Okay good afternoon everyone thank you for coming to today’s uh scrutiny brard meeting it’s the adults health and active lifestyle scrutiny brard on the 13th of February um my name is Andrew Scopes I’m a counselor for the be hbert Ward and I’m the chair of this committee

    Today we have um some really important topics to talk about um the they’re somber and and serious so um I trust everyone will treat them that way as as usual I would like to start by int introductions going around the table so I’ll start going to my left as I said

    Already I’m councelor Andrew Scopes and and I’m the chair of this committee thank you good afternoon I’m John Beal um former chair of Health watch still a board member of Health watch and a co-opted member of this board good afternoon councelor James Gibson and I represent crosat wi

    Ward good afternoon Council Taylor and I represent Chapel Alon Ward good afternoon my name is Ray Jones I’m I’m represent horor and uting for councelor ell good afternoon councelor Kevin Richie Bramley and stanel Ward hello councelor of maleia France May representing mtown and mean w hi everyone Victoria Eaton director of

    Public Health at Le city council good afternoon Caroline barrier director for adults and health at the council good after afternoon everyone Dan burn Health Improvement principal for drugs and alcohol in the public health Team lead city council good afternoon I’m Magdalena Buu I’m the head of Public Health for drugs alcohol and safe

    Communities I think hi everyone um I’m an a first I can’t work the button uh I’m a consultant in public health uh in lity Council hi everyone I’m Mandy Madison and I’m the program manager for the Department of Health social care uh with the lead for drugs and alcohol in the auan

    Over good afternoon everyone my name is Nick rank I’m the assistant director with forward leads drugs and alcohol community service thank you I’m councilor winage you’re representing mly South councilor com harbrook representing Rothwell good afternoon everyone I’m Council Caroline Anderson I represent Adin wfd Ward good afternoon I’m Angela brogon the principal screeny

    Advisor super welcome everyone okay so we’ll go through the first um few formal items I’ll hand over to Angela thank you chair um so under item one there are no appeals against the refusal of inspection of documents under item two there are no items for exclusion in relation to item three

    There are no items and under item four please may I ask if board members have any Declarations of interest and I shall take silences n thank you under item five we’ve received apologies from councelor ikbal and councelor Jones is attending as substitute member um Council Farley’s

    Also notified the chair that he may be late due to um being at a licensing committee meeting um we also had apologies Le from Council Vena um as the executive member for children’s social care and health p Partnerships thank you super thank you very much okay so moving

    On to the minutes of the last meeting which is page five of your agenda pack I’ll take matters of accuracy does anyone want to raise any matters of accuracy no okay Angela can you just run through matters arising thank you chair so um in relation to minute number 69 further to

    The board’s discussion regarding out of hours rement Arrangements um we’re just seeking responses with regard to registration services and the GP Federation so once we have those then those will be shared with board members in relation to minute 72 just confirmation that the scrutiny board’s observations regarding the proposed

    Budget proposals were incorporated into a composite report from scrutiny and this was shared with the executive board as part of its meeting on the 7th of February thank you thank you very much just on on that so our board we got everyone on the board got a s of it

    Before it was issued um I think we were a little bit ahead of of a board so that’s that’s good extra consultation okay so we’re going to move on to our first substantive item which is the leads drug and alcohol strategy and action plan so um I’m going to hand

    Over to officers to to introduce it I just um as always I always say to everyone you can assume we’ve read the paper but obviously anything you want to draw out feel free to thank you Council ARF was going to introduce the item so I will just cover some

    Points that she was going to mention um just thank you for the opportunity to come to the scrutiny board to talk about the drug and alcohol strategy and action plan um just to set the scene I think I just we just wanted to make the point

    That we uh are very well scrutinized on drugs and alcohol uh nationally and locally by the office for health Improvement and disparities so we’ve got a colleague um from ohid today uh The Joint combating drugs unit the Care Quality commission and locally through robust local governance Arrangements through Council Arif as our executive

    Member Victoria e as director of Public Health and we’ve got some good local governance Arrangements um through our local combating drugs partnership which was established uh recently with a refreshed membership uh and a number of boards that report into the combating drugs uh partnership councilor Arif as you’ve

    Arrived do you want to take over or don’t to keep going um I can say a few words as well I’ve got my notes here but if you said if you’ve done your part I’m happy to come in yeah sure sure no problem um chair my apologies for being late there was uh

    Some Highway maintenance on Clay Pit L and it’s just slowed us down so I’m really sorry counselor um Hal is nodding her head there it’s there I promise you um so look I’m really delighted to um she to report to scrutiny board to set the scene we wanted to assure that the

    Board um ass sure that the board uh sorry we want to assure that the board that the drug and alcohol working leads is already exceptionally really well scrutinized by both regionally and nationally uh by the office of Health Improvement and disparities The Joint com combating drugs unit and the Care

    Quality commission and locally through robust governance Arrangements through myself as an exemp member as you’ve mentioned and Victoria Eaton uh our director of Public Health um as a senior responsible officer um the the lead drug and alcohol partnership board and other boards that this report uh reports into

    Such as the leads health and well-being board sa leads exec um executive children young people’s partnership and of course this scrutiny board um lead has benefited from increased national uh funding which is always really welcome um and this obviously um comes with robust monitoring arrangements as well

    Uh the home office guidance to local delivery Partnerships uh required a local board to oversee Arrangements which is the leads drug and alcohol partnership board and a local and a local drug strategy delivery plan lead has already had a drug and alcohol strategy since 20 which is the 2019

    2024 and this was reviewed uh and redrafted by officers to meet a national deadline whilst we work at PA to meet Grant conditions and deadlines we are very aware of the need to take on the views of leads stakeholders so we are taking this opportunity to review the

    Strategy which ends this year uh we’re taking new views from the leads drug and alcohol partnership board and its subgroups uh and this board and will take the refresh strategy and action plan through our governance arrangements and we’re asking stakeholders today that uh what they think about this um what is

    Containing this draft uh and what is missing so I’m looking forward to the conversation from the board thank you thank you very much councelor Arif um Magdalen do you want to introduce the report report please thanks councelor Scopes so we need a strategy that is fit

    For leads and which will identify um an aim to address lead this strategic priorities Ambitions and vision for drugs and alcohol um but it must also be in line with from harm to hope uh now I’m noting that 20245 is an election year but also noting that from harmed hope is a 10year

    Strategy so while there’s a certain amount of future proofing needing um needed um it’s it’s within the context of that being a 10year strategy lead strategic priorities have been fairly consistent over the years so those have been about preventing new people from being harmed by drugs and alcohol harm reduction and treatment and

    Recovery from those already impacted by drug and alcohol harms we’ve always had a crime and Community safety focus and we’ve always always had a children young people and families focus and I hope that those are fairly uncontroversial priorities and and they have been our priorities through previous

    Years so we now have an opportunity to think about what’s different in 2024 and whether anything’s changed from previous iterations of the strategy we’ve suggested for example that the framing of the problem may have changed so in recent years there’s a stronger understanding of commercial determents of Health alongside social

    Determents of health so for example we understand that alcohol is an industry which creates Harms and while we’ve traditionally focused on these harms at an individual Behavior level we could focus on them at a Citywide systems and Industry level a commercial determent of health approach would for example focus

    On reducing exposure to alcohol um through approaches to planning licensing advertising and sponsorship from a social determinance point of view we appreciate that where you live your experiences and your um influences have an impact on the risk of you devel veloping a substance use problem so evidence for risk and

    Protective factors for example includes personal risk factors parental factors peers and other influences such as school connectedness and religious Faith so rather than individual Behavior prevention Focus the evidence suggests that a prevention Focus could be at a broader local systems level um but those are just suggestions and ideas leads is

    A inclusive recovery City and this provides another opportunity and potential Focus for the strategy so recovery’s always been in previous strategies alongside treatment we could choose to give this a stronger Focus um it’s really important that there’s broad consultation with stakeholders um including people directly affected by substance use to

    Get this right and today is opportuned to hear the views of this board um this is a journey there’ll be lots of hearing of people’s views and hopefully we’ll get a strategy that’s right for leads thank you super thank you very much um Andy it’d be really helpful if you um wanted to

    Have make any comments around how leads we fit into the system more more widely yoran H if you if you have anything to say thank you yes speaker thank you yeah so I think it’s probably worth noting I think you know to recognize as well I think

    That um leads is an exceptionally well um LED and developed um area um I think nationally um the the kind of commissioning and the service provision that you have in leads is is is recognized as as good practice and is really strong often I’m I’m kind of

    Asked to provide uh contacts within the city to kind of talk to areas elsewhere to talk about how how how well they’re doing and how well L they are uh in terms of um the strategy uh and how it fits with um the national strategy it absolutely mirrors um what we’ expect to

    See the kind of strands that that are often seen withinin those strategies um in terms of how they’re performing um they’re performing well um there’s always room Improvement and I think you’d be surprised if you didn’t hear me say that um you know there’s certain elements where you know

    Nationally where areas aren’t doing so great so uh one area particularly is opiates opiate numbers in treatment so that that’s one that nationally people are are struggling to kind of hit the targets uh and Lees isn’t any different there but in terms of uh that their delivery the the commission of the

    Service the way it’s designed Etc um really well well developed so yeah a lot of good things to say about leads super thank you very much it’s always helpful to get outside perspectives I’m also going to give Nick a chance I guess you work with leads

    City council a lot so good to hear your perspective on where we’re at certainly yeah um well forward leads forward leads were’re proud to be recognized as a CQC outstanding service and um through the uh oad Investments over the past three years uh we’ve put together a comprehensive

    Uh plan to uh expand Service delivery um and that’s continued in 23 24 uh 24 25 right where we we’re planning to expand the treatment and enhancing the quality of service uh we deliver uh we have a comprehensive approach uh for safer and healthier leads which is aligned with the city’s um vision

    Uh we’re a fully Integrated Service so um we are um able to offer multiple Services uh through the one door so people don’t have to um travel around the city to get the support and help that they need um where this year 2425 we’re focusing on expanding our community centers approach

    Um um we’re looking at digital inclusion and Recovery um and a specific focus on peer focused recovery support um as I said Partnerships are a significant um Factor within forward leads uh we work in an integrated way with uh colleagues from across the city offering a range of

    Support um we have successful collabor ations with multiple Health Providers um including lead teaching hospitals trust um I suppose in in in summary we’re we’re committed to providing a safe and effective um treatment service aligned with the inclusive recovery cities uh movement um a significant part of our

    Plan for 2425 will be working alongside David best and the and the community and the recovery cities um program one of those aspects will be working within the universities and the University Estates to offer drug and alcohol treatment support to the faculty and and students that we maybe not not reach

    Into our full capacity at this at this moment in time thanks thank you very much so um I’m going to open up to questions from board members and uh then we’ll go from there if that’s all right so I’m going to bring in councelor Gibson first hi and thank you for your report

    And for for all the really important work that you do um and we know you all do a fantastic job but I have a question so around mentioned in the report let me get the specific language commercial determinant of Health now I’m chair of the licensing committee for leads and I want your

