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Fife Alcohol & Drug Partnership

Delivery Plan 2012 - 2015

Fife Alcohol & Drug Partnership – Delivery Plan 2012 - 15

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Contents Introduction ........................................................................................................................ 3

Strategic Direction .............................................................................................................. 3

Governance arrangements ................................................................................................ 4

National Support and Engagement .................................................................................... 4

Commissioning Services .................................................................................................... 5

Commissioning by funding stream .................................................................................. 6

ADP Partner Funding ......................................................................................................... 6

Summary of Substance Misuse Provision In Fife from 2nd April 2012 ................................ 7

Key changes and milestones ............................................................................................. 9

Local Outcomes ................................................................................................................. 9

Local indicators ................................................................................................................ 13

Detail of local indicators ................................................................................................... 15

Core outcomes – As defined by the Scottish Government ............................................... 16

Core Indicators ................................................................................................................. 17

1. Health ....................................................................................................................... 17

2. Prevalence................................................................................................................ 18

3. Recovery .................................................................................................................. 19

4. CAPSM / Families .................................................................................................... 19

5. Community Safety .................................................................................................... 20

6. Local Environment .................................................................................................... 21

7. Services .................................................................................................................... 22


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Introduction

The Fife Alcohol and Drug Partnership was established in 2009 and brought together a range of partners including;

• Fife Council,

• NHS Fife,

• Fife Constabulary,

• Third Sector Drug and Alcohol Agencies (as represented by Scottish Drugs Forum on behalf of Third Sector Managers Group).

Strategic Direction

In 2010 the Fife ADP launched its 3-year Strategy (2010 – 2013) to meet the challenges outlined in the Scottish Governments key policy documents, Road to Recovery, Changing Scotland’s Relationship with Alcohol and Equally Well.

Our goal is to create an environment where recovery focused services complement the individual, family and community assets that help people achieve lasting change.

We believe that the evidenced based and outcomes focused commissioning and monitoring arrangements in place provide a sound basis for reducing the impact of substance misuse.

We recognise the challenge of tackling health inequalities in Fife and are committed to targeting ADP resources to deprived groups and communities.

We share the vision of Fife’s Community Plan for a confident, ambitious and caring Fife that is a great place to live, work and visit.

Our outcomes have been grouped under the following themes:

• Effective prevention and early intervention.

• Protect those affected by substance misuse.

• Effective opportunities for recovery from substance misuse.

These outcomes are closely aligned with the Community Plan outcomes in particular:

• Improving the health of Fifers and narrowing the health inequality gap.

• Making Fife safer.

Fife Alcohol and Drug Partnership Strategy Map


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Governance arrangements

The Fife ADP reports through the Health and Social Care Partnership to the Community Planning Partnership and primarily contributes to the Community Plan outcome of Reducing Inequalities.

Update reports on local statistics and progress are made to Fife Council Local Area Committees annually.

Fife ADP’s 2012 -2015 Delivery Plan and Annual Report will be submitted to the Fife Health and Social Care Partnership.

Fife ADP will also provide the Health and Social Care Partnership with biannual progress reports on its local performance indicators.

Fife ADP comprises of senior representatives of:

• Fife Council;

• NHS Fife;

• Fife Constabulary;

• Specialist substance misuse services from the third sector; and

• A Fife Council Elected Member

Meetings are held at least 5 times per year.

National Support and Engagement

Fife ADP accesses support through a number of national bodies in order to deliver on its outcomes:

Engagement with the Scottish Drugs Forum:

• To support engagement with the Third Sector Management Group in Fife;

• To assist in the development of the local Naloxone programme;

• To assist in the development of user involvement.

Engagement with the Scottish Recovery Consortium:

• To coordinate action to promote recovery;

• To assist and develop mutual aid and user involvement in Fife;

• To support and build capacity with Fife ADP to facilitate discussions with a range of stakeholders.

Engagement with the STRADA

• To deliver training in Children Affected by Parental Substance Misuse and Information Sharing – Responding early to Children Affected by Parental Substance Misuse.

• To develop and deliver training in Parental Capacity

In terms of further support requirements from national organisations in order to deliver on our strategy and delivery plan we may require advice and assistance to:

• Encourage the development of family support;

• Extend the range and focus of whole population approaches to alcohol misuse

Fife Partnership Executive Group

Fife Health & Wellbeing Alliance

Fife Alcohol & Drug Partnership

Fife Health & Social Care Partnership


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Commissioning Services

Following adoption of its strategy, Fife ADP agreed to adopt Fife Council’s Third Sector Monitoring and Evaluation Framework for future grant awards. Services are now commissioned by a competitive grants process based on service briefs designed to deliver the outcomes in the Fife substance misuse strategy (2010-2013).

