As Members are aware contracts with a total estimated value and above must be reported to the relevant Overview and Scrutiny Committee.  Reports must be provided at an early stage of the process once a draft procurement strategy and specification have been developed for consideration by Members.

The report of the Director of Public Health, (Document “B”) outlines, for Members’ information, the position of Alcohol and/or Drug services in the district the intention to commission those services under section 7.2.1 (Part 3G) of the Council’s standing orders in relation to contracts of over £2million in value. 

Recommended –

That the contents of Document “B” be noted and the release of the contract for procurement under the Council’s standing orders be agreed.

(Sarah Possingham – 07582 100244)

Members were aware that contracts with a total estimated value of £2 million and above must be reported to the relevant Overview and Scrutiny Committee.  Reports must be provided at an early stage of the process once a draft procurement strategy and specification had been developed for consideration by Members.

The report of the Director of Public Health, (Document “B”) outlined, for Members’ information, the position of Alcohol and/or Drug services in the district and the intention to commission those services under section 7.2.1 (Part 3G) of the Council’s standing orders in relation to contracts of over £2million in value.

The report revealed that Alcohol and/or Drug services in the Bradford district were last procured in 2016/17 as one integrated contract. The contract was awarded to Change, Grow, Live (CGL), a national organisation. To deliver the contract, CGL employed two local agencies, The Bridge Project and Project 6 as sub-contractors, who complemented CGL’s clinically based services, offering a range of recovery options and activities, community based support options and specific services for carers and/or significant others.

The new contract would be awarded to one provider with sub providers delivering local support.  Officers were working with partners in the Clinical Commissioning Group and across relevant Council departments to identify future service needs and create appropriate commissioning systems to re-source provision to meet that need.

It was reported that the Council had investment from the Public Health Grant of approximately £5 million into Alcohol and / or Drug Services.  New funding had been granted by the Office of Health Improvement and Disparities (OHID) of £9,228,611 as Supplementary Grant for the next three years to 2025.    The Council had also successfully bid from the Rough Sleepers Drug and Alcohol Treatment Grant (RSDATG) a sum of £461,090.50 annually to 2025. 

The total investment proposed for the services to 1 April 2025 was £7.2 million annually which meant the service would be in a much better financial position and could procure a good service for the people of the district.

Services forming part of the contract were reported in Document “B”.   The number of people in alcohol and drug misuse treatment in Bradford during 2021-22 was reported as 3559.  A breakdown of opiate, non-opiate and non-opiate and alcohol clients was provided.  It was reported that 27% of those using opiates and non-opiates were reported as living with a child under 18; whilst the number for people using services for alcohol and living with a child under 18 was 33%. 

It was explained that detailed consultation work had commenced including focus groups; surveys; GP consultation and stakeholder events and had provided important feedback. Document “B” informed Members what was intended to be procured.  Members were informed that alcohol and drug services included treatment based and recovery services and there was a need to buy a whole service encompassing recovery models.  Appended to the report was the Substance Misuse Services Review and Needs Assessment at 31 October 2021 and provided a detailed account of a needs gaps assessment; consultation approach; general public online survey; service user online survey; user focus groups; key learnings from consultations; GP online survey; key learnings from stakeholder events and consultations; overall findings and areas for further development and consideration.

Following a detailed presentation, a Member questioned the limited responses to consultation.  In response it was explained that service users were a difficult group to engage but officers were confident that they had worked with sufficient people with lived experience and their carers. 

It was questioned if performance data included in the 31 October 2021 report was up to date and it was confirmed that it was current at the time of the publication.  The number of opiate related deaths in the UK was reported as over 2000 and the figure in Bradford was queried.  It was explained that those figures were not available but it was known that the figure had fallen.  Limited resources had prevented the service conducting the work it wished but with increased resources there was now a dedicated post to review those statistics. 

It was acknowledged that the number of people in treatment was small and questioned how this compared to neighbouring authorities.  It was confirmed that the numbers in Bradford were worse than the national average.  A lot of financial resources had been cut from the service and this showed in performance. Work had been undertaken to keep people stable but the service had not been able to provide wider recovery work. 

It was questioned if the service reached out to all communities and it was explained that it was intended but had not happened.  Anonymised buildings should have been available but that had not occurred. The service had been admonished for not using the health service software ‘System One’ and this had taken time to redress.  Fourteen contracts were reduced to one and 170 people had been made redundant. 

The current contract was issued seven years ago and notice had been given to terminate that at the end of March 2023.  For the first time in a number of years’ financial resources were being put into the service. 

In response to questions it was confirmed that service user numbers were static and caseloads were below 40.  People could access support in home or in hospital.  A lot of preventative medicines were available and overdoses could be reversed.  Officers felt encouraged that increased financial resources would allow the work required to be conducted.

A Member suggested it would be useful to receive a performance report at the end of the contracts.

The district joint strategy Adverse Childhood Experiences (ACES) was welcomed and it was questioned where in the contract that work would be included.  In response it was explained that there would be a section included in the contract and outcomes for people with addiction with children would be monitored.  

That Member, in response to the reply, referred to 40% of people who were addicted to drugs or alcohol having a child in their family.  That resulted in 900 children living in families with an addict.  It was felt that, in the main, those families were not being helped and she needed to understand the support available to those people.  There were a significant number of children experiencing toxic trauma and she had seen a lot of traumatised children.  Assurances were provided that the service were dealing with adults and that they could support the families and children. The service had no     policy on that subject but were working with colleagues in Children’s Services on that issue.   In response it was stressed that strategies to build resilience were needed as a matter of urgency. 

The numbers of people in treatment were reported, however, the number of service users in general was requested and it was agreed that the details of the prevalence of drug and / or alcohol addiction would be provided after the meeting.  National average figures were available at Appendix three to the report. 

The contribution that drug and/or alcohol usage had on anti-social behaviour and the demands on the NHS; police and Children’s Services was raised.  It was queried if the service could support, financially, those agencies to reduce long term costs of future addiction.  Issues in the city centre with areas becoming gathering points for people with drug/alcohol issues were reported.  In response it was explained that there were clear requirements for the use of funding.  In the last six months an Alcohol and Drug Strategy Group had been developed with partners.  The findings of that strategy group would be monitored and supported if possible.

It was reiterated that, in previous years, GPs had been trained to treat addiction in their surgeries.  The increased funding may make it possible to resume that initiative. 

The service aimed to produce a strategy by the end of the year which would include priorities and determine actions required.  A Member suggested that this should be a wider strategy not just including treatment options. 

Resolved –

(1)  This Committee requests that the comments raised by members, be considered during this procurement process.

(2)  This Committee requests that a report relating to the level of support available for children living in families where there is an addiction, be presented to this Committee.

(3)  This Committee requests that the Drug and Alcohol Strategy be presented to this Committee, when it is available.

(Sarah Possingham – 07582 100244)