    Opinion on the national legislation so namely the uh licensing act 2003 and whether you think what’s your opinion on uh how that uh potentially undermines what you’re trying to achieve within with the commercial determinants of of health because obviously the licensing Act is permissive uh and also within the

    Licensing act there is no uh provision as a as a licensing objective for public health um which means that actually we’re making decisions around whether or not to uh to Grant a license to sell alcohol um we are sort of hamstrung in that we can’t take Public Health as a

    Consideration now le has done some fantastic worth with at work with our uh cumulative impact areas where we can make considerations based on the cumulative impact of alcohol in that particular area but as for the rest of leads uh it is difficult in that licensing the licensing as a licensing

    Authority we may not wish to Grant licenses based on public health considerations but we’re not actually legally allowed to do that so what’s your opinion on all of that please yeah it’s frustrating that Health isn’t a licensing objective however in lead we’ve got a really um robust process for supporting objections with

    Public health data and information um and been very successful in um having a number of licenses turned down in fact I’ve just got I’ve just seen an email I think I think there’s been 12 turned down over the last relatively short period of time I think a series of months in uh particularly

    Ls8 and n and councel I’ve is well aware of the process we’ve got um so we I suppose we what you say we’re getting round it we we’re we’re doing our best with what we can we could do and we’re doing much better in lots of areas of

    The country so we had the recent CMO visit and shared some of this information about the the approach we’ve got in leads um and many of your colleagues on licensing committees um have had our support in putting together these objections um so yes we’d love it

    To be a licing objective but we do have a really good processing leads that is having some great impact I think coun if do you want to add something yeah thanks for that that’s a really good question and uh a t question I think it’s extremely ex frustrating as

    As Anna said that it isn’t a licensing objective um I mean when we talk about why determinance of of of healthy what you’re consuming in terms of if you’ve got 70% of the shops selling alcohol which was the case in hair Hills as you said we’ve done extremely well in that

    We’ve got uh the council has got a policy called the commun of impact assessment and that’s where our Public Health colleagues come in um and even though um Health isn’t licensing objective is it’s the prevention of harm for children children and in an area like hair Hills where you’ve got a lot

    Of young children you’re able to Public Health come in and present their evidence and I think it was on page 18 if I’m not mistaken my batteries uh my laptop Switched Off where it talked about annually updating the data uh in terms of the alcohol and and influencing

    Licensing in in that way but I in my view it has to be a licensing objective it’s so very important but I just want to thank colleagues I think we’ve revoked in the last 12 weeks we’ve revoked eight LIC es and we’ve stopped I think six um new licenses in the last

    Four years since the year but we’re having to rely and go around it when we shouldn’t have to um so I think it’s a really important question um it’s frustrating more needs to be done on this agenda in my view thank you and I think that comment

    Is really helpful in the fact it should be there in HCK we’ve got a CIA as well and the challenge is where areas where there’s not necessarily as much reporting of crime as you might expect we managed to um use some data about Hospital admissions uh recorded linked

    To alcohol misuse um and again I think that’s the team and the executive working uh constructively with what we have but thanks for that really do you have a followup councelor Gibson not really just to just to agree really that it needs National legislation we are as

    A license and Authority we’re sort of held back we’re doing everything we possibly can as you said with this itive impact areas in particular those licenses have actually been reviewed they’re not new licenses they review licenses because some of those premises were um yeah involved in things they

    Shouldn’t be let’s say without getting into it um but yes we need we need the national legislation simple as that thank you Victoria did you want to come in thank you chair just briefly on the um question and point around um addressing commercial determinants as Magdalena set out as well as the

    Licensing um conversation which is is really really important um just to flag that some of the other key um areas that um we will be Keen to look at more um and this is part of a kind of a a national International movement as well

    But just in terms of um being very aware and um mitigating as much as we can and and pushing back against the the very proactive um strategies of particularly the alcohol industry around um Mis Mis information of harm from alcohol um the the um um the resources that are created

    By the industry for example for education in schools around alcohol harm um which are created by industry you know with with industry kind of um interests in mind so um we um we’ve been doing some work to to understand that more and to and to um and to play much

    More into that um that sort of activity which which is is creating um harm particularly around the alcohol industry so so so again it’s it’s about um uh prioritizing that work um pushing back to Industry much more than we previously have done alongside everything else that

    We’ll continue to do thank you thank you very much for that uh Victoria okay I’m gonna bring in Dr John B next uh thank you chair I suppose this is not so much question but observation um but members may wish to comment on it I think it was very useful

    To look at the social determents and then build on another group the commercial determinants but I I see both of those as part of a much larger group The Wider determinants um and and that we’ve heard about the legislative determinants and there are the taxation determinant so there’s a whole range of

    Things which we actually need to be some some of which we can directly address in leads others need government action in order to put the context uh that we we might want to work with so that’s really just point one that we need to look at that whole wider determinance not just

    Uh those that we’ve already mentioned um and secondly it’s always slightly puzzled me why we always put drugs and alcohol together there clearly are some things which are common to both but they are totally different in context one is an IL the use of illegal drugs the other is

    A use of what you might call a legal drug at least a a legal substance to which people can become addicted so the addressing those as I say there are some things in common so you can address both of them using the same techniques and the same information the

    Others because they are different sub substances and different legislative arrangements and so on need to be addressed specifically for drugs or for alcohol not for both thank you uh Dr John do do you want to comment on that um other than I guess we’ll bring it into the conversation if someone brings something

    In Andy you comment I think yeah I think probably a kind of better use of the term would probably be substance misuse wouldn’t it then it kind of Inc capules anything that kind of creates an issue with with addiction or or kind of dependence so I think yeah yeah okay

    Acknowledge yeah and I think I think the point you’re making uh Dr B is there’s something around some of the there’s some kind of police enforcement stuff around availability of drugs whereas alcohol there’s no uh other than where you can buy it we can all go to a pub and buys

    Essentially as much as as we want legally um okay so I’m going to move I think that’s a fair comment to be made and something that’s worth um uh consideration okay you going to move on to councelor Taylor um chair I was going to ask a

    Question after Bill just ask but I just Dro a bit in I know you’re doing a billiant work and thanks for the report but I would like to see more done in the deprived area I know we talk about aals and there was six refusal sorry eight

    Refusal and six stop what ha up with those with those in the deprived area because that’s where um most activity is because there’s nothing better to do with the priv area so that tends to drugs alcohol but every other shops is alcohol and drugs and vaping what are

    You doing in the deprived area to slow it down just specifically on the refusals of licenses they were in um LS 8 and N um so we’ve we’ve prioritized um action in those areas um in terms of license objections uh and the C cumulative impact policies

    Obviously tend to be in those areas so that that there’s a framework there that are focused naturally um our attention is is on in terms of Licensing objectives um did you want to talk about the work that in terms of the service Etc and how it’s focused in those areas

    Or yeah maybe Nick do as well you do yeah hi um yeah we’re acutely aware of the the the need to for our services to be in the places where they’re needed most um that’s part of the oid investment this year we’re looking to expand into those areas of the greatest social

    And economic deprivation um we’ve got a robust uh Community engagement strategy uh so we anticipate seeing more of our staff more of our um recovery coordinators based in those areas that that you mention delivering the services um that would otherwise be delivered within our our units um of which we’ve got we’ve got

    Four across the city um so some much more Outreach Focus going forward I’m not picking at you at all cuz I know you’re doing Absolut blend job but I’m just thinking back 2008 9 10 I sat in this chair when it was Dr Cameron and that’s where he started with

    The smoking Sensational and I represent the priv area and it’s still happening there back you know up so I’m not saying you won’t get it done but there’s a big bot there well one area of work that we that we’ve been doing um for the last couple

    Of years Dan might want to come in on this is um we’ve been fortunate enough through investment to procure a number of fiber scanners for the city so we’re working in collaboration with um ltht and GP surgeries to to get those out and about and um uh do liver scans for

    For for the residents of those areas um so again they’re not having to um to come into a unit um to have a diagnosis uh we link directly in with the with the hepatology team Dan is there anything you want to add on that yeah in addition that that

    Project’s grown so we started with only a couple machines now we’ve got uh several and in addition we now have a a mobile unit uh which is run from the hospital which goes into different communities but I think broader and and and and Nick already alluded to this is

    The the the significant investment we’ve received has also enabled us to uh to increase not just work in communities but Outreach um and being able to go and uh have specific teams that uh look at specific populations and specific cohorts and that’s expanded through across the three years that we’ve got

    Funding and the next year the funding goes up significantly again um and we hope that we will be able to expand existing teams further but also new teams which we put in our proposal thanks remind you we’ve got some brilliant third sectors who they are the art of their community and who

    The Community Trust so please think about our third sector who does reach the community thank you we’re currently doing a piece of work to Um to consult with third sector providers um in the areas where where we needed um looking at spaces for us to operate from so um you might be hearing from us very soon uh counc thank you very much canc that’s a really really important question because

    As you know in similar areas to haill and trown organized crime thrives in that area and access to um alcohol drugs is is is so very common I think the last point you made about 30 sector so as part of the CIA work that we’re doing

    And the off licens work we we work we worked with um Touchstone um to do some intense Outreach work um with vulnerable individuals to support them um so I think you’re right we’ve got to tackle this from every angle and I think I’m really glad that this conversation is

    Happening at at the board to influence this policy in terms of working those communities and going to them um and I think that that’s that’s really important because in in deprived areas there’s so many complexities um so it’s important that we’ve got third sectors that are trusted in that community that

    Can work with those um individuals and and obviously the police plays an important part in terms of the crime side of it as well Anna do you want to come in just one more quick point I supp just wanted to assure you there such a there’s a

    Really big step up in the funding this year which you’ve hopefully seen in the paper so um you know it’s going to enable us to put a lot more um resource into the areas you you describ and so I know I know no I know you know

    Absolutely um just you you didn’t have your microphone on but I think I think we’ll take your your comment I think it goes back to what actually Dr B was talking about about the wider determinance of health and what what drives people to um addiction and drug

    Use or misuse okay I’m going to move on to councelor Richie thanks chair excuse me um thank thank you for the report I think it’s really thorough um I’ve not looked at previous reports I know there’s sort of summarized there I don’t know if they had the detail that you’ve got here but

    It does look to have progressed um through the years which is welcome and we recently had a briefing from forward leads um staff and uh I found that really positive really reassuring for us as members how the great work you’re doing which is backed up by your

    Outstanding uh rating of course um just few comments points um I just wondered what your thoughts are on um the sort of language around alcohol so alcohol is a a bigger cause of death than drugs it’s in the report and admissions to hospital and we’ve there’s been a big Focus around

    Advertising football shirts and what have you but I just wondered if you thought well perhaps I’m leading you here but I certainly think the language around alcohol needs to change so how many people are in WhatsApp groups where it’s wine o clock and it’s this and it’s

    That you know and it’s all taken as really trivial and it’s a good thing to drink and what have you and what impact that has on society and younger people who may come across that I remember I don’t watch Coronation Street anymore but they were always in the pub and

