Questions for witnesses for 19 November 2007
The scrutiny review group is interested in the support provided to vulnerable groups with alcohol problems. These include the homeless, offenders, those with mental health problems, young people and domestic violence victims. The review group hope to find out more at this session about the current provision and access to services for these groups, what is considered to be effective ways of working, and where there may be room for improvement.
· Can you describe how, in general, the DAAT assures the delivery of `effective' services and the criteria it uses to judge effectiveness ?
· What are the strengths of this assurance process, and what are the challenge points?
· With regard to key vulnerable groups, such as people who are homeless, who offend, younger people etc, are there additional evidence bases for effective interventions that need to be considered, and if so, how does the DAAT address this?
· Is it possible to commission effective services given the current level of funding available for both adult and children and young people's services?
· How are services specifically targeted at vulnerable groups (young people, offenders, homeless, mental health) developed in Hampshire and what role does the DAAT play in this?
· What is being done in schools to educate young people about alcohol misuse and how effective is this?
· Children can be adversely affected by living with a parent with an alcohol problem, what can be done to help support young people in this situation?
· To what extent are you offering training to staff providing other services to these vulnerable groups on alcohol screening and interventions? (e.g. homeless shelters, women's refuges, probation staff, mental health workers) and are you aware of other sources of training for staff in these services?
· For vulnerable groups, uptake of services can be low, how could this be improved in Hampshire? More outreach work?
· What action is within the DAAT's remit to enhance the support to vulnerable groups? What are the current barriers, if any, to progressing this?
Hampshire Probation Service
· There is a strong link between high alcohol consumption and crime, however evidence indicates that alcohol services are limited for offenders in prison. It is now the responsibility of the PCT to provide health care to prisoners. What outcomes for offenders would availability of alcohol services have?
· You have commissioned a service focusing on the alcohol treatment requirement of the community order, how successful has this been?
· What other services do you consider important to help offenders with a drink problem when they come out of prison?
· Would it be useful to have a referral on arrest scheme for alcohol as there is for drugs? To your knowledge have referral on arrest schemes had successful outcomes?
· How are probation service staff trained in identification and brief intervention?
· Do you screen your clients for alcohol problems and if so how? To what extent do you offer brief interventions?
· Evidence suggests a large proportion of homeless people have alcohol problems. This may conflict with assisting them into accommodation. What is the policy on this in your service?
· Are you aware of the extent of `wet' hostels in Hampshire? What are your views on this model of service?
· In your experience, what is the best way to manage homeless people who have an alcohol problem?
· Could improvements be made to support homeless people with a drink problem more effectively?
HCC - dual diagnosis
· If a person's mental health is the biggest problem, with alcohol secondary, the person is treated within mental health services. Is there sufficient support from alcohol specialists to enable the alcohol problem to be treated effectively in this situation?
· Conversely, people with alcohol problems may have more minor mental health issues associated, to what extent do mental health workers liaise with alcohol service providers to advise on supporting the clients mental health concurrently with treating the alcohol problem?
· To what extent has Hampshire followed the advise published in the 2002 Department of Health dual diagnosis good practice guide?
· What is the current service model for the delivery of dual diagnosis services for people with alcohol and mental health problems and does this model meet the standards of best practice for service delivery?
· How adequate is the funding within HCC Adult Services to meet the needs of people with a dual diagnosis?
· What, in your view, would improve treatment of people with dual diagnosis?
· Integrated care for dual diagnosis cases appears to deliver better outcomes than sequential referrals to different services, however in Hampshire there is only 1 member of staff with an alcohol and mental health remit, why is this? Are you aware of any model of service delivery elsewhere that has more such workers and achieve better outcomes for people as a result?
· One of the barriers to improving the delivery of effective support and treatment to the most vulnerable people is said to be the absence of performance indicators; what prevents health and social care commissioners setting local targets, even when there are no national ones?
Eastleigh Young People's Initiative
· On what evidence did you decide to undertake the initiatives in the STAR programme?
· How positive has the reaction of young people been to these programmes so far?
· What barriers are there to progressing/expanding this work?
· Where do you get funding from to support alcohol work?
· Is there an evidence base which indicates that preventative work with children and young people reduces the number who have problems as adults?
· To your knowledge, has there been work done to assess the effectiveness of different strategies to reduce alcohol consumption among young people?
· Within young people there are vulnerable groups, such as looked after children, children whose parents have an alcohol problem, children who get excluded from school etc, does your programme take account of the particular needs of these young people?
Questions to be led by Members