Submitted by Lancashire Drug Action
1. The statutory structures across Lancashire
County, and therefore within the Lancashire DATs' jurisdiction,
are fairly complex in relation to many other areasprimarily
through the existence of four health authorities at present, and
twelve district/borough councils. As such, there are highly variable
demographics across the country. The Drug Action Team (DAT) has
been in place since the first National Drugs Strategy (1995),
and has wide representation, of members from all sectors.
2. The ability to translate national policy
directives with consistency across such a large geography is being
achieved through the development of relationships with the twelve
local Crime and Disorder Partnerships (CDRPs). In addition, the
DAT has an established network of other groups and forums that
seek to undertake project development, and advise the DAT in a
variety of fields.
3. As to the Children and Young People objectives
in the National Drugs Strategy, Lancashire DAT contains 596 state
maintained primary schools, 109 state maintained secondary schools,
and 39 special educational needs (SEN) schools. Implementing a
consistent approach to drugs education is therefore challenging.
The majority of secondary schools (90 per cent) have both drug
education programmes, and drug incident management policies. Primary
schools are prioritised according to those that approach the schools
advisory team requesting assistance in this work, in addition
to which pro-active advocacy work is now undertaken as a direct
result of the increase in Standards Funding.
The DAT commended the government
targets of all schools developing drug education programmes, and
policies by 2004, and the associated revenue increases that have
been allocated to support this.
The DAT believe that a distinction
should be made between the differing needs of primary, secondary,
and SEN schools, within national targets.
the DAT also recommend that a government
policy directive for achieving these targets via the larger shire
country DATs should take account of the larger number of schools
than the smaller unitary authority DATs.
The DAT welcome the increase in standards
funding, particularly the ring-fenced funding for drugs education
advisors. This increases local capacity for more creative strategies,
increasing the number of schools, or clusters of schools with
which DAT partners can work, and much valued time to sustain important
The DAT recognise the need for schools
to address a large number of issues within the curriculum, with
no statutory obligation for the inclusion of drug policies, or
drugs education outside of science programmes. The DAT commend
the National Healthy Schools Strategy as a vehicle for raising
the profile of substance misuse in context of PHSE in schools.
The DAT would also recommend an increased emphasis on drugs-related
policies and education programmes through the Office for Standards
in Education (OFSTED).
4. As to the second target of treatment,
the increase in funding, and the correlation between criminal
justice, and the health service, are enabling a more targeted,
effective approach to treatment across Lancashire. We anticipate
significant decreases in both drug specific crime, and drug-related
acquisitive crime as a result of offenders responding to treatment
interventions. The DAT view the National Strategy Targets for
treatment as highly relevant key performance indicators of the
effectiveness of the strategy over time. These are practical and
measurable targets. The DAT in its developing role as a commissioning
organisation is now able to impact directly upon the configuration
and development of treatment services via the Joint Commissioning
Group (JCG). In order for the objectives of the national strategy
to be achieved however, it is vital that DATs are given local
flexibilities in target setting. The nature of drug misuse in
an area, the geography of the county, and historical patterns
of commissioning and investment in treatment services, are all
factors that result in the need for locally sensitive service
developments. In addition, the majority of treatment services
have traditionally been funded from core Health Authority budgets,
with the ring-fenced drugs-specific funding being used to enhance
those services. These core budgets will be devolved to PCTs as
a part of the NHS modernisation agenda. Outside of increased funding,
the most significant area of service development that can impact
on service effectiveness and efficiency is the level of GPs that
participate in the care of problematic drug users. An increase
in GPs engaging with treatment services can have a large impact
on waiting lists.
The DAT recommend that the Department
of Health ensure that PCTs are aware of the commissioning responsibilities
of DATs, and that measures are put in place to ensure that treatment
service commissioning by PCTs is undertaken as a part of DAT commissioning
structures, with provisions to prevent disinvestment.
The changes in commissioning and
the general service development environment are significant from
the perspective of service providers and existing commissioners.
It is important that pressure is put on commissioners, and other
professionals, to modify the processes of development in light
of these changes, and embrace the multi-agency, cross-cutting
nature of commissioning, and development, rather than attempting
to manage new responsibilities via existing traditional practice.
The DAT feel that national policy
should identify the strategic direction for service development
outcomes, but local policy, and target setting, should determine
how those outcomes are achieved.
The DAT recommend that nationally,
steps be taken to increase the number of GPs prepared to participate
in a programme of share care.