    They’re always drinking and when the’re stressed oh I I need a whiskey and it’s that sort of thing and if you agree we we have a respon responsibility around around that and then moving on to um drug use particularly cannabis use and it’s an issue that’s concerned me for a while

    And wanting to understand more about the effects and the impacts what I’ve noticed over the last 15 years the stats seem suggest there’s been a reduction in drug use but I think perhaps it’s a shift in how it used so for example cannabis I never got involved with it

    But as a stuent well I want to really student actually but as a younger person you associated with students after a night out that have a spliff this that and the other but now what I’m seeing in communities is people almost relying on it day by day they’re walking around

    Smoking cannabis you know um so that shift which concerns me and I did we had a a briefing on cannabis use and I’m really grateful for the response that Magdalena and her team produced to me on some of my inquiries but just to bring those to this scrutiny board and also

    Link them to the strategy one of the issues is around um outcome one and 4.1 about the education and impacts of of drugs awareness Etc and I noticed that the advisory Council on misuse of drugs acmd the acronym um have not updated the Cannabis used since 2008 and it’s now

    20124 um I think that’s long overdue for an update and I would have thought there’s lots of evidence out there now from the countries or states in countries that have legalized cannabis to have more information about the impact of the long-term use and so on

    And so thought so I just wondered I did notice in 2023 they reviewed the M midino cannabis use hadn’t there but nothing actually on cannabis so perhaps a comment on that and also on the medicinal use um access to to those drugs I think is difficult through the

    NHS and I expect there’s a degree of self-medication you make the link cannabis medicine’s good cannabis will help my pain so is there anything we can do to try and improve access to those medicinal versions which are obviously safer and and more controlled and then another point I want

    To make on page 38 there’s a comment about prison use and having find it get get the quote right continue use on an incentivized drug-free living Wing in prison I that tells me that we’ve almost lost control in prisons and it’s endemic it’s used throughout um which is kind of quite worrying

    Really um so I’ll leave it at that um and yeah thank you very much I can make a start on some of those excellent questions Council rich I think that you’ve asked some really searching questions so um I would absolutely agree that there is some social norms around

    Alcohol and we’ve already heard about alcohol referred to as as a legal substance and a legal substance we know causes significant harms and I was just reading this morning a paper from America where um they were discussing that most Americans don’t realize alcohol causes cancer in fact some Americans think that alcohol prevents

    Cancer um and yet the World Health Organization has told us that there is no safe amount of alcohol that we can consume um in terms of can you know in terms of a risk of developing cancer so we remember I think some of us remember when cigarette packaging didn’t tell us

    That smoking caused cancer and I imagine that our grandchildren your great-grandchildren will be surprised that there was a time when bottles of beer and bottles of wine didn’t have the message alcohol causes cancer alcohol directly causes seven times the cancer so you’re absolutely right to call out

    Um our um messaging and our social norms around alcohol I think unfortunately as Victoria’s already alluded to the alcohol industry um is very unlean on some of the measures like minimum unit pricing and labeling harms labeling so I think um kind of members in this room

    That maybe have some more more kind of political and lobbying influence that that might be that might be something to to kind of consider um cannabis as you you alluded to we did prepare a report which was about um cannabis in leads and one of the things we very frequently heard from

    Localities teams and communities teams was that people were using cannabis daily to self-medicate for conditions and as I wrote in the report that concerned me because cannabis isn’t effective for a lot of conditions it’s only effective for a specific number of conditions um for which um prescription

    Is available but as you point out the sort of Doses and administration that people are using to self-medicate they’ll be taking in more tobacco often they’ll be causing more harm through self-medication and that’s not to hate on people who are genuinely trying to sort out their difficulties and their

    Problems um so I think there’s kind of an urgent need for us to try and help people with those difficulties and tried to get them to proper sources of help um for the conditions they’re trying to self-medicate and some of that’s about GP access some that’s about um Treatment

    Services um talking to people about their long-term conditions and linking them in with with kind of help for those so they’re properly uh properly helped um I won’t talk about prison drug-free Wings because I think handy might be might be better placed to do so if that’s

    Okay I think the issue about prescribing of cannabis um for medical use but has been raised before and I just wonder whether scrutiny might want to um ask a a medicine’s management expert to come and explain the process because there is some there is some guidelines on it Etc

    So if that would be of interest maybe that that might be something you want to do it’s obviously be an NHS colleague than ourselves I think certainly getting a briefing note following up so um and if you could Point Angela in the right direction um the report that Melina said

    Previously which was circulated around the whole board and this meeting will be suitable followup okay great I’m going to let let Andy come in next yeah thanks that Moe passing over that question it’s probably really quite difficult for me to answer as a politically neutral civil servant um so

    Uh but I think I think yes I think you know I think you’re right in highlighting that I think probably you know without kind of getting into the politics of it too much you know it’s something that not some an area that o has particular influence over the

    Running of a prison U but I think you know I suppose what that is doing is actually acknowledging the fact that there is a need for in prison and I suppose you know to to ignore that would probably be uh remiss really and I think yeah y like you’re saying is it’s almost

    Kind of telling the story that potentially we may have lost um control over over prisons but I think to to dismiss that and not acknowledge it and not provide help for those people in there would probably be a worse crime um but yeah really difficult for me to answer that one I’m

    Afraid Thank you councelor Rich do you have any followup not really chair but just just to say um which I meant I did I forgot um just linking him with the wider determinance and it is covered in the reply that I had from Magdalena um I was concerned about the impact particularly

    On children and families and that that is sort of recognized in the outcomes that sort of cannabis use in the house um is having on people um but it’s kind of been covered by by Dr Beal and and the offices so I’ll leave it at that

    Thank you thank you very much for those questions counc richin again it’s interesting you go back um to certainly when I was a child smoking in the house was like cigarettes was normal um and there’s a risk that we come full circle with um uh cannabis okay I’m going to

    Bring in uh councelor Anderson next thank you chair can I just go back to the um issue of the police that um councilor Ari raised on page agage 37 outcome three there is quite a lot of reference to West yorshire Police and their involvement in this plan so can I

    Just ask you how often you meet with the police and what sort of relationship you have with them residents in my area report drug dealing quite often on streets they know exactly what time of night it’s taking place they know the registration numbers of the cars but the

    Police go off in a different direction they’re not interested sometimes they even know the the make of the car as well so if they know the time of day where it’s taking place and the registration numbers doesn’t take a lot of resource to just go and be at that

    Point at that time and it just not happening they’re just not interested so until we get that relationship right we’ll never break these gangs thanks councelor Anderson I mean I can I can speak about at a strategic level and then I wonder if colleagues have I’ve got a better answer an

    Operational tactical level so it’s a strategic level We join the West Yorkshire combating drugs partnership which is chaired by Allison low who’s the deputy mayor for policing crime um and we also are members of the safeer leads executive where West George police are represented um and the reducing

    Reoffending board acts as a subgroup to the leads drug well we we they don’t act as a subgroup we um we would take issues to them so for example we took this strategy to them and West Yorkshire police and probation have had input in in this strategy um through that route

    So as a strategic level I think we’re very well joined up with West yorshire Police at an operational level at a neighborhood kind of community level um I’m going to have to defer to other colleagues who might be closer closer to the ground I don’t know if Nick you’ve got anything to add

    Yeah um so we’re increasing forward Le we’re increasingly um uh linking in with the with the police um in response to uh well in relation to Crim criminal justice objectives so um just to come back to councilor Richie’s point about um prisons so we work with uh the the

    Prison service and uh the probation service in terms of uh people that are are released from prison so our uh aspiration is to see as many of those people that that that do have a a need enter treatment as quickly and as efficiently as possible also with the

    Police um we’re involved with with them across multiple um elements within our service delivery so we have a criminal justice team um it’s it’s an evolving um relationship um but one that’s incredibly important so although those those relationships aren’t maybe um where we where we want them to be

    There’re certainly on that on that road to um to collaborating to provide an effective an effective service uh doesn’t really sound very satisfactory but um I just this is what you would probably call lowlevel drug dealing but it is that’s where it all you know it’s all filters down to there

    And until you get the people at the top you’re not going to stop the people at the bottom but we still need to tackle it from the bottom up as well so it’s a shame we haven’t anybody from the police here today actually I know this is not a

    Crime scrutiny board it’s a health scrutiny board but all the same they are they do feature quite heavily in the in the plan yeah thanks for that counc Anderson and it’s uh certainly something I see in parts of my ward as well where um to be

    Fair the police and the um uh leads antisocial Behavior team work quite closely together um and they shut down houses and I often think they’re playing a bit of a game of whacka all because you shut one house and another one pops up and I think there’s that strategic

    Piece which is the county line stuff and um and I always worry about the young people who get drawn into it on their electric uh bikes selling drugs so I think um if the board supports my suggestion I think we should write as a board to um the police and ask um for

    Some reassurances and saw your hand up do you want to come in do you any comments on that yeah uh Council Anderson I was going to suggest that I um contact UM safeer lead’s colleagues if that be okay with your query anything that you can do to help us much appreciate

    It yes yeah and and I think that’s still there’s there’s something in writing to the police recognizing the challenges that we’re seeing across the communities in lead yet Victoria com in as just very briefly to add that the um the police do sit as partners on the on the drug and

    Alcohol partnership board um so we will work with them through the board and and and I’m very happy to take this conversation back to the board so we can do all of those things but just to reassure you they are around the table of the board as

    Well thank you very much okay I’m going to bring in uh councelor James next uh I think I might be helpful with this the poli’s strategy as I’m told is they’re not after the kids on the bikes thereafter what’s supplying them and sometimes I I made a various complaints

    To the police about a particular piece and it ended up with a major raid and with a major catch and I think sometimes that’s their strategy now I don’t like that strategy but I understand why they do it that way but that’s not my question so that’s that just that’s

    What’s coming to the place from when we’ve asked that question um I’m interested in two things particular is one is the work that you’re going to do in schools or doing in schools how many schools have you actually got into and have any of schools actually said no

    We’re not interested in this because this is a Citywide problem and there the second question which I’ve had some personal experience of dealing with ex offenders who leave prison went into prison with no addictions whatsoever and actually came out of prison with addictions so what is the connection

    Between when they leave to be thrown out to do whatever and then why the addiction that they have what help is there for them and are they directed as they come out of prison and I think that’s quite a serious problem I I directed a gentleman to last week

    Actually who was was waited five weeks for an appointment it wasn’t particular by that but has actually got some good help on that but my concern is what connection do we have and do does actual prison service understand that when they’re giving people things that are potentially addictive there is a longer

    Term effect than after they’ve left prison yeah well we have um we have really good uh relationships with all the refering prisons in the region um we see a phenomenal amount of people referred to us from the from the prison service whether that’s Le or Wilston wherever um and increasingly we’re we’re

    We’re targeted on um making sure that those people come in make it into treatment so it’s um yeah yeah um Andy’s just showing me the ndms um which is the National Drug Treatment monitoring system uh data so in leads we’re actually performing above the national average um

    I think it’s is it 60% on three month basis yeah 57% uh with the national average at 40% so um and as I said being in the biggest uh County we’re take we’re taking referrals from from all from all over uh which is which complicates things but um as as we

