Substance misuse

Drug related deaths, homelessness and dual diagnosis

Central Bedfordshire has a lower standardised mortality ratio than Bedfordshire as a whole and for East of England. Progress around the recording and reporting of Drug Related Deaths, protocols pathways and review processes have been greatly improved in 2013/14. A clear multi agency protocol and process has been agreed and quarterly panels will meet to review any cases where there was a drug related death. This will enable professionals to identify if improvements can be made in practice or in service delivery and to enable a coherent review to take place to inform policy and practice locally. Local practice will also be informed by the current PHE consultation taking place around the provision of Naloxone to prevent Drug Related Deaths; results of this consultation are imminent.    

Central Bedfordshire has a lower standardised mortality ratio than Bedfordshire as a whole and for East of England. Progress around the recording and reporting of Drug Related Deaths, protocols pathways and review processes have been greatly improved in 2013/14. A clear multi agency protocol and process has been agreed and quarterly panels will meet to review any cases where there was a drug related death. This will enable professionals to identify if improvements can be made in practice or in service delivery and to enable a coherent review to take place to inform policy and practice locally. Local practice will also be informed by the current PHE consultation taking place around the provision of Naloxone to prevent Drug Related Deaths; results of this consultation are imminent. 

Drug Related Deaths in Central Bedfordshire 2009 - 2011

Source: NDTMS Team East Public Health Observatory Mortality Dataset:  annual extract of Office of National Statistics Mortality Data (1) 

2001 7 3 160
2002 11 5 136
2003 7 3 118
2004 5 3 144
2005 7 4 131
2006 6 3 123
2007 6 3 157
2008 11 5 159
2009 6 3 134
2010 7 3 126
2011 3 3 117
Deaths 2009-11 16 9 377
Average Deaths 2009-11 5.33 2.33 125.67
Population Aged 15+ mid 2009-11 1,012,613 623,752 16,633,050
Rate per 100,000 Population 1.58 1.12 2.27
Expected Deaths 22.95 14,14 377.00
Standardised Mortality Ration 0.70 0.50 1.00

European Monitoring Centre for Drugs and Drug Addiction definition drug related death:  ‘deaths happening shortly after consumption of one or more psychoactive drugs, and directly related to this consumption (2)

Homelessness

Indicator Year Central Bedfordshire  No. Central  Bedfordshire Rate England Rate East of England Rate
Numbers and rates of homelessness ONS Published Statutory Homelessness Statistics by Local Authority Table 784 (3)   Source: Fingertips Indicator 1.5i and 1.5ii (4)
Statutory Homelessness - Homelessness Acceptances 2012/13 159 1.45 2.37 n/a
Statutory Homelessness - Homelessness Acceptances 2011/12 169 1.6 2.3 2.2
Statutory Homelessness - Homelessness Accommodation 2011/12 46 0.4 2.3 1.3
Statutory Homelessness - Homelessness Acceptances 2010/11 130 1.25 2.03 1.75
Statutory Homelessness - Homelessness Acceptances 2009/10 94 0.9 1.9 1.5

Dual diagnosis

Percentages of those beginning Treatment with a Dual Diagnosis

 

 In quarter 1 of 2013/14 Bedfordshire data disaggregated to form the two Unitary Authorities and since then there has been an increase during 2013/14

Pathways exist between the community mental health teams and the CAN pathway, however gaps in services exist between:

  • Long waiting times for Assessment and Single Point of Access Team
  • No clear pathways for those with Autistic spectrum disorders, ADHD or personality disorders
  • The crisis team operates predominantly through A&E

Qualitative work in the form of surveys and discussions with stakeholders revealed that there may be concerns regarding referrals for individuals with mental health and substance misuse issues – they are finding that service users are transferred between substance misuse and community mental health teams with no clear agency taking the lead.  There is a dual diagnosis policy written by CAN in place which should be adhered to which details the responsible authority. 

More work should be undertaken to build upon the existing examples of very good practice. 

References

(1)  Public Health Observatory Mortality Dataset:annual Extract of Office of National Statistics Mortality Data

(2)  European Monitoring Centre for Drugs and Drug Addiction 

(3)  Numbers and rates of homelessness ONS Published Statutory Homelessness Statistics by Local Authority Table 784

(4)  PHOF Fingertips Indicator 


Last updated Wednesday, 1st November 2017