Contact: Mike Webb Ext: 6033 email: [email protected]

1.2 The strategy reflects recent legislation, national policy and government standards as identified in the National Service Framework for Children, Young People and Maternity Services. The Children Act 2004 requires that all agencies are committed to supporting and improving the life chances of all children including those in a caring role and the strategy supports the five outcomes described in `Every Child Matters' and endorsed in the Children Act.

Be healthy : agencies will ensure that the health needs of young carers are identified and met. Very often children in a caring role will have their own health problems which may include anxiety or depression, eating disorders, self harm, or use of alcohol or drugs.

Stay safe - young carers like other young people should be protected in their home, school and community environment. Young carers may be bullied at school because of the care they provide at home, or because they have a disabled sibling.

Enjoy and achieve through learning - young carers often miss out on their

schooling because of their caring role at home. Schools should ensure that if a child consistently fails to hand in homework, is late for lessons, or misses school she or he should not be chastised. Sensitive discussions and enquiries may be

Make a positive contribution to society - young carers should be encouraged and supported to make a positive contribution to society through school, leisure and their family. This may mean that agencies involved with the child and her or his family will need to consider ways of supporting the family to reduce the hours of caring for the young carer needed.

Achieve economic well-being - young carers should not miss the opportunity to gain meaningful employment - which may include part-time/Saturday work when they are still in education, or full-time employment on the completion of their education. Support to achieve all the above aims will contribute to this final aim.

4. Background

4.1 Alcohol Misuse has become a growing concern nation wide. This was highlighted in March 2004 with the publication of the National Alcohol Harm Reduction Strategy, which outlined the total cost to the UK economy of Alcohol misuse to be around £20 billion.

4.2 Within Hampshire, a Needs Assessment was carried out by Alcohol Concern, entitled "Tackling Alcohol Related crime and Disorder in Hampshire." This led to the development of the Alcohol Strategy Co-ordinator Post that would develop a Hampshire Wide Strategy and set up a Hampshire Alcohol Focus Group

4.3 Currently the post of Alcohol Strategy Co-ordinator is funded for one year, and will cease as of March 2006. The post was funded from GOSE and the Young Persons budget. It is hoped that further sources of funding will be found to enable the post to continue in order to begin to co-ordinate the implementation of the strategy.

5. Hampshire Alcohol Strategy - Summary of recommendations

5.1 The strategy is divided into a number of thematic areas. Each one gives an overview of the scale of the problem, outlines existing work in the area and then proposes some solutions. The following sections provide a brief overview of the recommendations for action in relation to each thematic area.

5.2 Information and Communication

· Develop an information and communication strategy

· To raise awareness of the hidden harm caused by alcohol, linking with the Primary Care Trust Invest to Save Agenda

5.3 Licensing and the Night Time Economy

· To create a safe night time economy that effectively tackles alcohol related problems

· To replicate existing examples of good practice county wide

5.4 Binge Drinking

· Ensure that treatment is available to binge drinkers over 18

5.5 Young People

· To provide an alcohol service for young people within each locality, possibly by seeking to commission services at a local level following the Children Trust Model

· To inform and educate parents regarding the risks associated with alcohol misuse

5.6 Adult Health

· A fair and equitable treatment service that is available to all and not dependent upon an individual misusing drugs

· To identify the most appropriate treatment care pathway for an alcohol client and to identify where this breaks down

5.7 Sexual and Domestic Violence

· To raise awareness of the role that alcohol plays within both Sexual and Domestic Violence

6. Hampshire Alcohol Strategy -Summary of alcohol misuse

6.1 - Information and Communication

6.1.1 - There is a need to ensure that individuals are making informed choices about their drinking and to ensure that those who are drinking at harmful levels are identified earlier.

6.1.2 - Binge drinking is generally taken to be drinking more than 8 units a day for men and more than 6 units a day for women.

6.1.3 - A significant percentage of people who are drinking at harmful levels will not come into contact with alcohol treatment services but will access other services.

6.1.4 - A recent survey in Southampton General A+E showed that during the day 20% of cases were alcohol related, rising to 80% at peak times. The opportunity for staff to provide information to patients is significant, particularly within A+E and GP surgeries. Through short interventions, a significant reduction in alcohol consumption can occur. It is key to identify problem drinkers sooner through Brief Interventions and Screening.