    Can see from the from the ndms data the performance is the trend is going upwards so we’re getting better at um supporting those people into into the service um um and some really good news as well um not Le specifically but the York h is now the second uh best

    Performing uh region in the country on continuity of qu care from leaving prisons into drug treatment what was the first part of your question again oh you young people’s yeah yeah schools basically a lot of the addictions may start at a fairly early age with teenagers in particular I’m

    Interested what work you doing with that to buiness yeah so we’ve got a really high performing young people’s service within forward leads we are based in many schools I can’t give you exact numbers but um we we do have a team of staff and an increasing uh expanding

    Team of of uh young people’s specific workers that go into schools through the oood investment this year we’ve we’ve appointed uh well we will be appointing um additional Staffing to to um to support that that work that’s already happening uh that’ll involve group and community community workers so again it’s it’s

    Getting into the schools getting into the community areas working with um in a community assets based approach um so and the performance in terms of um people young people leaving treatment successfully is again above the national average so there is a definite commitment to to young people thank you

    Will you be able to follow up on the number of schools that have been worked with and how many if any have said no to support I certainly will yeah you do you have a followup no thank you I just um it’s in interesting maybe not uh just a

    Comment a link I know a lot of third sectors are trying to talk about um knife crime in schools for example the Le United Foundation is trying to go into most schools about knife crime and it feels like there might be an actual link to see if we can uh work with third

    Sector on that that messaging and Link in the two I’m going to Bringing Down you put your hand up yeah thank you chair um so so yeah go to address both of those issues so the first one the school so there’s a multiple prom attack with regards to

    School so Nick’s already outlined that uh the forward lead service have a a really well established Young Person’s team and obviously the the funding for next year we’re going to grow that and they work in schools so that’s that’s one aspect uh in addition uh we have

    Safer schools police officers who who go into schools as well uh and also talk about drug and alcohol issues um particularly in relations to to antisocial Behavior crime the law Etc and then on top of that lead city council also uh have a team that uh work with schools um around um various

    Aspects of of the curriculum in which drugs and alcohol is also uh um part of that on on the other uh aspect which was which is the criminal justice side of things and and prisons to to community so um continuative care is so that’s that’s going from uh prisons to

    Treatment services in the community and also the other way around uh is a is a is a big Focus for the for the national uh strategy and that’s reflect both uh in lead city council uh across across our teams but also the in collaboration with the the treatment service and and

    The prism um to um to raise the number of people who who are coming out of prison who need drug and alcoh treatment going into that treatment and to and to remove uh many of the barriers that that that are there um in addition uh we’re

    Looking to to raise drr which is drug requirement uh drug sorry drug rehabilitation requirements uh and alcohol treatment requirements so that’s people uh through the courts who uh can be given that option to to go to the service and and have uh uh treatment for for those those issues and and and as

    Has been mentioned there there’s there is a big move generally in terms of Criminal Justice roles many more drug and alcohol uh workers who specialize in criminal justice that not just the forward lead service but our integrated Defender Management Service uh and uh those working directly with uh all of

    The other criminal justice agency so we’re talking police custody prison uh courts and probation thank you chair Toria thank you chair just in relation to the um point about um schools I think um just to make a a a broader point which hopefully is helpful I think it’s

    It’s it’s really it’s really good to have a comment on the question around what are we doing kind of Upstream around prevention um and obviously it it um the first part of the strategy is to reduce use in the first place I think the the really important thing that I’d

    Like to share with this board is that the additional money that we um have received temporarily from through the through the government um is predominantly for for for treatment services which is incredibly welcome and and we’re doing some wonderful work in the city around treatment um but we we

    We want to stretch that as much as it’s possible to use that more broadly um around prevention and support um and The Wider determinance um you mentioned at the beginning councel scope so there is a little bit of an art in in doing that we we we’re making the point back to

    Colleagues in oead and broader that there’s only so much that you know treatment of young people who are already you know harmed by substances is one thing and it’s very important but we have to have more capacity to do much more work around around Skilling up young people to navigate this and pre

    And preventing use in the first place and that’s the area that there isn’t any explicit new funding around we’re having to create that as we go so it’s a really good point um but just to share with you we we’re trying to be as flexible and

    Move as much Upstream as we can but there are criteria around the funding that make that quite tricky at times thank you thank you for that Victoria that’s really helpful okay I’m gonna bring in councilor harbrook next thank you chair um I think Victoria may have partially answered the first

    Bit I’ve got uh one comment one comment which leads into a question and one fairly simple question um reading through the report there’s a lot of really really good um outcomes and activities and things that are listed in there one thing that stuck me is other

    Than on page 29 where it talks about impacts on children I personally felt there wasn’t enough around the secondary victims of substance misuse you know that the the children the parents the partners because you know the um the outcome for the individual who’s addicted is is one aspects and there’s a

    Lot of really good stuff in here around treatment but actually that whole thing around the wider societal impact which actually can often be crueler and more devastating because for one addict that can you know have a impact on mult multiple individuals um the next one was again

    Feeding into the outcome uh I’m very interested in terms of the the individual sto stories or whether there are cohorts that are identified so for example in you know just calling out the young person who goes out on a night out and may not be addicted but has an

    Accident due to inebriation is one type of you know harm from alcohol compare that with the poor guy that I saw lying outside Matalan last week sort of completely coma so it’s clearly homeless clearly drinking as a source of last respite is a very different strategy to

    Approach them I would imagine then for example you know a middle class home Drinker who you know pops into Tesco on the way home every night and take something home with them or like as was touched on by one of the other um members the the roots and strategies

    Where people you coming into and out of prison or into and out of Care Homes have so I I personally would like to see more in terms of not the stories but you know I don’t know if it’s where this leads into a question is is it fair to

    Cluster groupings of we are going to aim at this type of person um whe you know whether and clearly you know there are differences from everyone’s individual but whether it’s fair to make groupings and whether that would help make this Mo make this what is a very very thorough and very

    Very detailed list of actions be read in a way that is more ah I see who you’re trying to get up with this with this approach so that’s kind of where that leads into a question and then the final question which is a fairly simple one is anally I hear that

    Younger people are drinking less and it’s less of a problem um I just wondered whether you could kind of comment in terms of the long-term trends in terms of alcohol use and how that’s changing the work that’s been done thank you thank you for that really helpful question councelor hartbrook um so I

    Would tend to agree that you’re right that we need to have a stronger focus on what people often term affected others so people who aren’t using the substances themselves that might be in the household um they might be colle colleagues of people who are using substances so I would agree with that

    And I know um councelor Arif and Caroline barrier have asked us to take this to us and Cara groups so I hope that when we go to the Cara groups we’ll be able to kind of add some um kind of really rich detail and Nuance about what

    That needs to look like and the strategy from the people who are directly affected so thank you for that challenge that’s really helpful um on the second question I I think you are also right that there are there are different cohorts there’s different experiences of alcohol use and

    That we might need to stratify those cohorts more so just an example we’ve got a role within leads teaching hospitals trust who um trains the workforce around identifying alcohol related harms and using a test that’s called audit C alcohol use disorders um three question test so it’s about do

    You drink and how much do you drink on and on how many days it gives you numerical score and that gives you an idea about whether that’s likely to cause harms and be problematic and therefore whether you’re likely to need treatment so that would pick up the

    Young person who’s fallen off their high heels typically and has got kind of cuts and bruises and and and hopefully not head injuries it would pick up that person coming to a KNE but it would also pick up somebody who’s maybe um I’ve heard um I’ve heard A&E staff refer to

    Sunday sippers so kind of people who are lonely and drinking alone and then they come to A&E maybe because that’s triggered another health issue but alcohol is the other uh the alcohol’s the trigger for that so again A&E can pick up those people as well and obviously the very vulnerable Street

    Cohorts so Al no although not all those people will end up at A&E for those that do I think that we’ve got we’ve got a route to identifying those people experiencing harms and providing them with very brief advice and referral into treatment and I think I think it’s right to kind of

    Stratify um those um the data does tell us that that drinking in young people is declining um I’m not in leads I don’t live in leads I’m not in the communities and I think I’d be really interested um because the data is only one part of the

    Story I think be really interested to hear what elected members think about that and what they see in their communities and third sector organizations because it’s fine looking a line coming down on a chart but it’s very different in your communities and what you’re seeing so I think we we’d be

    Really open to hearing about that thank you thank you and just briefly to add to what Magdalen has said that um even though um it justes look like the trend is changing with this younger generation to to to less drinking alcohol um and we do need to understand more about that

    And and why and and what they’re potentially replacing it with um the the um the drug related deaths are still going up so that that kind of work through to to harm hasn’t yet happened and um so we’ve seen an increase of about 25% of drug rated deaths in the

    Last couple of years um so again it’s it’s kind of really keeping an eye on kind of prevalence and is that actually right and therefore is it it’s not working its way through to the data we see on either harm or death at the moment which is obviously what we’re

    We’re very focused on and in terms of patterns of of um groups of people as well um alcohol always been an interesting one um in its complexity of how it plays out across a city like leads um so really different to some really different to smoking for example

    Where you know they’re more priv the community um the the higher the prevalence whereas in alcohol um people from all communities tend to drink about the same but the more harm is caused in our more deprived community so this there it’s that relationship between you know patterns and type of drinking not

    Just level of alcohol consumed which is really different across different communities um but I really welcome your points around um get into some of those individual stories so people can see how this relates to different people that we we need to support thank

    You no I was I was just going to jump I mean clearly as you’ve articulated it’s a very very complex picture and I think you know drinking and smoking are things that have you know that take often take decades for the full effects of an addiction to to to materialize I think

    I’m curious as to you particularly with the younger people because I I know from from you I’ve got a 22y old and a 25y old not speaking about them as particular but talking about their peers and possibly them at times um I think there are there there’s a higher

    Prevalence of people who don’t drink at all I think there’s Al there’s a higher prevalence of those who I think what what seems to have gone is the more of the kind of continuous casual drinking it tends to be more big nights out so more impact when there isn’t so probably

    You have more accident related more kind of uh um but it’s it’s a very interesting picture and I think it’s interesting as to you know if alcohol’s going down good but if that just means that they’re doing something else instead then potentially it’s you know

    The same or even worse so I think it’s very it’s very interesting to sort of to UNP pick that and just work out what the trends are but also to work out actually what’s the cause and cause versus correlation of that thank you thank you and do you want to come in

    Yeah just kind of reter sort of drill down on some of the Points Victoria they made there about about yes um you know the the kind of number of people that are particularly drinking is falling and that is accelerating as well so the number the people that aren’t drinking

    Accelerates and is more and more over years uh that have gone uh but also as well it’s still the second um highest rate of referrals is for alcohol in young people’s drug and alcohol services and what we’re finding is that those who are drinking are drinking to higher

    Levels with more risk involved often comties mental health uh also poly drug use as well so that they may be drinking less but those who are drinking are drinking in a more problematic fashion which I think speaks to what the kind of stuff you were saying there as

