Andrew Brown, Senior Programme Manager

1. PHE Alcohol Treatment Capital Fund 2019-20Meeting the needs of people experiencing rough sleeping with alcohol problems Andrew Brown, Senior Programme Manager

2. About the fund • PHE has been using capital funding grants since 2013 to 2014 to invest in 158 projects (at an average of £200 to 250k per project) to support the recovery of people dependent on alcohol and drugs. • This year we narrowed the focus to supporting alcohol treatment for three reasons: • Alcohol dependence is a significant public health priority, impacting on individuals, families and communities. • The numbers in treatment for alcohol problems have been falling from a peak of 91,651 in 2013-14 to 80,454 in 2016-17, a 12% reduction. • Prevalence estimates have remained stable with 600,000 people likely to benefit from treatment for their alcoholdependence. Alcohol Treatment Capital Fund Grants

3. PHE Inquiry into the fall in numbers in alcohol treatment 2018 • 22% fall in those entering treatment for alcohol and not any other drug between 2013/14 and 2017/18 (England) • Only 4 out of 5 people with alcohol dependence enter treatment • The findings suggest that financial pressures and service reconfiguration has affected alcohol treatment numbers more than treatment numbers for other substances • Unintended consequences of integration for alcohol users: barriers to access, engagement, and referral pathways; a lack of alcohol expertise, alcohol-specific treatment pathways and evidence based interventions. • Integrated services can provide effective alcohol treatment and numbers do not necessarily fall. Services where numbers increased associated with: strong strategic leadership; a focus on the needs of alcohol users in service specifications, models, and pathways; and staff with alcohol expertise. PHE inquiry into the fall in alcohol treatment numbers

4. Why the focus on those experiencing rough sleeping? • The government’s rough sleeping strategysets out a number of ambitions, including tackling the high rates of alcohol dependency in those experiencing rough sleeping. • Two in five (43%) of people experiencing rough sleeping in London were identified as having support needs around alcohol. This compares with 2% in the general population in England. • The number of new presentations for alcohol treatment where the person has no fixed abode has been falling , but there were still over 2,500 new presentations where that was the case in 2017-18. Alcohol Treatment Capital Fund Grants

5. Where was successful Bath and North East Summerset Birmingham Bradford Brent Cheshire and Merseyside Croydon Derby Hillingdon Hull Lancashire and Blackburn and Derwent Leeds Manchester Middlesbrough Newcastle North Tyneside Nottingham Oxfordshire Peterborough Portsmouth South Gloucestershire Stoke West Sussex Wolverhampton 12 out of 23 successful bids included at least an element that explicitly addresses the needs of people experiencing rough sleeping and an alcohol problem £6m to be used in 2019-20 Alcohol Treatment Capital Fund Grants

6. What else are we doing – Rough Sleepers Grant • £1.9m to test a community based models to improve access to health services for people with co-occurring mental ill-health and substance misuse needs who are experiencing, or at risk of returning to, rough sleeping • The models can take several forms • Model 1: A flexible way of working adopted by health and/or housing/homelessness professionals • Model 2 Targeted interventions that engage individuals and support access • We are not looking to pilot models that have never been used before, but to test models that already exist, either elsewhere in the country, internationally or for another (but relevant) population • Plan to fund five projects and an evaluation • Deadlines for application are on 5 July Alcohol Treatment Capital Fund Grants