Joint report of Corporate Director for People and Director of Public Health
Following an introduction from Councillor Linda Woodings, Helen Johnston, Consultant in Public Health, presented the report stating the following:
· Nottingham’s alcohol and drug treatment and recovery system includes an integrated treatment and recovery service for adults, a criminal justice pathway, and services for children and young people and families impacted by substance misuse. The substance misuse treatment and recovery services in Nottingham city need to be re-commissioned, with new contracts to be let from 1 July 2023.
· The Supplemental Grant has been allocated to Nottingham City to support improvements in the quality and capacity of drug and alcohol treatment 2022/23 to 2024/25. Along with other ring-fenced grant funding and partner funding, this marks a step change in investment in substance misuse services, for consideration alongside the commissioning review to ensure Nottingham has sufficient high-quality service provision.
· The report seeks approval for the re-commissioning of substance misuse treatment and recovery services in Nottingham from July 2023, and the receipt/spend of Supplemental grant. The proposal is to approve spend for commissioned services under five year contracts with two options to extend for further two year periods against a nine year budget.
In response to questions, it was confirmed that a two percent uplift had been applied to the Public Health grant funded elements due to anticipated Agenda for Change increments on staffing costs. This applies across the life of the contract. A more substantial risk arises post March 2025 as there is no guarantee of ringfenced grant funding beyond that point. This risk is being mitigated through contractual arrangements.
(1) approve the receipt of up to £2,899,440 from the Office of the Police & Crime Commissioner as a partner contribution to substance misuse
(2) approve the receipt of the full allocation for Nottingham of the Supplemental Substance Misuse Treatment and Recovery Grant (including the Inpatient Detoxification grant line) from the Office of Health Improvement & Disparities to 31 March 2025 (total indicative value of £7,064,863), paying attention to grant conditions
(3) approve the spend of £1,829,466 on substance misuse services and activity to 30 June 2023 as set out in Appendix A to the report
(4) approve the spend of £291,177 of the Inpatient Detoxification Grant through a consortium procurement of additional inpatient detox beds within the Midlands to 31 March 2025
(5) delegate responsibility to Director of Public Health to agree the service model for the commissioning of substance misuse services against the entire budget available, through applying the insight and commissioning recommendations developed within the strategic commissioning review and in consultation with the Portfolio Holder
(6) approve undertaking a procurement process for the following services as outlined in Appendix B to the report:
· Integrated drug and alcohol treatment and recovery services for adults
· Drug and alcohol treatment and recovery services for people in the criminal justice system
· Integrated drug and alcohol treatment and recovery services for children and young people
· Family support service for those impacted by substance misuse
· Harm reduction service including specialist needle exchange & sexual health
· Shared Care in primary care.
(7) approve the spend of ring-fenced Public Health Grant, ring-fenced substance misuse grants, and partner funding up to a total value of £62,498,502 on substance misuse services for Nottingham for 1 July 2023 to 30 June 2032, with funding contributions detailed in Appendix C to the report.
Reasons for recommendations
(1) New substance misuse treatment and recovery service contracts need to be let from 1st July 2023.
(2) A commissioning review of substance misuse services in Nottingham is underway. The procurement exercise for new services needs to be completed in autumn 2022, to allow for service mobilisation in 2023.
(3) The commissioned services for adults, children, families, the criminal justice pathway, and the harm reduction service will be procured such that additional substance misuse treatment activity grant-funded by the Office of Health Improvement and Disparities is provided by the awarded treatment service provider, as this is not standalone activity.
Other options considered
(1) The current contracts have been aligned such that they cease on 30 June 2023. Without re-commissioning, there would be no commissioned services and a lack of provision, with Nottingham City Council neglecting the duty to ensure these services.
(2) Under a ‘do nothing’ option’ on the Supplemental Substance Misuse Treatment & Recovery Grant, there would be no receipt of the grant. This would put Nottingham at significant disadvantage for the delivery of From Harm to Hope with a lack of benefit for Nottingham residents.