    Well okay thank you very much for that okay I’m G to move on to councelor France May hello thank you for the report um I think some of the questions um I’m going to pose are possibly being answered um in a roundabout way as well I think one

    Of the um points I want to make is regarding on page 34 you talk about developing um targeted treatment priority groups and vulnerable groups I just want to say I have noticed for the last couple of years um forward leads have been looking at the Muslim Community especially leading up to

    Ramadan um but I do think that needs to probably start a little bit early rather than the month before probably three months before to to to um to start raising awareness but I’d like to know more about you have you know in more detail what you doing basically to um

    What work you doing with those groups you know what work you doing with the mosqu the temples and the local churches in getting into some of those um hard to hit communities and the second question I would like to ask is on page 40 you talk about um again it’s the forward

    Leads um vulnerable young people and um to receive targeted input and information from services and I know Victoria you’ve mentioned about um funding and capacity which you know completely understand but my concern is we’ve got young people that are in our system in in our care system and they’re

    Leaving the system and going into the world but what what interventions are in place to support those um those young people in you know in in the chaos of it all really um So within our 2425 proposal to oid um we have included uh a Young Person’s care lever

    Coordinator so um that was uh that’s a new area for us so that’s something that we’ve re one one at the minute yeah uh so that’s something that we’ve um we’ve identified as a need um and an area for Innovation for us so uh they’ll work obviously within The Young Person’s team and

    Um work with um uh those young people transitioning from from from the Care Home sector um in answer to your other question about uh working with communities uh that is a current an ongoing piece of work that we’re doing so we’ve got the the community engagement strategy so what we where’re

    Where we’re at currently with that is identifying as I said earlier in where we need to be um which uh communities where we don’t have a a presence in um we’ve got some work to do in terms of uh our service user population being representative of the

    City as a whole which at the minute It Isn’t So we recognize that that we need to do that and we need to get out to those places where um we need to build trust and um develop relationships with with communities and with leaders specifically with leaders within those

    Communities so part of that work will involve going to mosques uh developing those relationships we don’t expect um that you know that trust to happen to De to be developed overnight that’s something a longer term strategy that we want to um create um so that for whatever reason restricts

    People from from contacting forward leads and seeking help that uh there’s that trust there that that that that they will approach us thanks thank you dear follow up M uh Council fance me I’d probably like to see a little bit of that strategy if it could be forwarded on really I’d like to

    Have a look at that yep I’ll f with that on super thank you very much Nick okay I’m gonna bring in councelor kider quite a few points actually um after councilor Anderson said about the police uh once a month we do our safety meeting with the police and uh every

    Month we bring up this about the um uh you know where the where they’re picking the drugs up that the queue and it’s like a bus stop and I appre I I agree with councelor uh Anderson that I just don’t think the police take it serious

    Um you know we are asked to keep our eyes and ears open but yet you know and I’ve heard this uh from a pcso oh will they’re not so bothered because at least they know where they are now to me that’s wrong so

    That’s the first thing so I I do I I do think we really could do with somebody from the police coming and talking to us going back to the liver about the liver testing um we were approached in Moy to the Town Council by our um community

    Champion at Morrison’s and we had a a Evan come into the car park in Morrison’s um the end of end of January 26th of January now I haven’t heard any results as yet but as far as I know there was quite um if you can say a

    Buzzing town that people were going when they knew that it was free to go and you know you you wait ages for a doctor’s appointment so I actually say that’s great and thank you for that um going back to the drugs and alcohol um in

    Moley I mean we we don’t have a big big problem but back in the 80s 90s the serious drug people now have gone into being alcoholics now what we had in Marley was at mly Town Hall we had regular on a Monday night uh a meeting uh a bit like

    Alcoholics Anonymous or drugs Anonymous where people came together now I can’t think that that’s happening now and I wonder if if anybody could check that up because it was a regular thing on a Monday night at mly Town Hall and there was always quite a lot of people there

    Started at 6 o’clock went until maybe about 8:00 and they purposely kept the town all open which are no cutbacks and what have you but I’m just worried that in mly uh you know we’re not getting that service of somebody could come back and let me know about that um and to be

    Honest you know we’re talking about all this drinking drug I think our next problem is the Vapes and I think we really really need to get a grip of that VAP these Vapes uh you know they’re all saying oh they’re safe and this and other no

    They’re not and uh you know there’s so many business particularly in Mory um that are selling them and you can see youngsters uh you know I do in vigila in a school and they’re always catching kids with with the Vapes which at 12 and 13 year old 14 year old is absolutely

    Diabolical but I do think that’s going to be our next thing after the drugs or as well as the drugs should I say um and that’s all I’m saying thank you um thank you councilor K just um just Vapes first um as you know we did a p at joint work

    With Council covering children’s families board so they are doing a piece of work on The Vape so I think that’s probably for their board for the children’s they’re hoping the government will ban single use Fates which will hopefully reduce children’s uses but 100% agree with you um and uh just also

    On the place I think your comments uh noted as well I think goes back to I think as a board we do need to write to the police but also the other comments made earlier around Victoria feeding back to the well health and well-being board but Magdalene do you want to come

    In as well yes it was just a comment about the mutual Aid meeting that met in moley I don’t know specifically and I can look but Public Health um intelligence um working with forward leads and others we have created a map of mutual Aid so smart recovery groups

    AA groups na groups um alanon groups for families uh Cocaine Anonymous groups so we have produced that map and I know that there is a commitment in terms of um increasing the the number of smart recovery uh groups as well in leads so we’ll get that map to you and we can

    Check where the nearest meetings are we can’t guarantee because they’re they’re volunteer organized they’re they’re kind of peers helping each other but if anyone does want to set up a smart recovery group we’ve got a link into smart recovery nationally um there’s training available for people to set up

    Smart recovery groups there’s a license there’s lots of support so we’d really support people who want to set up Mutual Aid um so yeah we’ll we’ll be in touch thank you thank you very much um just a question for me around um so on the last

    Page of the report uh it talks about key performance indicators and I think you say you that that gets reported to the health and well-being board would it be possible to share one of those reports with the screening board so we can see sort of data you get and how it’s been

    Monitored and see magdalina nodding so I’m taking that as a yes great okay and then I’m just going to bring in um councelor Richie for yeah thank you it’s just on the mutual Aid groups and councel which makes a really good point just to say um I sponsor um four rooms

    In the Civic Hall uh Monday to Thursday or Friday one day off uh which is just an administrative thing you know I’m not trying to claim I’m a here or anything but that came about um each group does run as its own separate entity and that came about someone approached me about

    It I met them heard of what I’d never heard of them before i’ heard of AA but not not any and uh it works really well I’ve got through Co and they’re still meeting every year the book of the room so I guess it is as Magdalena says down

    To an individual volunteer to want to set those group and just a nice footnote every year they make a voluntary donation to the Lord May’s appeal in gratitude of of views in the room so doing some great work okay good um we I think we’re

    Coming to end of that item I can’t see anyone else indicating um but just want to thank officer and um and guests for coming I think it’s been a really uh helpful conversation and and I do think it’s worth uh just noting again um about how you guys have been recognized so

    Nationally for best practice and so that’s that’s really positive and it it’s good to be doing good work so thank you very much for that and obviously great work that forward leads is also doing um so that I’m going to close this item and just going to um basically

    Everyone who’s a guest is is changing around so I’m going to have a 10- minute 10 minute break while we change everyone um I’d really appreciate if everyone’s in their seats by 5 past three at the latest so we can start again all together thank you very much

    Okay uh welcome back um can I draw everyone’s attention back to this meeting in the room thank you very much so for our second substantive item um item uh eight on page 49 um obviously very um important topic but very sensitive topic um but I think Karen’s

    Goingon to uh lead with a bit of intro about that so I’ll hand hand over to you um as I say to everyone you can assume that we’ve read the papers um do you want to comment first cank yes please chair thank you um so lead is committed to reducing the number

    Of uh lives lost to suicide every death is tragic leaving a lasting de and devastating impact on families friends and whole communities factors leading someone taking their own life are complex and are rarely down to one reason this is why no one organization is able to directly influence factors

    Alone and it’s important we must continue to take collaborative and systemwide approach this is De demonstrated by our strategic approach and the development and delivery of our action plan it’s great that we have Representatives here from the third sector leads ICB to support the work that’s being led by our Public

    Health Team and I thank them for their time today we can never really mitigate the impact of broader policy or national or Global incidents nevertheless our action plan for the city aims to prevent suicides locally by targeting our resources in effective approaches that work I I will now hand over to to car

    And the team to tell you a little bit more thank you thanks Council for that introduction um I just wanted to welcome the colleagues that are with me so I’ll let them introduce themselves and then I’ll just say a little bit uh by means of introduction so Rachel do you want to go

    First yeah thank you hi everybody I’m Rachel Bley I’m a health Improvement principal in our public mental health Team hi I’m Ed Vine had pathway integration for the lead’s office of the West Yorkshire ICB and hi I’m juel sson I’m from Le’s mind so a representative of the third

    Sector I’m like Hannah I can’t press the button but it’s obviously a habit in the public he um I just wanted to say that talking about suicide can be really distressing and upsetting because we know we don’t know whether anyone in this room or or anyone who’s watching

    The webcast has been touched by Suicide so I just want to remind people at the outset whether it’s in person or people on the webcast um for anyone who’s been affected or bered by Suicide um I’m welcome for them to take any time out of

    This meeting um and and take time out um what I would say is J is here today on behalf of these mind uh we we are thankful in Le to have a suicide bereavement service um which people can access if they want to um that’s

    Peed and they can access that by uh the website of of leads mind or by calling and I’ll give you the number 0113 305 5800 now that’s not a crisis help line was for anyone who’s been bered or been touched by Suicide um and as I said

    It’s pure Le so I just wanted to say that at the beginning I wanted to start from the standpoint that suicide is preventable uh and our strategy uh and action plan is really based on that um it’s led by our strategic Suicide Prevention group um which has membership

    From across the city uh with a W very wide range of organizations um but those organizations that have got the greatest potential uh to address suicide and and make the greatest impact in helping to prevent suicides um that’s there’s Council there’s NHS colleagues uh there’s people from third sector organizations

    Universities police transport and and obviously the Samaritans and but we do also have our broader network uh which duels currently chairs um which has a range of individuals and organizations anyone one who’s interested in in suicide prevention uh so colleagues and those with lived experience have been affected

    By Suicide have collaborated in this plan it’s not a plan that just um Us in public health have sat down and written um it we’ve had a workshop and wider work around developing this broad plan so the plan just very briefly is based on both national and local data we also

    Have local realtime surveillance data that we received from West yorshire Police and we also did our lead suicide audit which was uh for the years two 2019 to 21 um for E we’ve structured that um strategy and action plan based on the national um strategy that was launched

    In September last year we know from published evidence many of the risk factors that might lead someone to to take their own life so in the briefing paper that you’ve already seen and I I presuming that you’ve read it um includes how we ensure we’re targeting our work to prevent future deaths there

    Are a number of caveats um and Rachel would tell me off if I didn’t raise that um about using data and evidence um and it’s very difficult it might seem like a small number um but what I really want to stress can’t stress enough really we must always remember that every number every