An outline of our funding position, including the identified resources split against each of the new service briefs for drug and alcohol services, is provided in the table below.

Funding Position 2012/13 to 2014/15

2012/13 2013/14 2014/15

Available Funding £ £ £ £ £ £

Drugs 1,711,591 1,711,597 1,711,603

Alcohol 2,559,878 2,559,878 2,559,878

Carried Forward 86,362

4,357,831 4,271,475 4,271,481

2012/13 2013/14 2014/15

Funding Allocation £ £ £ £ £ £

Service Brief

SB1. Substance Misuse Education Barnardo's 135,000 135,000 135,000

SB2.Vulnerable Young People Outreach

Barnardo's 97,850 97,850 97,850

Clued Up 77,150 77,150 77,150 SB3.Children affected by parental substance misuse

Barnardos 179,000 179,000 179,000

SB4.Specialist Harm Reduction Addaction 200,000 200,000 200,000

SB5a. Integrated Addiction Services NHS Fife 1,759,451 1,759,451 1,759,451

SB5b. Integrated Counselling DAPL 295,000 295,000 295,000

SB5c Integrated Community Rehabilitation

FIRST 269,426 269,426 269,426

Frontline Fife 61,574 61,574 61,574

SB6. Employability & Training Next Steps 150,000 225,000 225,000

SB7. Direct Access Service FASS 162,265 162,265 162,265

WFCDT 99,735 99,735 99,735

Total 3,486,451 3,561,451 3,561,451

Top- Sliced

GP Brief Interventions 206,040 206,040 206,040

A & E Brief Interventions 134,956 134,956 134,956

Monitoring 50,500 50,500 50,500

391,496 391,496 391,496

Other Funding

Drug Deaths Monitoring & Research 7,446 7,446 7,446 Addiction Services - Needle Exchange 15,000 15,000 15,000

Psychology Service 52,000 52,000 52,000

Scottish Drugs Forum 11,000 11,000 11,000

85,446 85,446 85,446

Requiring ADP Approval

ADP Support Team 175,291 175,297 175,303

Total Allocated 4,138,684 4,213,690 4,213,696


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Commissioning by funding stream

ADP Partner Funding Partner Service 2012/13

£ 2013/14

£ 2014/15

£

NHS Fife Harm reduction/Needle Exchange 61,000

Alcohol Related Brain Damage Co-ordination

35,000

Fife Alcohol Support Service 226,215

Health & Well-Being Alliance Vulnerable in Pregnancy Project 75,700 71,158 66,888

Scottish Government Drug Court 689,061

Drug Treatment & Testing Orders 550,244

Fife Council Social Work

Fife Alcohol Support Service 70,656 70,656

FIRST 290,866 290,866

DAPL 300,915 300,915

Clued Up 132,626 132,626

West Fife Community Drug Team 56,373 56,373

Time4U 45,555 45,555

Fife Council Community Services

Wise Choices (YMCA) 70,000

Fife Constabulary Alcohol liaison officer 27,420

Drug liaison officers 36,519

Robertson Trust LOST (conditional upon confirmation of

matched funding) 6,000

Lloyds TSB (Scotland) Barnardo’s - Family Matters (conditional upon confirmation of matched funding) (Feb 2012)

116,126

Fairer Scotland Funding Next Steps 98,500

Challenge Fund (Adult literacies)

Next Steps 23,800

ESF Priority 5 Next Steps 163,000

Totals 3,075,576 968,149 66,888

0

10

20

30

40

50

60

70

80

90

100

% split

SB1 SB2 SB3 SB4 SB5a SB5b SB5c SB6 SB7

Service Brief

Alcohol

Drugs

Fife ADP service activity 2012-2015 is split between alcohol & drugs funding as per Scottish Government requirements. This is illustrated in the diagram opposite.


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Summary of Substance Misuse Provision In Fife from 2nd April 2012

Glenrothes and North East Fife CHP

Kirkcaldy and Levenmouth CHP

Dunfermline and West Fife CHP

North East Fife

Glenrothes Levenmouth Kirkcaldy Cowdenbeath City of Dunfermline

South West Fife

ADAPTADAPTADAPTADAPT

Direct Access drug and alcohol partnership. Brief interventions, advice, signposting and counselling.