6.1.5 - Southampton General trained a specialist nurse in alcohol interventions for inpatients with alcohol liver disease. This reduced alcohol related morbidity, with an 80% reduction in bed days. This represents a saving in the region of £100k or a saving per patient of approximately £4,000.

6.1.6 - It is important to seek to develop a coherent strategy of public information, perhaps including a joint Crime and Disorder Reduction Partnership publicity campaign.

6.2 Licensing and the Night Time Economy

6.2.1 - Society as a whole is a victim through the hidden cost of alcohol and drug abuse. In 47% of violent incidents, the victim believed the perpetrator to be under the influence of alcohol.

6.2.2 - All of the Community Safety Partnerships identify alcohol misuse as a significant problem. A significant amount of work is already underway or planned, for example nearly all partnerships are working with local Pub Watch Schemes to improve the Night Time Economy.

6.2.3 - In Aldershot Town Centre, custody records from Jan 04 show that of 139 individuals arrested, 64% were under the influence of alcohol. In Basingstoke a total of 36% of public order offences occurred between 10.00 p.m. and 2 a.m. Fri - Sat and Sat - Sun. On a Sunday 67% of offences occur between 12.00 and 2.00 a.m.

6.2.4 - Work is needed to review the success of Alcohol Consumption in Designated Public Places Areas and to consider extending where alcohol related disorder remains a problem.

6.3 Binge Drinking

6.3.1 - There is an increase in the proportion of 16-24 year olds who are drinking above safe levels, in particular of young women. The number of young men who drank more than 21 units in a week was 39%, while 31% of young women drank above 14 units a week.

6.3.2 - Binge Drinking is an ongoing issue within Town Centres. A number of local partnerships are setting up groups to specifically look at alcohol related issues within the Night Time Economy. Data between April 2004 and March 2005 in Aldershot showed that of the 362 crimes recorded, 273 occurred between 11 p.m. - 1 a.m. at the weekend.

6.3.3 - Binge drinkers are a problematic area for alcohol treatment services with the range of treatment available depending on how a service views the client group. Binge Drinkers are seen to be psychologically and not physically dependant on alcohol and this creates variation between different services as to when they receive help. Seeking to ensure that services address this issue in a similar way across the county is important.

6.3.4 - Shops selling to underage drinkers is a county wide problem, noted in particular in Havant and the New Forest. Police action on sales, particularly on off-licenses that break the law and to encourage Challenge 21 in shops, is important.

6.4 Criminal Justice

6.4.1 - The Winchester Prison resettlement team ask prisoners to complete a questionnaire in order to identify issues that need to be addressed prior to release. One question asks `do you feel Binge Drinking or Excessive Drinking is a problem', from February to September 2005 the results were:

No Problem - 1397 Some Problems - 159 Significant Problems - 437

6.4.2 Information from this team is passed onto the Winchester CARAT team (Counselling Assessment Referral Advice and Through-care), however they are not able to work with a client if they only have an alcohol based issue. Funding is needed for the team to take on alcohol as part of the wider remit, in order to begin to address what is an issue for the Prison.

6.5 Young People

6.5.1 - British teenagers are among the heaviest drinkers in Europe. In January 2005 a questionnaire was carried out in Hampshire among 225 young people, of whom 92% were aged 16 and below, and 50% were aged 11-13 years. The report concluded that 52% drink alcohol on a `regular' basis.

6.5.2 - The misuse of alcohol by young people is a recurring theme within Crime and Disorder Reduction Partnerships. In Eastleigh and Havant the partnership felt that overall the biggest issue facing them is alcohol consumption fuelling Anti Social Behaviour in the area. In Basingstoke, Gosport and Rushmoor young people gather in open spaces and parks to drink, up to 70-100 at a time, with parents dropping them off with alcohol.

6.5.3 - A lack of parental responsibility around Alcohol consumption is a recurring theme. Locally, when young people were asked "how do you obtain your drink", of the 127 responses, the highest category was `parents provide them' (46%). Parents need to be provided with information regarding the risks associated with alcohol misuse, in particular around the link with increased risks of Teenage Pregnancy and Sexually Transmitted Infections.

6.5.4 - Engaging with young people in other activities has proved one way to encourage them to not drink as much. In Basingstoke, non - alcoholic cocktails, or Mocktails, have proved very popular. There is a need to give young people an informed choice and to tell them of the short term damage that alcohol can cause.