    Percentage uh we’re talking about today is a person in leads who lost a life to Suicide so I would just like to remind members today the about the importance of language when we talk about suicide uh I think counselor Scopes um has already raised with you around uh

    The the language guidance that we shared as an appendix um so I really just um ask colleagues if they want to add anything and then I’m happy for it to be opened up to questions so thank you chair thank thank you very much um George do you want to give any comment

    In terms of third SE sector uh sure I can do I guess just to say though I am representing leads mind one organization one third sector organization and in leads we have got a vast u a vast and big third sector um third sector so I am only representing

    Le’s mind um but with that real sort of look to we have got loads of other organizations doing great work and as as already mentioned in the previous item that there are trusted um organizations in different communities across leads as well so it is about us all sort of

    Joining together um and I think what’s been what’s great about the network and the Strategic group is that that Collective voice is very much part of both of that and is very much part of the action plan thank you do Eddie or want to make any comments

    Eddie I I’ll just come into cir because of course the the the funding and the programs of the work we have in the NHS particularly related to mental health are very specific but similarly being part of the Strategic group and the network it really helps us to Target the

    Resources in terms of what we’re genuinely understanding around where risk stratification is telling us that effort should be directed at um I I think some of the learning that we’re getting through through some of the better data quality from the surveillance data is is is infinitely more helpful than it’s previously been

    And what we’re not getting is the the lag in data coming through that we’ previously had through through National Suicide um through enish Etc which has been great and and and really helps us to to think much more proactively about how we are targeting and and and pushing our local priority should

    Be okay thank you very much um so we open up to questions from uh members in um I’ll I’ll start I know Karen we talked a bit about um about the date in terms of ethnicity in terms of whether we can um there’s groups that we need to provide more

    Support to I just wondered if um and I thank you for the extra data in here about that I guess just wanted to highlight it here um because I I think um just want to get your take on if if more data is needed and would it be

    Beneficial to you and your team if that was recorded yeah it would be very helpful um we’re getting um more and more data locally on our on our suspected surveillance data but what we’re still finding that when we do suicide audits of the coroners records um the issue of a number of

    Different things including ethnicity is still not being largely recorded um and I think that’s a national issue I don’t think it’s just it’s not just leads um it is a national issue um but really it’s of great concern that protected characteristics are still not being recorded by Coroner’s records

    Routinely um and I think we need to think about how we might escalate that issue we raised it at our last suicide audit we’re reason it again in this suicide audit um and it is concerning that it other organizations have to record it why aren’t the coroners

    Thank you for that Karen and and and it it it’s certainly something we’ve discussed um as well as an EXA member it really does worry me that this we’re not recording um the ethnicity I’m looking to um write a letter to the coroner I wonder I mean if the the board would be

    Minded to do the same to to to to put that pressure on really I think it’s just crucial to have that data because it helps in terms of how we respond as as a service and what we do in terms of targeting thank you very much and um

    Yeah I think unless members object i’ be very very supportive of that um and then the other question it might be more um for uh the ICB in terms of commissioning work I know that um the on on page uh 98 of the pack the table shows that

    Um 165 deaths were um mental health was a factor and I guess that uh brings you to the question about Mental Health Services in in the city and I and um when I was reading a report I also noted that um there a small race tragic number

    Of um young people under 20 or so um in in that group and I just wondering if is there a big overlap in the young young people I guess what work has been done to tackle mental health iess young people and uh all age groups thank

    You so I suppose as I pointed out earlier there are a couple of big transformational programs that um have come with targeted investment in terms of improving um commissioned resources for uh people with with with more complex mental health needs um I think there’s a number of things in

    Terms of some of the work we’ve done through through understanding some of the data um we’ve we’ve for example we have a a range of um um grants funding schemes trying to work differently with communities because a lot of the challenges in terms of engaging um with some population cohorts is the distrust

    That they have of statory Mental Health Services the distrust that they have of um um the NHS in in in general um and this this and the distrust of Clinical Services really um through part of our community transformation program we’ve invested to dat I think half a million

    Into grants funded schemes through uh Grassroots Community groups through targeted work with communities in terms of um identifying how we could support people in terms of that proactive early offer for intervention um the schemes that we’ve recently done have been targeted at um I think young black men

    And targeted at um where people are experiencing the real impacts of the cost of living crisis so really paying attention to the wider determinant help issues and impacts also where they’ve particularly have that intersectionality with with sort of deprivation and and the added complexity that comes with

    Having a complex mental health need on top of that um all of all all of this understanding is is part of the way that we have developed and co-produced our response to um improving our uh mental health provision uh through Community transformation and crisis transformation um the work has all been done through

    Engaging with people with lived experience and engaging with communities particularly communities where we know we haven’t had that reach in terms of statutary provision previously um and I suppose we’re at the point of launching this new model of care that wraps around local communities rather than sits

    Within sectors um uh um on a larger scale which has always been the barrier I think between communities and um and Mental Health Services per se um so we’re starting to go live with that in three early implemented sites in April which would be really positive so these

    New models of care will work around local care Partnerships with our vcse partners with primary care networks um and with secondary Care Mental Health Services in a way that doesn’t just Silo someone’s mental health need out with The Wider determinant impacts that really Drive good mental health and

    Well-being um and addressing those needs not in silos um so that feels quite positive and quite a step forward and all of that’s been designed and developed um and co-produced with um the communities that we’ve uh worked with in terms of setting those up the one last

    Point I’ll make is um previously that the staty services have delivered a a model of Community Mental Health provision that is just isn’t different no matter where you live um this new model of care will have an element of that that’s the same in terms of the clinical care and what’s the best

    Evidence in terms of the interventions that are required um but it will also have that bespoke um piece which is the personalization to local community needs that we’ve done in a a really data driven way to understand what the population needs are wrapped around each each local care partnership Primary Care

    Network area which is a a huge shift from how we’ve done things previously um I hope I hope that explains it and didn’t sound too waffly but I suppose we’re trying to get it to a population Health Focus that’s genuinely rest stratifying where we should Target the resources rather than looking at a

    Citywide sector approach to driving mental health care and chair if I could just come in to to add to that um that’s about Services when people are are in those Services what I would also stress is the work that we’re doing for our own young people in terms of prevention and I

    Think one of the previous scrutinies we came and talked about the mental health strategy which is all age uh and the prevention aspect in Priority One so it’s thinking about that as well we it’s not just about the services it’s about that prevention as well and certainly we

    We have a grants program specifically focused for third sector organization around Suicide Prevention that very Upstream work so it’s not just about the services it’s actually trying to think about that the good mental health and wellbeing and and that prevention agenda which we we are invest in across the system as

    Well wanted to uh thank you just wanted to come in that point as well um so the the audit data that you’re referring to it’s incredibly complex to to capture some of that um we have a team that go into the coroner’s office who read through toxicology reports medical

    Records witness statements to then um pick out where we think the was that mental health problem so there’ll be some of that 85% where it will be a witness statement or a relative saying they were suffering with their mental health it doesn’t necessarily mean they were at the beckan center or they were

    Receiving that that service so we need to always take that with caution but I guess what it does do is it tells us that those people were suffering um and do need some some support so the support through the services that Eddie talked about the support through third sector

    Grassroot organizations for people who are living you know in the community it they they both need to come together to do that prevention element thanks thanks very much just um just a little bit of push back Eddie so um I guess in terms of new way of

    Working I would say at the moment there’s long waiting lists for mental health health service um needs and that weight is probably not always good for people so I guess do you believe that the new system will reduce weight in lists and I guess the second question is

    Around you talked about distrust of um NHS and providers I guess do you do anything around commissioning around third sector providers where um trust may may be there already thank you um yes in short so the the if we look at the investment envelope across our community mental health

    Transformation program we’ve I think we’ve had an additional 4.8 million pound come into the system over over the last three years and that will become recurrent um a significant proportion I think we’ve invested I’ll have to come back to you with what the actual figure is so I

    Don’t want to give give give something that’s inaccurate but um um a significant proportion of that has invested into into bolstering our vcse support um and our support through as I’ve described the grants funding schemes that are the very very early proactive interventions with Grassroots Community groups that um we know that

    Through our risk stratification that we we find difficult to reach in terms of statut provision and and access I I think the the demands that we’re seeing and the demands that we’re seeing we’ seen a long tale of covid recovery through through Mental Health Services and we’re seeing demand go through the

    Roof but what we’re also seeing is demand for wider mental well-being and emotional distress and social crisis that isn’t just diagnostically driven mental health intervention that needs medicine that needs psychological support blah blah blah so it’s wider than that I think this the whole concept of this different approach that focuses

    On not just it’s that very early Upstream element of proactive intervention then there’s the stuff around how you build the building blocks around communities that support people to maintain their Wellness in terms of The Wider determinant then getting really really quick access to intervention that’s actually culturally

    Appropriate is going to meet your needs rather than trying to shoehorn you into something that um isn’t going to get you the outcomes that that’s required um and doing that in a way that targets our resources to best effect if you’re asking me whether we have enough money

    To deliver the mental health services in the way that it’s just going to have no waiting list I’d say no I think this will be the bit that gets us to a different approach where not everything is a service offer something is a bit around how do we support people to

    Maintain well in the communities what is the relationship with people that we have in terms of expectation on Services as well and what what is the actual service offer we need that’s going to deliver outcomes rather than just um hold the risk for people should we say

    So it’s a different culture that we’re trying to work within within as well uh all of this is being evaluated we’ve got current evaluation going on about the process of design and taking into the first year of delivery um through Niche so it’s an external evaluation we’re

    Doing across the whole of West Georgia each of the places has done very different models of of of how we’re transforming our services I’m sure we could quite happily share the the the evaluation data with you because it’s it’s yeah it’s it’s quite ambitious in terms of the cultural shift we’re

    Wanting thank you very much for that okay I’m GNA bring in councelor kider next um hi um this is very close to my heart because um as a mother of a 29 year old daughter who 18 year old down in rampton down south uh contemplated suicide after after being bullied at

    University and I couldn’t get any help down there I broke brought back to to to to leads and the help she got locally from you guys was amazing so I just really really applaud you and she’s gone on to doing Masters and she doing really really well so thank you from bottom of

    My heart the question I just want to ask you uh I’ve done a lot of work with the marketplace and I understand it might be closing I’m am I right in saying that the marketplace in leads where uh young people can go and um you know uh we have

    A lot of experience in my area where they’ve gone for you know mental health support you don’t know I I I’m it’s yeah I I think there’s been something around um relooking at what the what the provision is um but I I don’t think we we’re up point of discussing that at

    This point in time right it’s just it’s just somebody told me uh and my daughter had read it somewhere and I just really really concerned because um you know Le City Center was so ideal for my area and I know a lot a lot of kids who have gone

    Down and they’ve had some fantastic support I mean certainly can say the provision for young people in leads um the investment is the same as it has been previously so there will be young people that we the support for young people’s mental health um in leads going forward whether it’s Marketplace