● ● ● ● ● ● ●

Specialist Harm Reduction Service, triage and referral.

C Clear Peer education project relating to BBV. ● ● ● ● ● ● ● ARBD Nurse Service

Support for people affected by alcohol related brain damage in Levenmouth. ▲

Addictions Clinical Psychology

Psychological Interventions for individuals with complex/severe co-morbid psychological problems and substance misuse. ● ● ● ● ● ● ●

Addiction Services Drug and alcohol treatment service providing stabilisation, prescribing and detoxification interventions for people experiencing drug and/or alcohol dependency. ● ● ● ● ● ● ●

Substance misuse education, Vulnerable Young Peoples Outreach, Children affected by Parental Substance misuse.

● ● ● ● ● ● ● Vulnerable Young Peoples Outreach (Partnership with

Barnardos). ● ● ■ ■ ● ● ●

Psychological Services, Family Support, Alternative and complimentary therapies to adults.

Young peoples service (Fife Council Funded). * * * * * * *

Drug Court Supervision and Treatment Team

Supervision of Drug Court orders including drug treatment and testing. ♦ ♦ ♦ ♦ ♦ ♦ ♦

Counselling for problem drinkers and family members aged 16+, Pre & post detox support, relapse prevention. ▲ ▲ ▲ ▲ ▲ ▲ ▲


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Triage, Referral and Community based rehabilitation service. * * * * * * *

Housing support and advice, court representation, temporary accommodation, housing management, Prevention First (enhanced housing options), employability and social enterprises.

* * * * * * *

Awareness & Education for solvent misuse issues, Sign posting & referrals to local agencies & 24 hour helpline. ♦ ♦ ♦ ♦ ♦ ♦ ♦

Personal development, employability skills and training for individuals who have had substance misuse issues and who wish to progress towards further training/ education/employment/volunteering.

* * * * * * *

Enhanced addiction casework service in Prisons. Available to Fife prisoners in Scottish Prison Service. ♦ ♦ ♦ ♦ ♦ ♦ ♦

Specialist Midwife

Specialist midwife support and early intervention for drug and alcohol misusing women and their families. ♦ ♦ ♦ ♦ ♦ ♦ ♦

Specialist Pharmacist

Provide specialist pharmaceutical expertise, advice and information for strategic planning, development and support of patient focussed services for substance misusers.

▲ ▲ ▲ ▲ ▲ ▲ ▲

Drop in advice, harm reduction, needle exchange and blood borne virus prevention * * * * * * *

Wise Choices

Community based educational programmes for adults aged 16 – 64 which focus on alcohol and drug misuse, assisting people towards work readiness. ■ ■ ■ ■ ■ ■ ■

A range of support to anyone affected by substance misuse including family members. Harm reduction advice, needle exchange service.

♦ Key: ● ADP funded ■ Fife Council funded ▲NHS Fife funded * ADP/Fife Council/NHS Fife funded ♦ Other external funding source


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Key changes and milestones The current Fife ADP Strategy covers the period 2010 – 2013. The main aim of this Strategy was to provide the framework for a move to outcome-focused services.

A new approach to the commissioning process was implemented in order to develop an integrated model of service delivery to improve outcomes for service users. Following the grant funding process, proposals were approved by the Health and Social Care Partnership in January 2012 with new Services in place from the 2nd April 2012.

The key strategic changes which we intend to achieve are set out in our strategy map and are as follows:

• Raising awareness and understanding of the risks and consequences of substance misuse;

• Promoting healthy lifestyle choices and opportunities;

• Identifying high-risk groups and promoting early intervention;

• Identifying and protecting those most at risk from the substance misuse of other;

• Tackling problems associated with the supply and availability of substances;

• Tackling substance-related violence, crime and anti-social behaviour;

• Promoting effective access to substance misuse recovery services;

• Providing an effective range of treatment services in Fife;

• Supporting the longer-term rehabilitation of those recovering from substance misuse.

Key actions / milestones for Fife ADP over the coming year:

• To work with our Community Planning Partners and service providers on the development of a new Strategy for 2013 – 16;

• To work with our new service providers to collect evidence of achievement of agreed outcomes and performance;

• To continue to support service development, evaluation, improvement and quality assurance;

• Increase service user feedback, participation and involvement and investigate commissioning external evaluation of services;

Local Outcomes

Fife ADP has developed logic models tied to each of the Strategy Map themes and which reflect the contribution to national outcomes.

