly pointed to the importance of looking at a younger age group than
16 years when considering preventative programmes. Research findings in
this area have therefore looked at secondary school age groups too.
2. Key findings
- There is a lack
of funding towards alcohol treatment services, even with a changing
national public health agenda and the launch of national / local alcohol
harm reduction strategies.
- Scarce resources
are focused around chronic adult drinking behaviour rather than more
preventative work focusing on sensible drinking and reducing harm.
- There is no comprehensive
or aggregated evidence on hazardous / heavy drinking in young people
locally. Evidence gained from individual agencies particularly those
working with vulnerable young people suggests that alcohol consumption
is increasing and onset of alcohol misuse is occurring at a younger
age.
- Social and family
consequences of alcohol misuse are already noted by agencies working
with the most vulnerable of young people.
- Youth / community
workers have identified a need for a variety of ‘frontline’ workers
to receive training in ‘signposting’, brief intervention, counselling
work with young people, particularly in posts where the relationship
with the young person is one of high trust / confidence.
- Best practice
evidence points to the effectiveness of intervention work at ‘critical
times’ e.g. after an alcohol related injury.
- Research evidence
points to the importance of family involvement, peer – led and interactive
education programmes. However locally, there has been an erosion of
a parent / carer drug coordinator and drug worker (attached to City
schools) posts in the last year.
3. Recommendations
- A broader range
of diversionary leisure activities to be partnership funded and targeted
towards areas where there are problems of substance misuse. It was thought
that the City Council should be the lead partner in taking this forward.
(The Local Area Agreement is seen as the key mechanism for delivering
this and should be included as a significant factor in achieving the
LAA target of ‘Reducing the harm caused to young people under 18 from
illicit drug and alcohol use’.)
R2 The
Children’s and Young Person’s service at Oxfordshire County Council
to review;
Current funding
of generic counselling support services for young people and parent
/ carers
Substance
misuse support / brief intervention work within the school setting
(in consultation with Oxfordshire DAAT)
R3 Pending
the results of the ‘ Strengthening Families’ programme in the UK,
Oxfordshire DAAT should investigate the possibility of a pilot programme
operating in Oxford (shire) utilising the expertise of Oxford Brookes
University, ‘Face to Face’ and ‘Parent-Talk’ Services.
R4 Oxfordshire
DAAT should be the hub for disseminating good practice, information
on support and treatment services available (e.g. a more developed
web site and ‘Crystal Mark’ approved help / support literature)
R5 Oxfordshire
DAAT to develop a standard training package for ‘frontline’ staff
such as: ‘Signposting’ for Community substance misuse workers; Brief
Intervention work for Youth Workers, School Nurses and offer subsidised
training courses in the above areas.
It is understood
that the dedicated alcohol budget for Oxfordshire DAAT in 06 / 07 is uncertain.
However the review group support the proposal that any future funding
will be targeted towards the scoping of primary care and shared care treatment.
The review group recommends that this scope should include:
R6 An analysis
of current practices and training requirements in relation to screening,
prevention and treatment for alcohol misuse.
R7 The
introduction of minimum standards for screening & brief intervention
work e.g. QUADs (Quality in Alcohol & Drug Standards) or Models
of Care.
R8 Introduction
of common questioning / screening tools e.g. AUDIT model (see appendix
7) The WHO brief intervention ‘toolkit’ once launched would enable
this.
‘Shared Care’
contracts
The review group
recommend that a Shared Care contract for alcohol include;
R9 A broad
but clear definition of alcohol misuse, that includes hazardous /
risky drinkers
R10 A payment
system which encourages as many practices as possible to participate
e.g. initial set-up costs, one off payments on evidence of implementation
of the locally agreed screening protocol.
Pending the results
of pilot study findings from Brookes University (on reducing ‘risky drinking
patterns) Oxfordshire PCT’s should consider allocating any future ‘Choosing
Health’ funding towards:
R11 Wider
research initially linked with GP surgeries with a high student or
18 – 25 year patient base. (Oxford University could be approached
to help finance this)
R12 Oxford
Radcliffe Hospital Trust pilot the use of alcohol screening questionnaires
within Accident & Emergency departments.
R13 Pending
results of more accurate data recording for alcohol related incidents
at A & E, Oxfordshire PCT’s (in consultation with DAAT) should
consider the appointment of alcohol health worker(s) within hospital
setting(s), to provide brief intervention treatment or appropriate
referral to a more specialist counselling / detox services
R14 All
agencies connected with alcohol treatment / prevention should co-operate
in sharing information around current work to ensure the best use
of limited resources.
R15 Resources
should only be used for projects where there is evidence of effectiveness
or if research funds can be obtained, on well structured projects
testing the effectiveness of different approaches.
R16 Intervention
/ treatment pathways should be modelled in accordance with ‘Models
of Care’ (see appendix 2 & 2(a) ) with interventions tiered to
match patient need and clinical pathways.
R17 Resourcing
of treatment services need to be reconfigured towards need and prevention.
Increasing brief intervention work with a large and growing population
of hazardous / heavy drinkers is regarded as the most effective use
of scarce resources.
R18 Oxford
Health Overview and Scrutiny Sub – Committee to review progress against
key objectives outlined in the Alcohol Strategy for Oxfordshire 2006
– 09.
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