    Or elsewhere I think that’s the point that you for that that’s um makes me feel a little bit better thank you thank you councelor K I’m bring in Dr John B next uh thank you chair um a number of years ago Health watch leads did a major survey of Mental

    Health Services in the city and one of the areas which it appeared that was not being delivered particularly well was um crisis Services now we haven’t gone back and looked at detail although there has very recently been a West Yorkshire wide review of Mental Health Services which again has said crisis

    Services aren’t as good as as as we we would like them to be um bearing in mind that the most commonly recorded risk factor is a mental health history and I take the point that they may that person may not have been in touch with mental

    Health services it it may have been a a family member a friend who reported a history um and also bearing in mind that under living situation by far and way the largest group are people who live alone so I guess my question is ch PR Services as I

    Understand it are delivered as it were in a partnership between the Mental Health Trust the foundation trust the um leads Community Trust and the third sector working together and part of C crisis services are actually delivered by the third sector um so the question is how is that working um that cooperation between

    Those groups and and not only in terms of the actual crisis service itself but actually trying to prevent getting to the need for a crisis service and and secondly bearing in mind that living alone is is also one of the factors I wonder to what extent social prescribing

    By GP practices could play a role in supporting those people I think it’s a really interesting question H Dr Bill I think we’re in danger of of sort of going into the whole debate around crisis Services which I think needs its own discussion Eddie’s going to will come back yes I

    Acknowledge that we have crisis Services both in NHS but also in the third sector but I just think I feel we’re in danger of kind of going sideways into Services rather than thinking about what we brought to which is you know the the whole issue around the suicide

    Prevention strategy so um with respect if we could perhaps partk that one for now and think about this strategy thank you mind coming back briefly because it’s I think it’s a valid question really and and there has been work ongoing um particularly around um how the various offers because it’s a big

    Landscape of offers we have we have a crisis house we have a children young people’s uh mindmate Spa we have um a number of Crisis cafes um and we have an integrated pathway with our our straty crisis provision with with a an overnight crisis house stay and we’re

    Also looking about how that can support proactively people coming back from long stay out of area hospitals for for complex emotional needs particularly um so so you you asked the right question people get confused around that plethora of um resources is and how it works and joins together so it certainly is part

    Of our community transformational work is about how do we have that access that makes sense and how do we join it up so that people are knowing where they’re going um and how do we understand that we’re getting the outcomes through that and what we’re not just having is people

    Bouncing around a multitude of services alongside that is how do you then join that with the proactive Upstream offer I’ve described in terms of our approach for Community Mental Health transformation how do we have that connectivity together to make sure that is one access route um and there’s a a

    Load of work that’s happening behind the scenes for that also and I I acknowledge the point of um it’s still a confused landscape people are still confused about access we have a number of evaluation projects on the go at the moment one one that’s being supported through um some Public Health colleagues

    As well through our crisis cafes across West Yorkshire um and we need to pull all this together similarly for the same reason about how do we join this all up into something coherent got some great offers they’re just fragmented um I can just come back on the primary care and social prescribing

    If that’s okay so we have um on our um strategic suicide I can’t speak strategic Suicide Prevention group we have um a rep representative of primary care and we’re really Keen to work with him to make sure we’re working with GPS to encourage and support that suicide prevention is everybody’s business so

    That we’re working with Social prescribers the primary care social prescribers but also third sector social prescribers so that they’re confident they’re comfortable they’re compassionate in in recognizing where there may be concerns issues being aware of all the sort of variety of um support when I say crisis I’m talking about

    Somebody’s um sort of Crisis around wider determinance not necessarily A Mental Health crisis but so that we can support them to identify recognize and then support people into those so the primary care and social prescribing element of our plan is yet to be built but we’re really Keen to work with GPS

    Work with people on the ground to understand what what in addition we could be doing to increase that sort of professional curiosity or whether we can look at flag based systems um so that one’s definitely going to be um developed in 24 25 do you have a follow up Dr B just to

    Say I I I think the comments very useful and we may be need to look at um Crisis Care in the context of ongoing mental health care in more detail at some stage thank you I’d ask you to bring that up again in the next uh next item

    When we’re talking about our work schedule um okay I’m going to bring in councelor har Brook thank you chair um two questions um I was really drawn to the table on page 90 um around the death from suicide comparison of gender counts and reading again some of the other stuff that’s in

    The really good report around the prevalence of of suicide you know and the risk factors attributed to that I was drawn my eyes immediately went to the um what seems like a drop in the number of male suicides from 83% down to 66% but then just rereading the pack

    Just now actually it looks like the what’s happened is between 19 and 21 compared with the uh years before numerically the number of female suicides was gone up so I just wondered whether I don’t know what the answer is but whether partly you could unpick if there’s any stories or any um learnings

    That can be shared from that and then the other question I’ve got is I mean sort growing up in the sort of 70s and 80s certainly amongst my older aunts and relatives you know the CW cancer was one of those words that just didn’t get used in

    Society and I have a feeling that amongst many generations now the sww suicide is one of those last perhaps taboos that doesn’t get talked about enough in society and I think it often comes at the end of a spectrum of other um other issues that people are experiencing it’s sadly you know the

    What happens at the end of other other processes and I appreciate that this strategy is around that um prevention at the end rather than the um more longer term societal stuff that may prevent people getting to that I don’t know 20 30% outcome uh tra you traa tragic event but

    I just wondered whether you could comment on in terms of the the taboos that still a risk exist around talking about suicide and how we might challenge some of those so start with your first question first first one first uh so yeah in terms of the male female split so the

    The data that you you’ve referenced there in the audit was from 2019 to 2021 and you you quite rightly pointed out we did see fewer male suicides within that period of time um I’ve just had a very quick look um I guess this highlights um the importance of the real-time

    Surveillance system that we have with West georia Police so we receive a weekly email from West georia Police that tells us um everything that sadly happened for Le’s residents the previous week and it means means that we can really be on the board with direct directing um and targeting our resources

    Now rather than relying on data from a couple of years ago um so uh as of last week we look at the last rolling 365 days and we have seen that mail rate go up again and it does really highlight the importance of using that data and

    Making sure we we target our resources based on what we know from that audit but we’re also really up to date um I don’t know if you’re aware but we also since writing this report we’ve also got access to the National realtime surveillance system as well which means

    We can keep an eye on how leads sort of Compares with national or other areas as well that helps us sort of direct that work as well answer the second question second question about stigma um really so we share the language guide really Keen to ensure that people are comfortable and

    Confident in raising the issue in talking about it we know um talking about the issue um asking the question um doesn’t have that damaging effect that people worry that it might do so we’re really Keen to make sure we support people to continue to talk about it um we’re working alongside West

    Strcture ICB who’ve got a campaign um around checking with your mate which again is is promoting asking those questions and again in terms of making suicide everybody’s business we really want to support people to access training to become Champions we’d really welcome everybody today if they’re not already becoming a Suicide Prevention

    Champion I think we included the link in the report if not we’d really value your support in doing that and encouraging your communities and your colleagues to do that as well so that we all see our place um in challenging in raising the issue and trying to with that

    Stigma okay does anyone else have questions councel thanks J I thought you’d already clocked me actually never mind um so my first question was going to be how it links in with the Community Mental Health transformation and Eddie’s um covered that comprehensively so thank you for that just one question on it if

    Somebody um presents within the mental health system and they’re not disclosing suicidal feelings however they’re from a cohort which is in the highest um triggers of potential um suicidal death by suicides would that be brought up as part of this sort of consultation uh um you know would they

    Be asked I suppose as part of the consultation how are you how are you feeling do you feel suicidal or Suicidal Thoughts so that’s one question the second question on the peer support bereavement groups have they promoted at the point of um a death by Suicide to the to a wider family but

    Then are they also because people might not be ready immediately everyone’s going to react differently to such a tragic event would there be some kind of follow-up support and and that ongoing care and offer to join those and then the final point is on page 95 with the

    Breakdown in the stats for uh the audit I think it’ be helpful for context to have the percentages overall in the categories so you do refer to ons stats for carers but what the percentage ons wise for unemployed and versus employed I’m just it gives me a better understanding

    Of which is the obviously if there’s more people employed it follows that you might get more people um from that cohort but if they’re only 2% of unemployed in the country then that’s quite a significant amount that a fifth of the deaths are from um unemployed people so yeah that’s it thank

    You we’ll go backwards on your questions if Rachel could answer question three Jules question two and then Eddie question one is that is that okay thank uh thank you I’ve not seen on report some of the suicide data against some of the sort of demographic data

    That you’ve talked about um I could be corrected but I’m very happy to go back and see if they do um provide that because that would be it would be helpful like you say if if only 2% of the country are unemployed yet we know

    That X perent have taken the lives so I will take that back to and try and UNP pick that more yeah sure in terms of suicide bement service in leads um we’re really lucky that there is a post within West Yorkshire police who has direct contact with families um after a death by

    Suicide and they provide the services information and uh with their consent will give give us the information of those families as well so we can directly um Reach people um in the real aftermath of a death by Suicide um the services open to people at any point so

    Any historical uh loss is to people are still eligible to be referred and they can self-refer into the service at any point so we do a lot of work in terms of Outreach um so if we thanks to the um suspected what SSS data um thanks to

    That we’re able to do targeted promotion in specific areas of leads based on that information and we continue to promote the service so that people know that anyone affected and is anyone affected including people that have witnessed found Emergency Services anyone that’s affected can refer themselves at any point

    After um and comes to the bit around the I is the caveat that I don’t work operationally within the provision but I do understand understand what’s commissioned and what’s been designed through Community transformation so yes is is the short answer um um all all of the access would be through a helpful

    Conversation I think we’re changing some of the language around assessments to a helpful conversation to help people identify what their presenting need is and what they wish out of the support that they access rather than the clinical intervention but that will be underpinned through uh um an understanding of risk and an

    Understanding of the factors that are presenting also I I think what’s really shifting in in the community transformation that’s quite important is currently we move people around the mental health system based on risk so if you’re too risky for your access to a Primary Care Mental Health you make a referral to your

    Community mental health Team who will then do another assessment process and decide whether they’re going to accept you against their criteria or not and if it’s too risky there it then gets passed on in terms of the crisis provisional or acute impatient this new model starts at the front door of your Primary

    Care Network local care partnership and that’s where your assessment starts and is layered by drawing in expertise around that same so people aren’t rejected people are don’t helped support access to the right expertise and the right level of support that they get so that all has to be underpinned by risk

    But it’s risk in a different way through understanding how you then get the expertise that you need to address those needs rather than using it as a currency to shift people around a system which which feels like a a very nuanced shift in the way we better make use of our

    Resources but also better get people to the right help early doors thank you chair ju if I could um make a a general point I guess um around the um the really clear understanding around um history of contact with mental health services and and and the mental

    Health um problem noted which is the 18 5% I think it’s it’s incredibly important um that we distinguish between that 85% figure that had noted a mental health problem but often as Rachel has said it was a testimony of a family member or friend or whatever um in terms

    Of contact with Services the 66% two-thirds of people who took their own lives had no history at all of contact with mental health services so two-thirds of people had absolutely know history of contact and a third did and that’s really important that we we understand