These are provided on the next three pages.


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Deliver Effective Prevention & Early Intervention Initiatives

Raising awareness and understanding of the risks and consequences of substance misuse

Promoting healthy lifestyle choices and opportunities

Identifying high-risk groups & promoting early intervention

Activities

Outputs

Reach

Short -

term

Outcomes

Fife ADP

Strategic

Link

Up to date substance information & awareness

raising, resistance techniques

Brief alcohol advice

School based & off campus delivery through classroom,

group work and drama

Fife Wide All P7,S2 & S3 pupils

Under 18s deemed ‘most at risk’ from substance misuse

*Increased knowledge of:

• the effect that a range of substances can have on the body and mind;

• the wider impact of substance use

• the associated risks;

• actions that can be applied in challenging situations

Cross sector delivery of alcohol brief interventions as

per HEAT4 target

Fife Wide Individuals identified as

harmful or hazardous drinkers

• Service uptake and engagement aimed at reducing alcohol consumption to safe levels

• Onward referral where required

Overdose training Naloxone training & supply

Drug death research

Vulnerable young people’s support & outreach service

One to one support, group work, family work

Assertive Outreach

150 high risk individuals (12-18 years)

From 2 of the 3 CHP areas to complete Fife wide provision

Improvement in:

• Substance use

• Health & wellbeing

• Social skills, confidence and self esteem

• Relationships Reduction in criminal activity and anti social behaviour

Provide overdose interventions & training

Contribute to drug death research

Fife Wide Anyone who may be in contact

with someone using harmful substances

• Improved personal safety

• Increased numbers trained to manage an overdose situation

• Increased numbers issued with Naloxone

Inputs Substance Misuse Education Service

All services that Work to reduce drug deaths

All services delivering Alcohol Brief Interventions

Young people’s outreach service

National ADP

Outcome

People are healthier and experience fewer risks as a

result of alcohol and drug use

Fewer adults and children are drinking or using drugs at levels or patterns that are

damaging to themselves or others

People live in positive, health-promoting local environments where alcohol and

drugs are less readily available

*Health and Wellbeing outcomes in the Curriculum for Excellence


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Effectively Protect Those Affected by Substance Misuse

Activities

Outputs

Reach

Short-term

Outcomes

Fife ADP

Strategic

Link

Family service focusing on children affected by parental

substance misuse

Alcohol diversion scheme

One to one support, group work, family work,

parenting skills

Fife Wide Families with children aged 0-11 whom are affected by parental substance misuse

• Children will be: Safe , Healthy, Achieving, Nurtured, Active Respected Responsible & Included (SHANARRI principles)

• Parents engaged with stabilisation and recovery services

Alcohol Brief interventions

Fife Wide Individuals fined for low

level alcohol related offences

• Service uptake and engagement aimed at reducing alcohol consumption to safe levels

• Onward referral where required

Information & advice, brief interventions, counselling

assessment and referral for additional support

Core assessments in adult substance misuse services

offering structured interventions

Child protection needs assessments

Home safety needs assessments

Fife Wide All adults undergoing structured

intervention for substance misuse problems

• Improved identification & responses to children affected by parental substance misuse

• Improved supportive environment for children

• Improved identification & responses to home safety needs

Drop in clinics &

Internet

Fife Wide Anyone affected by another’s

substance misuse Fife Constabulary referrals

• Reduction in the use of drugs.

• Reduction in the consumption of alcohol.

• Improvement in health and wellbeing.

• Increase in appropriate referrals

National ADP

Outcomes

Children and family members of people misusing alcohol and drugs are safe, well-supported and have improved life-chances

Communities and individuals live their lives safe from alcohol and drug related

offending and anti-social behaviour

People live in positive, health-promoting local environments where alcohol and

drugs are less available

Inputs Service for Children Affected by Parental Substance Misuse

Direct Access Service

Direct Access Service All Adult Recovery Services

Tackling problems associated with the supply and availability of substances

Identifying & protecting those most at risk from the substance misuse of others

Tackling substance-related violence, crime and anti-social behaviour


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Deliver Effective Opportunities for Recovery from Substance Misuse

