The 10-year drug strategy: Southampton City Council

Notable achievements include significant progress in key performance indicators such as reductions in drug-related deaths and increased treatment completion rates. Central to these successes is the involvement of the voluntary sector. The voluntary sector providers approach places a strong emphasis on recovery, integrating various art and creative therapies into the treatment model. One particularly inspiring aspect of the program is the inclusion of former service users who have transitioned into roles within the service. Their lived experiences resonate deeply with current service users, fostering trust and motivation within the community.

Southampton has voiced concerns about the potential for a "cliff edge" scenario due to short funding cycles, jeopardising the sustainability of interventions that have proven highly successful over the past two years. The city faces significant challenges related to crime and county lines issues, resulting in historically high rates of drug-related deaths. Additionally, there is a notable prevalence of child protection cases, placing strain on the capacity of the system to adequately support these vulnerable groups. To address these challenges, Southampton has adopted a collaborative approach, leveraging resources from the voluntary sector and additional agencies to provide a comprehensive, wraparound support system. This strategy emphasises early intervention and risk reduction efforts aimed at addressing needs before individuals enter formal treatment services.

Another risk associated with the short-term funding cycles is the potential loss of staff due to the lack of funding certainty. Southampton highly praises the work of Dame Carol Black and acknowledges her recommendations for achieving quick wins to secure future funding. However, there is a need to strike a balance between short-term gains and long-term planning. Convincing the treasury of the value of continued investment requires demonstrating the effectiveness of less measurable aspects, such as community engagement, lived experience initiatives, and long-term recovery support. While these efforts are invaluable to the strategy's implementation, they often take time to yield tangible results.

Southampton is nearing a section 114 notice, indicating heightened financial scrutiny. This situation presents significant challenges for commissioning, particularly when collaborating with voluntary sector providers. In light of the financial constraints, voluntary sector providers are required to assume a greater level of risk when engaging with the council. This increased risk can impact the scope and effectiveness of service provision, potentially hindering the implementation of the drug strategy.

Fortunately, Southampton had already committed to the Health in All Policies (HiAP) initiative prior to the onset of the pandemic. This proactive approach facilitated the development of an effective drugs and alcohol strategy that was aligned with the HiAP framework. As a result, the strategy was integrated across all council departments, including transportation, education, children's services, and adult services. Holding individual departments accountable for their contributions to HiAP ensured a cohesive approach to combating drugs and built a solid foundation for transitioning to drug partnerships. Southampton has seen a decrease in the number of people entering treatment for opiates in the last year, but with increases for both non-opiate and alcohol use. 

Southampton has seen a decrease in the number of people entering treatment for opiates in the last year, but with increases for both non-opiate and alcohol use.

Number of people entering treatment (2022-23)

By adopting this approach, Southampton ensured that drugs are not addressed in isolation but rather as part of a broader health agenda integrated into all aspects of the council's work. This holistic approach enabled a more comprehensive response to drug-related issues, fostering collaboration and synergy across different sectors. Additionally, the establishment of strong partnerships under the "safe city" initiative further underscored Southampton's commitment to addressing drugs and health as top priorities within the council's agenda.

Southampton acknowledges the potential risks associated with political changes and their potential impact on the drug strategy. However, the local teams have demonstrated adaptability in response to temporary shifts in local government, such as transitions from Labour to Conservative during the pandemic and back to Labour thereafter. This experience has prepared them for working effectively regardless of political changes. 

With a Labour majority in Southampton, any change in government at the general election would likely be seen as advantageous at the local level. Consequently, major decisions are not being postponed in anticipation of the general election. Instead, the primary focus remains on addressing the immediate financial challenges to mitigate the risk of a section 114 notice. This pragmatic approach reflects Southampton's commitment to maintaining continuity and stability in its drug strategy implementation efforts despite potential political fluctuations.

The administrative burden of reporting requirements is viewed as significant, adding to the challenges faced by Southampton in implementing its drug strategy. A sustainable source of funding would provide much-needed assurance to the system and voluntary sector providers, upon which the success of the local strategy heavily relies.

Southampton has established robust processes for identifying and testing new drugs, facilitated by the drug alerts system designed to flag up potentially harmful batches. These efforts are strengthened by close collaboration with the NHS and police within the system. 

Utilising an email communication system among all core services, Southampton ensures swift dissemination of information to key decision-makers regarding developments related to new drugs and associated risks. This efficient communication mechanism plays a vital role in addressing emerging challenges and ensuring timely responses within the region.

Southampton places significant emphasis on prevention efforts, although these must be balanced with the attainment of strategy key performance indicators (KPIs). As a port city, Southampton recognises the critical role of its relationship with the police not only in safeguarding the city but also in upholding its strategic status as a port city, thereby contributing to the protection of the entire UK.

This collaboration has resulted in several large-scale police interventions aimed at intercepting significant quantities of narcotics on vessels entering the city's port. By preventing these drugs from reaching the streets, Southampton and its partners are actively working to curb the spread of illicit substances and mitigate associated harms within the community.

Southampton has actively engaged drug users in providing representation of lived experience at local scrutiny boards, which has proven to be immensely powerful and impactful on local councillors. Despite the city's strong focus on prevention efforts, which extend to collaborating with children's services, homelessness services, and local partnership action plans, these initiatives are not always fully recognised at higher levels.

To address this, Southampton emphasises prevention through indirect means, understanding the crucial role of factors such as education, housing, and employment opportunities in shaping drug-related outcomes. While the treatment element receives greater emphasis at the national level, Southampton remains committed to addressing the wider determinants of health, as highlighted by the Health Foundation's reports.