    That and get that right but I guess it’s it’s it’s um I it’s that inevitable conversation we have around Mental Health Services when we talk about suicide when actually two-thirds of people have never had any contact and you know before they took their own lives and therefore um what we do as a

    City and a society outside Mental Health Services will will impact on reducing that 66% um it is a little bit confusing with the 18 figure because that really stands out um but I just wanted to make that point that actually when we look at the people who are most at risk of taking

    Their own lives it’s you know that the that the effort we can put into wider societal work to support particularly men who live on their own and some of the other groups of risk around social support as well as getting the mental health services stuff right but we we

    It’s just making that point about proportionality really um so so again just to draw that to the the the the board and the other interesting um angle which again when we loop around on these suicide audits it’s interesting in terms of services that the um often people who

    Take their own lives are described as kind of hard to reach and kind of isolated whereas one of the the interesting figures that always jumps out for for me is the um the third of people who um had had actually access the GP in a month prior to the death so

    They are presenting to Primary Care Services much more than Mental Health health services and how do we work with all all of our partners in the city to I you know to notice risk and intervene so it was really just to kind of stress that point about the 66% with no history

    Of contact with Ser with mental health services and how we can keep the conversation as as broad as possible around social support thank you thank you Victor and um it’s really helpful uh intervention just um how do you think we can uh do that around uh helping I guess

    GPS um if they’re the people who’ve seen like medical professionals have seen in most recently well I’m going to defer to my trusted colleagues here because obviously there there’s a load of evidence around can of what works in terms of interventions and and Rachel’s point about suicide being everybody’s

    Business and people knowing what to look out for and what brief interventions would make the most difference and where to sign post to I guess that’s a good starting point isn’t it Rachel but I’ll let you say a bit more uh yeah so similar to what I said

    Before that we’ve we’ve got somebody from primary care sitting on our strategic group and we need we need them to tell us and lead and work with us so we can we can share the evidence like like we’ve said we know how many people presented at Primary Care the week

    Before their death uh the month before the death three months before the death and we’ve also got sort of demographics and breakdown G geographically as well of where those people were so we’re really Keen to work with primary care colleagues to look at whether we can have flags on systems whether we can

    Encourage that professional curiosity whether we can um upskill and support those those compassionate conversations so that like Eddie said we we’re not assessing risk necessarily but we’re having those helpful conversations in primary care when people are turning up so that we can identify if somebody does then need some some further support on

    Whether that be social prescribing whether that be a specialist service whether that be a mental health problem you know that needs medicating necessarily and that’s what we need to do so we’re we’re very much on with creating a plan with primary care and those Support Services to to try and get

    That right and there’s a couple of things in in place already so we want to go and talk to groups of GPS we want to go and talk to social prescribers to understand how it feels um and to also share our data to so that they can

    Create those ideas so we can work with them and support that thank you very much and and I guess that feeds into um the action that’s on page 68 of the pack which is um in short tailored setting based approach is taken to identify those at risk um yeah so

    It’s good that it’s on the action plan do you want to comment again Victor well only just to make a really brief um practical point that a lot of learning over the years has shown that those presentations at Primary Care before people sadly take their own lives um

    What’s interesting is that they don’t they don’t often present with a mental health presentation they would come with something else a physical problem but obviously it’s it’s so it’s it’s working with gen GPS to be a to look for those signs when people present with a particular you know there there’s um

    Evidence about people with long-term conditions or other physical health problems presenting with that but actually being really high risk of of suicide so again I think it’s getting Beyond The Stereotype of somebody presenting with their mental health as a in crisis before before they take their

    Life but often they they present in very different ways yeah thank you for that and I guess um GPS don’t often have long with um their their patients so it’s I guess that’s makes it very very um challenging okay thanks for that Victoria uh councel

    ERS did uh you come in next thank you uh chair um and thank you for bringing this report today it’s uh you know it’s very interesting read and uh quite an eye opener and also thank you uh chair for circulating the the document the creating hul through language because

    Talking about suicide is is something that I wouldn’t naturally feel comfortable talking about but reading this it does it does help those discussions and something that I’ll certainly be promoting uh to people I know and constituents um the question I have is I I wonder if if any of the

    Members or visitors today have seen a campaign I don’t know if it was by Norwich City or featured norch city um but if I I I imagine if I I won’t go into too much detail but because uh I think people it would be interesting to

    Uh to see it it’s uh it’s something that sticks in my mind um and actually it actually addresses something that Victoria mentioned there about how people may present differently um so the question I’ve I want to ask is as a as a city are we working with some of the our Region’s largest

    Sporting or recreational organizations uh who have uh much bigger potential to reach these Target audiences quite you know it’s relatively easy so I just wondered if there was something that we can be doing there and uh as mentioned I would recommend that everyone does search for that campaign because it’s h

    It’s quite a powerful one thank you um so yeah I’ve seen it I think uh if I if I’m right H it’s a football club two men watching yeah uh so it is a really really powerful campaign so I guess in answer to your question yes we’re working with Le rhinos um we’ve

    Been working with them for a number of years and they also sit on our Network they’ve also and we’ve supported them to receive grants from us as well to do some of that real Grassroots um Grassroots work themselves um we’re also working alongside West yorshire ICB um

    Who funded the checkin with your mate campaign and we’re looking to go to sport leads board um and also to go to um some of our bigger clubs separately to see if they can support some of that that campaign work um leads rers have been great they’ve had I think

    Um information in Match Day programs on their boards um and we’re really Keen to continue that partnership with them to look at player testimonials so we can start to really get that conversation going so yes in answer to your question but really Keen for any opportunities to further develop that I just say

    Something on also work with other organization like rugby league cares um who who do um training training with other organizations as well but from a from a rugly focus so um sport is one of the main areas that we we know um kind of chimes with with men particular

    But not not solely um but yeah so yeah it’s been part of our longer term work thank you it’s great to hear that you are already uh engaging with in those conversations and looking to continue them um I guess the the point just add to the point I was trying to

    Make is I think that uh by having an identity as a leads based club or some in the region it may just help Target uh more local sort of uh people who are who are going through U difficult times all right thank you appreciate it thank you very much for that uh

    Council erson if you wanted to share a link around the the group that’d be uh appreciated okay um I think we’re at the end of that conversation I just um like to thank uh you for coming today thank you for the report um and uh the work

    That’s been done but also like a really detailed and I I think action plan which is time bound and I think that’s something that uh your report is stood out compared to a lot of the reports we get is very um very precise so and the additional information I’d ask for it

    Chair’s brief is in the paper as well so that’s all very appreciated um yes so thank you for the work you’re doing um and thanks for your time today okay so that’s that’s the end of that item you’re free to to go if you want to we’ve just got the work program

    Now as members um as you’ll see we’ve got a act a meeting agenda for the March which is the last um meeting of the mun Municipal year but I’m very open to ideas for agenda items for the next Municipal year um for the successor board whoever um obviously we don’t know

    Who who will be on that board um I think we’ve had a comment already from Dr Beal around Crisis Support Services um and I think I’d I’d welcome that as a as a topic but if you if you don’t think of it right now feel free to email me um at

    Any point before uh may I guess um that’s when I’m still definitely chair for so I can uh I can influence the agenda up until that point for sure um do any members want to make any comments at this point or is anything that you want to say

    Angel I think I think just what’s reflected in the report as well um just to formally note that in view of time turn um time frame changes that have been made to the Community Health and well-being service pilot program the update report um is now going to be

    Scheduled for the scrutiny boards July meeting so as the chair mentioned our next meeting we’ll be bringing along a proposed sort of dra work program to pass on to the successor board so that’s one of the things that we’ll be reflected on there amongst other things which we can discuss at the next

    Meeting thank you councel har uh just a thought on sequencing of the work program for the following year obviously we are in an election year at the moment I’m just thinking perhaps some thoughts to some of the you know we’ve some of the topics we’ve touched on today uh touch on national government

    Issues you know to to resolve them such as you know government strategy I just wonder whether we need to look at the sequencing so that the more purely leads based or purely I say administrative topics that we discussed routine topics are discussed earlier and then the the more politically contentious topics are

    Discussed later on so that we’ve uh we know we know who we’re targeting yeah I take that point so if we want to write to a minister we’re writing to someone who’s just started in post dver and someone who might be towards the end of their term um whoever

    That might be okay Council Richie yeah thanks um in terms of future work programs and um this I’ve only had this year on this board so it may have been done but I think looking into um the prevalence and patterns of um asthma and respiratory uh illness in

    Particularly in young children I think would be useful to bring and I think it’ Link in to the mot around housing and what have you it might end up being joint work with another scrutiny board as well if depending on what the outcomes are councelor

    Finy um I think I think I say this every well the past two years at least um can we talk about uh Workforce and where we obviously we’ve spoken about it this year but it’s it never ends um uh Workforce and wider integration of of NHS Services um and

    Then one for one for Autumn would be winter planning yes thank you I’ve um I’d actually done a little bit of um correspondence about uh work force levels and level of Bank St being used across the NHS uh the Le teaching Hospital trust um so maybe I I should

    Circulate that around the board it it hadn’t sort of highlighted as um a major problem which is why I hadn’t Advanced it sort of as an item but I’m definitely interested in work force planning um I think it’s really important but I’ll ask Angela to circulate some of the

    Information I got got this year but let’s let’s keep it as a on on the radar winter winter planning is definitely something we did this year and we’ll need to do every year yep okay counc odison thank you chair on the crisis Services uh agenda piece could we

    Potentially put some emphasis on those in our sort of authority border border areas who maybe have a GP in one city but be a a resident the other and how it’s a point that I’ve raised before or about the relationship about sort of being batted over you know one side to

    The other because essentially uh people in crisis need that uh that assistance quickly um I’m not saying it has to focus all but just be included on it thank you yeah thanks for that and um after your comment when I’ve talked to Ford leads I’ve asked that point about

    That transitional point I think it’s really interesting and challenging point because the system they call it system flow in NHS it’s difficult to do anyway especially when you’re moving cross border as it were um thank you and as I say do if something comes to you this

    Week please please write to me because um if we can I guess in terms of our role I think it’s particularly useful for us to get the first uh two or three meetings sort of lined up for the next board but still leave space for them to

    Have some some options did you have another comment counselor yeah I was just thinking of topics that have come to me that have had a health angle and I’m not sure if it is for this board it’s a bit like the the Vapes issue where it’s multi- systemic but I think

    It’s potentially one we should talk about is I had a lot of contract around mold and damp in housing and the impact of that on people’s Health uh both in Council accommodation and in private private rented and it feels as though clearly there is a health angle there so

    It feels something we should raise even if from a monitoring perspective rather than a Solutions perspective yeah thanks for that certainly something that comes into my inbox as a ward representative regular in both Council houses and um private rented I I think I think we’ll have to think about whether that’s our

    Board but if it’s not I mean I’m always up for writing to another board and asking them to look at something um okay good um thank you very much for your time everyone really appreciate it I feel like we’ve had a really important meeting today and uh so

    I hope you have a good rest of the day and see you next time thank you

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