Inputs

Activities

Outputs

Reach

Short term

Outcomes

Fife ADP

Strategic

Link

Direct Access Service Employability Service

Harm reduction and outreach service including

injecting equipment provision

Recovery focussed employability service

*ABI, MI, wound care advice, BBV Info, overdose & suicide intervention, triage

assessment & referral

Fife Wide Injecting users, homeless,

chaotic individuals

• Reduction in risk taking behaviour

• Reduction drug and alcohol consumption

• Increase in numbers entering treatment

• Improve health and well being

Individually tailored employability programmes

Fife Wide 300 adults 16+ in recovery

from substance misuse

Improved:

• employability skills

• engagement with employment, education or training

Increased:

• confidence & self-esteem

• aspirations

Information & advice, Brief interventions,

MI, triage, assessment & referral

Integrated Recovery Service

Integrated recovery service

Joint recovery planning

Prescribing, detoxification, counselling community

rehabilitation

Fife Wide Anyone experiencing

problematic substance misuse

Reduction in:

• the use of drugs and/or alcohol

• risk taking behaviour/risk to children

Improvement in:

• physical & psychological health

• life and social context

•

Drop in clinics &

Internet

Fife Wide Anyone seeking advice

or treatment for substance misuse

• Reduction in the use of drugs.

• Reduction in the consumption of alcohol.

• Improvement in health and wellbeing.

• Increase in appropriate referrals

National

ADP

Outcomes

Fewer adults and children are drinking or using drugs at levels or

patterns that are damaging to themselves or others

User Involvement

Service user groups/forums

User representation

Service level agreements

Fife Wide Service users,

families & communities

• Improvement in sustained recovery

• Services meet user’s needs

• Services actively involve users in planning and delivery

Individuals are improving their health, well-being and life-chances

by recovering from problematic drug and alcohol use

Alcohol and drugs prevention, treatment and support services are high quality, continually improving,

efficient, evidence-based and responsive, ensuring people move through treatment into sustained recovery

*ABI – Alcohol Brief Intervention, MI – Motivational Interviewing, BBV – Blood Borne Virus

Harm Reduction Service

Promoting effective access to substance misuse recovery services

Providing an effective range of treatment services in Fife

Supporting the longer-term rehabilitation of those recovering from substance misuse


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Local indicators These will enable progress to be measured. A list of data sources and rational for target are located on page 14

Local indicator Baseline 2015 Target

1 Reduction in Problem Drug Prevalence Rate 15-64 1.38%

Reduce by 0.38% to 1%

2 Reduce % of Males (16+) drinking above recommended weekly limits 27%

Reduce by 3% to 24%

3 Reduce % of Females (16+) drinking above recommended weekly limits 19%

Reduce by 3% to 16%

4 Increase % 15 year olds reporting never trying drugs 80%

Increase by 5% to 85%

5 Increase in %13 year olds reporting not consuming alcohol now/ever 54%


6 Increase in % 15 year olds reporting never trying alcohol now/ever 27%


7 Decrease in the number of substance related A&E admissions for Under 16's 149

Reduce by 25% to 112

8 Increase in the annual Naloxone supplies made 229 Increase

9 Deliver the number of Alcohol Brief Interventions in wider (non primary care) settings in line with HEAT Standard New

10% of ABI’s delivered in

wider settings


10 Increase % of services reporting a safer and more supportive home environment for children affected by parental substance misuse New 100% services

11 Decrease the re-offending rate for alcohol related anti social behaviour following an alcohol intervention 19% Decrease

12 Increase the number of prisoners taking up substance misuse interventions via through-care addiction service. 135 Increase

Deliver Effective Prevention & Early Intervention Initiatives

Effectively Protect Those Affected by Substance Misuse


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13 Increase % pupils who know how to access support for drugs 68%


14 Increase proportion of problem drug users in treatment 32%


15 Percentage of clients receiving treatment within 3 weeks of referral to a specialist drug and alcohol service in line with HEAT A11 Standard 81% 90%

16 Increase % of services evidencing user involvement in the planning and delivery of substance misuse services New 100%

17 Decrease annual average acute admissions related to drug misuse 387 Decrease

18 Decrease proportion of admissions drug misuse in 20% most deprived 51% Decrease

19 Decrease annual average of acute admissions related to alcohol misuse 2234 Decrease

20 Decrease proportion of admissions alcohol misuse in 20% most deprived 38% Decrease

21 Reported reduction in problematic substance misuse new Monitor

22 Increase the number of ex-prisoners who go on to access ongoing support from though care i.e. education, training, employability or community based recovery programme 2 Increase

