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A ‘specialist’ and community-led strategy in Staffordshire

A ‘specialist’ and community-led strategy in Staffordshire. Tony Bullock Public Health Staffordshire April 28th 2014. Contents. Strategic transformation – why? 2 Balanced strategic framework Responding to ‘dependency’ 4 A more sustainable future?. Strategic transformation – why?.

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A ‘specialist’ and community-led strategy in Staffordshire

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  1. A ‘specialist’ and community-led strategy in Staffordshire Tony Bullock Public Health Staffordshire April 28th 2014

  2. Contents • Strategic transformation – why? 2 Balanced strategic framework • Responding to ‘dependency’ 4 A more sustainable future?

  3. Strategic transformation – why? • Commissioning question: “To improve the lives of individuals, families and communities affected by problematic drug and alcohol use.” • What policies to draw from? • Leads to a broader strategy

  4. Strategic transformation – why? • A more balanced approach • Prevention/ early intervention/ ‘treatment’ • Individuals/ families/ communities • Harm reduction/ abstinence • Specialist services/ community-led initiatives • A more sustainable approach • Financially viable • Contributing to wider outcomes

  5. Transformation - background • Some examples of good practice – BAC • Fragmented commissioning – DAAT/ PCTs etc • Huge disparity between drugs and alcohol • Predominant focus on treatment of individuals • Primarily reliant on commissioned services • Isolation of treatment system from wider structures

  6. Transformation - approach Basic Public Health principles: • Population-level perspective • Needs-led • Evidence-based

  7. Strategic perspective - making sense of complexity

  8. Simple but comprehensive structure…

  9. Basic strategic framework

  10. Basic strategic framework

  11. Basic strategic framework

  12. Balancing needs and evidence

  13. Gradual rebalancing of emphasis

  14. Strategy in action… • New prevention initiatives • Large scale brief interventions • Rebalanced ‘treatment’/’recovery’ system

  15. Strengthening Families Programme Excellent evidence base Investment in training Delivered by established social care service

  16. Systematic education in schools Again, evidence based Consistent approach to PSHE Again, delivered by established education support agency

  17. Awareness campaigns

  18. Alcohol brief interventions • Aa • Specialist services • GP-based provision – part of hypertension checks • Provision of self-help materials

  19. Responding to dependency … • Focus on people • Not just ‘addiction’ per se • Wider determinants – housing, mental health • Wider outcomes – health, crime, child protection • Focus on place • Problems disproportionately concentrated • Potential influence of community assets • Becoming an asset to the community

  20. Key features… • Build on existing recovery communities • Stimulate new networks • Developing ‘Oxford House’ type approach • Service redesign

  21. Existing communities • Championing 12-steps fellowships • SMART • On-line networks • Service user groups

  22. www.recoverychampions.com

  23. Social enterprise

  24. Social enterprise

  25. RIOT radio www.riotradio.co.uk

  26. Stimulating networks • Asset-based community development approach • Baseline Research and Development • Identify potential ‘assets’ • Facilitate connections between people • Generate links with services

  27. ‘Oxford House’ approach www.oxfordhouse.org

  28. System redesign • Split county into three • 1 contract in each area • Requirement to sub-contract • Must embed within local community

  29. Specialist, peers and community assets Peers/ families Commissioned services Community assets AA/NA SMART Champions Self help Recovery communities Social activities Hidden harm Carers Harm reduction Engagement Education Employment Housing Primary care Mental health CAB/ Debts Third sector Therapists Sports clubs Hobby clubs Stabilisation Progression Consolidation

  30. Local partnership Local NHS Trust Local housing charity Specialist addiction agency Local peer-led well-being charity Local homelessness/ DV charity

  31. Wider outcomes Overcoming drug/alcohol problems - use, injecting, associated risky behaviours Be healthy - physical health, well-being Build recovery capital - homes, jobs and friends Happier families - safeguarding, parenting, carer support Stronger communities - reduced crime/fires, more community involvement

  32. Sustainability • Not just specialist services • Embracing existing resources • Generating resources • Contributing back to the community • Outcome focus • Impacting on wider PH/LA/CCG outcome

  33. Next steps • Asset-based community development – prevention • Local grant opportunities – enabling local initiatives • Co-produced recovery communities • Becoming community assets

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