Mark Drakeford, Minister for Health and Social Services
The Welsh Government published its ten year strategy, “Working Together to Reduce Harm”, to tackle substance misuse in October 2008. The Strategy sets out a clear national agenda for tackling and reducing the harms associated with substance misuse in Wales. Our Programme for Government commitments further demonstrate the importance the Welsh Government places on this challenging agenda.
In February 2013 the Welsh Government published its ‘Substance Misuse Delivery Plan for 2013 – 15’ which supports the strategy and clearly sets out the actions that are being taken forward over this period to reduce the harm associated with substance misuse. Given the impact substance misuse has on health and social services, it is an important part of my portfolio and the commitments contained in the delivery plan must be implemented against the backdrop of the prudent healthcare agenda we are pursuing in Wales.
The way in which substance misuse services have been shaped and delivered in recent years provide good evidence of prudent healthcare in practice. Prudent healthcare is built around a set of principles that remodels the relationship between service users and providers on the basis of co-production, ensuring both are equal partners in any treatment delivered. It also means that we must use resources effectively by delivering services that are evidence based and provided by a broad range of professionals. The substance misuse agenda, rooted as it is in building in the needs of service users at the outset and delivered by professionals in both the statutory and third sector is a good example of how the principles underpin service delivery and have resulted in improving treatment engagement rates and referral to treatment times. We know, for example, that this is an area that has seen some services successfully delivered by non clinical substance misuse workers which is entirely in line with the ‘only do what you can do’ principle
In collaboration with our delivery partners we will seek to ensure that we strengthen the way in which prudent healthcare shapes substance misuse services in the future and will reinforce this through the publication of our revised guidance on ‘Commissioning Substance Misuse Services’ to Area Planning Boards early next year.
The 2014 Substance Misuse Annual Report published today outlines the progress being made to deliver on a number of key actions in the implementation of the strategy. Sustaining recovery is at the forefront of our objectives and following the launch of the ‘Recovery Framework’ in February 2014 we have worked in partnership with practitioners to develop and roll out ‘Theory to Practice’ training for commissioners and providers to ensure that recovery based approaches are fully integrated into core substance misuse treatment services. This will be augmented by training being developed for service users to ensure they are aware of recovery oriented systems of care and will continue to ensure the voices of those who rely on and deliver substance misuse services shape the implementation of this framework.
We have also developed a refreshed ‘Service User Involvement Framework’ with input from the All Wales Service User Movement (AWSUM) and the seven Area Planning Boards to ensure that there is meaningful involvement of service users in the planning and delivery services. Implementing this framework will ensure that the principles of co-production are embedded in the work that we do.
We have previously stated our commitment to support the armed forces community and our aim to ensure that disadvantages that veterans face in comparison to other citizens when accessing services are redressed. New guidance has, therefore, been published this year aimed at improving the identification of veterans with substance misuse issues and improving their access to treatment.
Reducing deaths from drug related poisoning and from drug misuse remain a priority given the tragic impact on families and the wider community. We know that the majority of these deaths are preventable and we have published guidance in undertaking systematic reviews on fatal and non fatal drug poisonings aimed at further reducing drug related deaths.
This year saw the conclusion of the successful European Social Fund (ESF) Peer Mentoring Project, which at the end of the project had supported 11,199 participants to access training or employment. A positive independent evaluation, published in February 2014, outlined the many real life stories showing how the scheme has helped turn around people’s lives. We are keen to ensure that we build on the success of the project and are currently developing a proposal for the next round of the ESF funding to support people with substance misuse and mental health issues in the workplace and back into work.
Reducing the harm associated with alcohol misuse remains a top priority. I am determined to use all the policy levers available to us in Wales to tackle alcohol misuse. There is significant evidence that the price of alcohol matters and it is no coincidence that as alcohol has become significantly more affordable in recent times, alcohol-related death and disease has also risen. As part of our wider strategy to reduce alcohol misuse, we included a proposal to introduce a minimum unit price for alcohol of 50p per unit within the Public Health White Paper entitled ‘Listening to you – Your health matters’. 140 responses were received in response to this consultation which showed broad support for introducing minimum unit pricing in Wales. Earlier this year the independent Advisory Panel on Substance Misuse published a report recommending the introduction of minimum unit pricing as a measure that will effectively target the heaviest drinkers and endure the greatest health harm. This report adds to the growing evidence base for this policy and will inform the alcohol element of the proposed Public Health (Wales) Bill.
We continue to work with partners to tackle the harms associated with substance misuse and there continues to be significant challenges in the coming year.
I have asked the Advisory Panel on Substance Misuse to consider the policy responses required to the increase in the drug related deaths relating to tramadol and other prescription only medicines.
We will also publish a revised service framework to meet the needs of people with co-occurring substance misuse and mental health issues as well as developing a residential rehabilitation framework to ensure that Welsh substance misusers receive quality treatment and support.
The attached report shows the progress being made to implement our 10 year substance misuse strategy and supporting delivery plan over the last year. Tackling the harms associated with substance misuse continue to be a priority for the Welsh Government and by the continuing investment in the substance misuse agenda, further embedding the principles of prudent healthcare and the ongoing collaboration of partners across Wales we will continue to make progress in this important area.