23 Decrease in the Number of Drug Related Deaths 35 Decrease

24 Decrease in the Number of Alcohol Related Deaths 80 Decrease

Deliver Effective Opportunities for Recovery from Substance Misuse


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Detail of local indicators

Indicator Source data Rational for target 1 ISD study Estimating the National and Local

Prevalence of Problem Drug Misuse in Scotland. Nov 2011 (2009-10 prevalence)

By 2015 Fife ADP would want to have the same prevalence rate as Falkirk at 1.0% of population

2 & 3 Scottish Health Survey (2008/9) Fife ADP should be aiming 3% over 3 years which will positively impact on performance related funding

4,5, & 6 ISD Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS) 2010

Targets are based on the improvements rate recorded over the previous 4 years

7 ISD Scotland – SMR-01 – 2009/10 Targets are based on the improvements rate recorded over the previous 4 years

8 Fife ADP Local Data submitted to Scottish Government 2011-12

2011-12 is baseline data – Fife ADP would look to increase year on year

9 NHS Fife 2011-12 for HEAT Standard H4 HEAT Standard requirement to carryout 10% of Fife’s ABIs in non primary care settings

10 Fife ADP Performance Data All services to provide information on a quarterly basis to evidence actions

11 Fife ADP Performance Data – Alcohol Diversion Scheme 2011/12

2011-12 is baseline data – Fife ADP would look to improve year on year

12 Fife Council Criminal Justice Social Work Service – Throughcare Addiciton Service – annual return 2010/11

This is based on an increased noted since 2008

13 ISD Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS) 2010

Aim to reinstate the 2006 findings when 82% of pupils knew how to access support

14 ISD study Estimating the National and Local Prevalence of Problem Drug Misuse in Scotland. Nov 2011 (2009-10 prevalence)

Fife should be in the top 10 council areas as in previous 2006 data

15 NHS Fife waiting times input for HEAT Target A11 – met 2012 trajectory

HEAT Target requirement of 90% seen within 3 weeks

16 Fife ADP Performance Data – Monitoring and evaluation framework

All services monitored externally to evidence user involvement

17 & 19 ISD Scotland – SMR-01 – annual average based on 2008-2010 data

Targets to show improvement

18 & 20 ISD Scotland – SMR-01 – annual average based on 2008-2010 data

Service delivery is weighted according to areas of greatest need with a focus on deprived communities

21 Fife ADP Performance Data Baseline to be set 2012 22 Fife Council Criminal Justice Social Work

Service – Throughcare Addiciton Service – annual return 2010/11

An increase indicates improvement and positive destinations

23 & 24 General Register Office For Scotland annual average based on 2008-2010 data

Decreasing the number of deaths is an indication of successful interventions


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Core outcomes – As defined by the Scottish Government 1. HEALTH: People are healthier and experience fewer risks as a result of alcohol and drug use: a range of improvements to physical and mental health, as well wider well-being, should be experienced by individuals and communities where harmful drug and alcohol use is being reduced, including fewer acute and long-term risks to physical and mental health, and a reduced risk of drug or alcohol-related mortality. 2. PREVALENCE: Fewer adults and children are drinking or using drugs at levels or patterns that are damaging to themselves or others: a reduction in the prevalence of harmful levels of drug and alcohol use as a result of prevention, changing social attitudes, and recovery is a vital intermediate outcome in delivering improved long-term health, social and economic outcomes. Reducing the number of young people misusing alcohol and drugs will also reduce health risks, improve life-chances and may reduce the likelihood of individuals developing problematic use in the future. 3. RECOVERY: Individuals are improving their health, well-being and life-chances by recovering from problematic drug and alcohol use: a range of health, psychological, social and economic improvements in well-being should be experienced by individuals who are recovering from problematic drug and alcohol use, including reduced consumption, fewer co-occurring health issues, improved family relationships and parenting skills, stable housing; participation in education and employment, and involvement in social and community activities. 4. FAMILIES: Children and family members of people misusing alcohol and drugs are safe, well-supported and have improved life-chances: this will include reducing the risks and impact of drug and alcohol misuse on users’ children and other family members; supporting the social, educational and economic potential of children and other family members; and helping family members support the recovery of their parents, children and significant others. 5. COMMUNITY SAFETY: Communities and individuals are safe from alcohol and drug related offending and anti-social behaviour: reducing alcohol and drug-related offending, re-offending and anti-social behaviour, including violence, acquisitive crime, drug-dealing and driving while intoxicated, will make a positive contribution in ensuring safer, stronger, happier and more resilient communities. 6. LOCAL ENVIRONMENT: People live in positive, health-promoting local environments where alcohol and drugs are less readily available: alcohol and drug misuse is less likely to develop and recovery from problematic use is more likely to be successful in strong, resilient communities where healthy lifestyles and wider well-being are promoted, where there are opportunities to participate in meaningful activities, and where alcohol and drugs are less readily available. Recovery will not be stigmatised, but supported and championed in the community. 7. SERVICES: Alcohol and drugs prevention, treatment and support services are high quality, continually improving, efficient, evidence-based and responsive, ensuring people move through treatment into sustained recovery: services should offer timely, sensitive and appropriate support, which meets the needs of different local groups (including those with particular needs according to their age, gender, disability, health, race, ethnicity and sexual orientation) and facilitates their recovery. Services should use local data and evidence to make decisions about service improvement and re-design.