6.6 Adult Treatment

6.6.1 - Alcohol has a major impact upon an individual's physical and mental health, costing the Health Service £1.7 billion each year and impacting upon a variety of services. Recent figures suggest that for every £1 spent on treatment, £5 is saved on the costs of heavy drinking on Society.

6.6.2 - It can be estimated that of the adult population in Hampshire, perhaps 80-90,000 people could benefit from alcohol services. It is worth noting that the estimated number of Problematic Drug Users in Hampshire is estimated to be 7009.

6.6.3 - The number of Alcohol clients seen by services is approximately 2,500 clients per year. An estimate of individuals likely to seek help from local alcohol services would be between 5,000 - 8,000 a year, more than twice the capacity of services.

6.6.4 - The biggest set back to alcohol treatment is the lack of funding that services receive. The Primary Care Trust have responsibility for adult alcohol treatment and Social Services have responsibility for alcohol rehabilitation. The Drug and Alcohol Action Team pooled treatment budget is ring fenced and can only be used for alcohol when it is the secondary drug, not for alcohol by itself. Services are not monitored for success around alcohol treatment, the only target being the overall NHS target to see a client within 13 weeks. Waiting times for alcohol services are:

Basingstoke - 8 weeks

New Forest - 2.8 Weeks (Average)

Spencer House - 3 Weeks (Recently 13)

Frimley Park - 70 Weeks non urgent, 18-20 urgent

Orion Centre - 0 weeks

Avalon - 0 weeks

6.6.5 - It is essential to develop alcohol services that are able to respond to the needs of Hampshire Residents in an effective and timely manner. However, without the provision of extra funding, this will not be possible.

6.6.6 - Services are not monitored for success around alcohol treatment, the only target being the overall NHS target to see a client within 13 weeks. Greater work is needed around the development of recording alcohol based treatments and there outcomes.

6.7 Sexual and Domestic Violence

6.7.1 - National and International research regarding the links of alcohol misuse to both sexual and domestic violence would seem to indicate that alcohol is a significant factor in both areas.

6.7.2 - Hampshire Police data suggests that over the previous twelve months, of the 1529 reported incidents of rape and attempted rape, 39% of all offences involved alcohol misuse on the part of either the victim or the perpetrator. Anecdotal information from the Police toxicology department suggests that incidents of date rape drug use may be as low as 1%, leaving alcohol as the key drug.

6.7.3 - It is important that staff in alcohol services have awareness of domestic violence issues, particularly within the context of assessment. Drug, alcohol and domestic violence agencies often serve the same client base. However few organisations are currently equipped to provide the range of services needed by survivors or perpetrators of domestic violence / abuse who also experience problematic substance use. These links need to be strengthened and developed.

7. Alcohol Focus Group

7.1 A Hampshire Alcohol Focus Group has been established with the purpose of guiding the develop of the Alcohol strategy as well as to raise the profile of alcohol misuse within partner organisations. The group includes representation from the Police, Youth Service, Treatment Providers, Hampshire Licensing Forum, Community Safety Partnerships and the Strategic Health Authority.

8. Financial Implications

8.1 CDRPs are all investing in work around alcohol misuse, however in many cases this is part of other services, for example community wardens will encounter alcohol misuse on a regular basis but are not employed specifically to tackle it. The full picture of investment has yet to be compiled.

8.2 The Social Services budget for Drug and Alcohol misuse in Adults Services

is £775K.

This consists of the following:

Employees: £277K

Commissioned services: £498K

Of the above, £126K of the staff budget is funded by the DAAT for Duty and Assessment posts and £102K of the commissioned services budget is from client contributions. There will also be an apportioned overhead.

8.3 PCT investment in Alcohol Services is as follows. This picture is not complete. While East Hants / Fareham and Gosport PCT have historically invested more in alcohol services, at this point they have not been able to verify the exact nature of this. It has previously been estimated to be in the region of £300,000 for each area.

9. Local Area Agreements

9.1 Alcohol is currently a key element of the `Tackle crime and Anti-social behaviour recognising the harm of drug and alcohol misuse' strand of the Local Area Agreement. The focus here is on prevention treatment and enforcement, with a focus on those aged under 25 years.

Section 100 D - Local Government Act 1972 - background papers

The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

NB the list excludes:

1 Published works

2 Documents which disclose exempt or confidential information as defined in the Act

None