Title

Cynulliad Cenedlaethol Cymru

Ymchwiliad i sylweddau seicoweithredol newydd (“cyffuriau penfeddwol cyfreithlon”)

Tystiolaeth gan Turning Point – LH 04

Turning Point response to National Assembly for Wales’ Health and Social Care Committee

Inquiry into New Psychoactive Substances

Overview

1.1 Turning Point is a leading health and social care organisation working in over 200 locations across England and Wales. We have been operating for 50 years, providing specialist and integrated services that meet the needs of individuals, families and communities. We are a social enterprise reinvesting its surplus to provide the best services in the right locations for those that need them most across mental health, learning disability, substance misuse, the criminal justice, primary care and employment.

1.2 Turning Point welcomes the opportunity to respond to the National Assembly of Wales’ Health and Social Care Committee inquiry into New Psychoactive Substances (NPS) or ‘legal highs’.

1.3 The information contained within this response has been gathered from Turning Point’s experience of delivering over 50 substance misuse services across England and Wales. We have included information that is specific from our Wales services and also information from across England which we think is relevant to this inquiry.

1.4 The key points from our response are:

· Outreach from services is vital to raising awareness of NPS.

· Services need to be flexible to local needs and adapt to meet the needs of their local community.

1.5 Turning Point has responded to a number of the areas that the inquiry has highlighted for consideration, our response is set out beneath the heading for each area.

How to raise awareness of the harms associated with the use of legal highs among the public and those working in relevant public services.

2.1 It is vital that substance misuse services provide effective outreach, in various settings making use of community links and new technology to increase awareness of the impact of NPS use can have, whilst also informing people about the support that is available.

2.2 In response to the development of NPS, Turning Point has developed a new service model for engaging and supporting people who use NPS called Wreckreational. Outreach is a key feature of this model, as is partnership working.

2.3 There are a number of elements to effective outreach and partnership working. The Wreckreational model identifies the importance of outreach to other health and social care services where people using NPS may present. For example the provision of satellite services within GP surgeries for people who may present to GPs with medical issues related to NPS use. As with use of other substances, it is vital that substance misuse services have strong links to sexual health services due to the impact some NPS can have on sexual inhibitions and potential for increased risk of contracting sexually transmitted infections.

2.4 It is important that services engage with other community services and members of the public that may encounter NPS use. Turning Point’s service in Llanelli has provided training to members of staff in the Job Centre Plus and Work Programme providers amongst others. We are also engaging in the ‘Behave or Be Banned’ scheme to raise awareness of NPS amongst bar and pub staff and have distributed information within local shops, which has been well received.

Recommendation

2.5 We would recommend that all appropriate substance misuse services in Wales have service models for addressing the use of NPS in their communities. Outreach is an important part of this, but it is equally important that people using NPS are able to access a full range of support including psychosocial interventions to support them to recovery.

The capacity of local services across Wales to raise awareness of – and deal with the impact of – the harms associated with the use of legal highs

3.1 Nationally Turning Point has recorded an increase in the number of people accessing substance misuse services related to the use of NPS, however the total number remains low. The table (Table 1) below outlines the number of referrals Turning Point has received for Mephedrone and GBL in three previous years.

Drug	Primary	Secondary	Tertiary	Total
2011/12	90	43	31	164
2012/13	129	72	43	244
2013/14	177	147	85	409

Table 1 shows the number of referrals to Turning Point substance misuse services for Mephedrone and GBL for each of the past three years. When people are referred into treatment their three main problem substances are identified, the table identies the number of people at who identified Mephedrone or GBL at each level and the total number of people who identified these substances for each of the past three years.

3.2 The data from Table 1 indicates that there was a 49% increase in total number of Mephedrone and GBL referrals between 2011/12 and a 68% increase between 2012/13 and 2013/14. This indicates that whilst the numbers are relatively low compared to people being referred for traditional illicit drugs, we are seeing a significant increase in people accessing services for NPS use.

3.3 Our substance misuse service in Wales has identified that the number of people currently seeking support for NPS use is being managed within existing service capacity. However, it is important that services are flexible and able to provide innovative services to address the complex needs of the treatment population and engage with local communities to tackle local needs.

3.4 As highlighted above, the numbers of people being referred to substance misuse services is relatively low, however due to the relatively new emergence of these substances it is difficult to predict future impact on services.

Recommendation

3.5 Funding for substance misuse services should be maintained to ensure that effective support can be maintained for a complex treatment population, including ageing opiate users, an increasing impact of alcohol on elderly people and the impact of NPS and club drugs on young people.

The effectiveness of data collection and reporting on the use of legal highs in Wales and their effects

4.1 The current data collection systems in Wales limit the ability to capture effective data about NPS use and the impact they are having on the substance misuse treatment system. This limits the ability of both services and commissioners identifying local needs and putting in place services that are designed to meet those needs.