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Core Indicators

1. Health

1.1 Drug related hospital admissions (Source: ISD Scotland – SMR-01)

ADP 2004/07 2005/08 2006/09 2007/10

Fife 112 115 117 115

Scotland 99 108 113 116

3 year rolling average rates per 100,000 population, Scotland and Council area of residence

1.2 Alcohol related hospital admissions (Source: ISD Scotland – SMR-01)

ADP 2004/07 2005/08 2006/09 2007/10

Fife 573 594 597 578

Scotland 734 752 743 724 3 year rolling average rates per 100,000 population, Scotland and Council area of residence

1.3 Alcohol related mortality (Source: ISD Scotland – NRS)

ADP 2005/07 2006/08 2007/09 2008/10

Fife 19 19 19 19

Scotland 25 25 23 22 3 year rolling average rates per 100,000 population, Scotland and Council area of residence

1.4 Prevalence of hepatitis C among injecting drug users (Source: HPS – NEVI))

ADP 2008/09

Fife 47.9%

Scotland 53.5%

Summary commentary: Despite a continual increase in the rate of drug related discharges from hospital in Scotland, latest figures show that the rate has decreased slightly in Fife which has remained fairly consistent over the previous 5 years. The alcohol related discharge rate is considerable lower than Scotland. Both Fife and National rates have remained consistent with slight reductions in the latest data. Rates of alcohol-related mortality in Fife are below the national average and equal to previous years. Prevalence of Hepatitis C is below the overall Scotland rate.


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2. Prevalence

2.1 Prevalence of problem drug users (Source: ISD)

Percentage of the total population age 15-64 years

Total 2006 2009/10

Fife 1.27% 1.38%

Scotland 1.62% 1.71%

Percentage of the male population age 15-64 years

Males 2006 2009/10

Fife 1.78% 1.78%


Percentage of the female population age 15-64 years

Females 2006 2009/10

Fife 0.77% 1.01%



Males 15-24 2009/10

Fife 1.78%

Scotland 2.28%


Males 25-34 2009/10

Fife 4.65%

Scotland 4.99%


Males 35-64 2009/10

Fife 1.02%

Scotland 1.78%

2.3 Drug use last month (pupils age 15) (Source: SALSUS 2006, 2010) Percentage of 15 year old pupils who used illicit drugs in the last month

ADP 2006 2010

Fife 15% 12%

Scotland 14% 11%

2.4 Drug use last year (pupils age 15) (Source: SALSUS 2006, 2010) Percentage of 15 year old pupils who used illicit drugs in the last year

ADP 2006 2010

Fife 23% 18%

Scotland 23% 19%

2.8 Weekly drinkers (pupils age 15) (Source: SALSUS 2006, 2010) Percentage of 15 year old pupils drinking on a weekly basis and the mean consumption in the last week

ADP 2006 2010

Fife 31% 22%

Scotland 30% 20%

Mean number of units in the last week

ADP 2010

Fife 18.1

Scotland 19.5

Summary commentary: There have been national and local increases in the estimated prevalence of problem drug use. Fife’s overall rate remains lower than Scotland however Fife’s Female problem drug users rates has risen at a significantly higher rate and is now fractionally higher than national estimations. Males aged 25-34 have the highest and similar problem drug prevalence rates in Fife and Scotland.

School pupils reporting drug use has declined in Fife since 2006 with data reflecting Scotland wide trends. Additionally the proportion of 15 years old drinking on a weekly basis in 2010 in Fife had declined by 9% compared to the last available data for 2006.