5. The "Communities" related targets
in the National Strategy are difficult to quantify. However, it
is in this area of development that the greatest level of new
activity is evolving, and within which the broadest range of organisations
is involved. There is a lack of central guidance on the nature
of developments that should be undertaken at a community level
with regard to the National Strategy. On the positive side, this
has lead to a number of innovative and productive project developments.
However it leaves the DAT with difficulties in assessing which
communities are achieving the requirements of the National Strategy,
and which require further support.
The DAT would recommend the development
of community models that highlight the characteristics of local
communities to which the DAT should aim.
the DAT suggest national consolidation
of good practice at a Home Office level, that relates to community
interventions, and which can be subsequently recommended to DATs
and CDRPs for implementation.
The DAT advise the development, and
specification, of achievable outcomes at a national level such
as the provision of family and parent support, development of
community consultation networks, and the equitable provision of
advice and information.
6. The targets relating to availability
are the most difficult for the DAT to assess. There is no methodology
yet agreed for the assessment of the level of drug availability.
Without baseline data regarding current levels of availability,
it is difficult to establish targets. It is also the most problematic
area of the strategy to take forward at a DAT level, as much of
the activity as identified in the National Strategy is a matter
for constabularies, and relies on a degree of covertness to be
effective. Rather than identifying a reduction of availability
as a target, it would seem at this stage, a more appropriate method
would be to target an increase in the level of activities that
are known to reduce availability, and for which quantitative impact
can be measured, such as street lighting, neighbourhood warden
schemes, intelligence network development, and drug-specific police
The DAT acknowledge the need for
much of the activity in the area of reducing availability to be
developed without the DAT arena.
The DAT would welcome measurable
target setting in relation to availability.
The DAT would highlight a potential
paradox within the strategy, in that effective enforcement is
proved to result in increased street prices of illegal drugs,
which is therefore likely to result in increased acquisitive crime
in order to fund drug use. The DAT endorse the approach that effective
treatment services within the criminal justice system (ie arrest
referral, DTTOs and prison-based treatment regimes) are an appropriate
method of breaking this cycle.
The principles that drive the National
Strategy, and the overall aims and objectives are commended by
the DAT; however, in order to determine the effectiveness of the
strategy, we would recommend the development of measurable performance
indicators in the areas of communities, and availability, and
the recognition at a national policy level of the relative advantages/disadvantages
in strategic implementation by a shire county DAT as opposed to
a unitary Authority DAT.
The level of activity undertaken
by DATs, and the progress achieved as a result against the National
Strategy is significant. However, the DAT, without statutory status
is limited in the range of responsibilities it can assume. We
recommend that central government departments be increasingly
charged with developing and implementing policy change in support
of the national strategy. DATs cannot independently achieve the
outcomes that the current National Strategy requiresthis
must be done in an environment of supportive policy developments
undertaken by all government departments.
The DAT would support the identification
of an increasing level of autonomy. This is due (at least in part)
to the DAT membership being based on senioritypresumably
because strategic thinking is required. If national strategy is
too prescriptive, opportunities for imaginative and strategic
thinking are greatly reduced. This can result in the risk of decreasing
ownership and commitment among members who may view the role of
the DAT as administrative rather than innovative.
The National Strategy is likely to
have the greatest impact on communities via local DATs in their
new role as purchasing organisations. Treatment service purchasing,
providing a strategic overview of the "Communities against
Drugs" funding, and management of DTTOs will all directly
influence services, waiting times, attitudes to substance misuse,
and levels of drug-related crime. It is vital that central government
communicates this new role of DATs in all arenas, and at all levels.
The activity of the DAT since the
inception of the new strategy in 1998 has been increasingly determined
both centrally and regionally. The DAT recognise the need for
consistency of approach at a national level, but it is equally
important that DATs are provided with the capacity to respond
to local issues. It is important to remember that DAT members
can only dedicate a percentage of their time to substance misuse
related issues, and that it is the supporting administrative staff
that are tasked with many of the nationally driven developments.
Any increase in activity that DAT support staff are asked to undertake
nationally will result in a corresponding decrease in their capacity
to respond to local issues, and act upon local needs.
In summary, therefore, the DAT sees
the National Strategy as an effective tool with which to combat
substance misuse. However, the DAT advocate an increase in the
integration of these strategic objectives across all government
departments, the development of measurable performance indicators,
and increased capacity building among Drug Action Teams as the
vehicles to co-ordinate implementation of the strategy at a local