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3. Recovery

4. CAPSM / Families

4.1 Maternities with drug use (Source: ISD, SMR02)

Rate of maternities (per 1000 maternities) recording drug misuse, 2004/05-2009/10 Three year rolling average

ADP 2004/05-2006/07 2005/06-2007/08 2006/07-2008/09 2007/08-2009/10

Fife 12.2 13.9 14.8 13.6

Scotland 9.6 9.5 9.9 11.9

Excludes home births and births at non-NHS hospitals. A maternity is defined as a pregnancy which results in a live or stillbirth; multiple pregnancies counted only once. To minimise the potential risk of disclosure, data has been grouped up into 3 year rolling aggregates. Scotland's figures includes births where health board of residence and/or council area is unknown or outside Scotland.

Summary commentary. Not all national indicators are available. The Rate of maternities recording drug misuse is higher in Fife than Scotland. The latest data shows a decrease in rate for Fife whilst in Scotland the rate increased.

Summary commentary: National figures not available. Fife ADP has set local outcome targets for recovery focusing on reducing substance misuse which includes abstinence, improving health and wellbeing and improving life functioning and social context. Personal development is centred on building assets to sustain recovery.


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5. Community Safety

5.1 Drug use funded by crime Source: ISD, SDMD (SMR25a)

Percentage of new patients/clients at specialist drug treatment services who report funding their drugs through crime (2009/10, 2010/11)

ADP 2009/10 2010/11

Fife 14.8% 12.2%


5.2 Reconviction of DTTO-ers (Source: SG, Criminal Justice Social Work Statistics)

One year reconviction frequencies rate for offenders given a Drug Treatment and Testing Order (2007/08, 2008/09)

Community Justice Area 2007/08 2008/09

Fife 241.0 148.0

Scotland 192.3 162.3

5.3 ASBO rate (Source: SG, Recorded crime data) Anti Social Behaviour offences recorded by the police (2009/10, 2010/11) Rates per 1000 population

ADP 2009/10 2010/11

Fife 33.7 25.9

Scotland 42.7 35.5

5.5 Alcohol/drug fuelled offences (Source: SG, Scottish Crime and Justice Survey)

Percentage of crimes where offender was under influence of alcohol

Police Force work area 2009/10 2010/11

Fife Constabulatory 18.0% 18.0%


Percentage of crimes where offender was under influence of drugs

Police Force work area 2009/10 2010/11

Fife Constabulatory 18.0% 5.0%


Summary commentary: Fife’s substance related crime rates are considerably lower than the averages for Scotland. The percentage of crimes in 2010/11 where offender was under influence of drugs in Fife has fallen dramatically since the previous year.

The rate of Anti Social Behaviour offences in Fife and reconviction rate measured for offenders given a Drug Treatment and Testing Order have also decreased considerably and are also lower than the rate for Scotland.


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6. Local Environment

6.1 Pupils age 15 being offered drugs (Source: SALSUS, 2006, 2010)

Percentage of 15 year old pupils who have ever been offered drugs (2006, 2010)

ADP 2006 2010

Fife 51% 41%

Scotland 53% 42%

6.2 Drug misuse in neighbourhood

Percentage of people perceiving drug misuse or dealing to be very or fairly common in their neighbourhood

ADP 2007/08 2009/10

Fife 11.6% 14.6%


6.3 Alcohol abuse in neighbourhood Source: Scottish Household Survey

Percentage of people spontaneously reporting 'alcohol abuse' as a negative aspect of their neighbourhood

ADP 2007/08 2009/10

Fife 6.0% 5.0%

Scotland 4.0% 4.0%

Summary commentary: The Percentage of people perceiving drug misuse or dealing to be very or fairly common in their neighbourhood is greater in Fife than it is in Scotland and it is increasing. The percentage of people spontaneously reporting 'alcohol abuse' as a negative aspect of their neighbourhood has decreased in Fife and is a similar proportion to the national figures. The Percentage of 15 year old pupils who have ever been offered drugs in Fife and Scotland has decreased significantly since 2006.


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7. Services

7.3 Treatment waiting times Source: ISD, Drug and Alcohol Treatment Waiting times Database (Table 1) Percentage of clients waiting for more than 3 weeks between referral to a specialist drug and alcohol service and start of treatment

ADP June 2011 Dec 2011

Fife 28.9% 12.5%


Summary commentary: In December 2011 the Percentage of clients waiting for more than 3 weeks for specialist treatment in Fife was 12.5% and lower than the Scottish Average.

Fife has made considerable progress with waiting times reporting since June 2011.

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