Sandwell Metropolitan Borough Council has worked with Alcohol Concern to support the most difficult, hard-to-reach drinkers.
These people are often involved with the criminal justice system or are frequent users of NHS services and do not want to engage with alcohol treatment. But through the Blue Light Project this is changing.
Estimates from Public Health England suggest that at least three-quarters of dependent drinkers are not engaged with alcohol treatment services.
In the average borough of 350,000 that would mean nearly 10,000 dependent drinkers going without help.
Many of these will also have other problems – they may be engaged in criminal behaviour or frequent users of NHS services.
The cost to the public purse in managing them can be huge. Work done by Alcohol Concern has suggested the most acute cases can cost in the region of £35,000 a year with some exceeding £100,000.
Mike Ward, a Senior Consultant at the charity, said: “What you find is that these cases are very complicated and entrenched and there can be an attitude that they cannot be helped. It is much easier to engage the people who want help – and there is a tendency for that to happen in many places.”
The solution Alcohol Concern has worked with a number of councils on a scheme aimed at engaging these high-impact, change-resistant drinkers.
Known as the Blue Light Project, it seeks to work with people who fit into three criteria:
- Alcohol dependent
- Burden on public services
- Non-engagement with treatment
In Sandwell, work started with the public health team in 2015.
Over 200 specialist and non-alcohol specialist staff, including emergency service staff, social workers, housing officers and police, attended a series of one-day workshops to learn how to identify Blue Light clients and how to provide brief advice.
A multi-agency group was also established to review the clients’ cases and organise extra support if necessary. This involves the input of social care, housing, mental health and the wider NHS as well as the alcohol treatment service.
It meets monthly with the idea of “unlocking the barriers” that these clients face.
Mary Bailey, Sandwell’s Substance Misuse Programme Manager, said: “The training really resonated with staff and the issues they face. By getting them together from numerous organisations it was apparent they were working with the same individuals.”
Following the training the different agencies have started working together more closely, supported by an information sharing protocol.
“It is allowing different organisations to really join up efforts and work better together,” said Ms Bailey.
“For example, we are seeing alcohol workers going out with housing officers and police officers. It is helping get these clients engaged with alcohol treatment rather than just contacting them cold.”
To date more than 30 drinkers have been supported in Sandwell through the scheme.
An evaluation of nine individuals who were helped in the first year showed a significant reduction in costs. It found these people were responsible for costs to the public purse of £244,000 in the 12 months prior to Blue Light, but by the end of 12 months that had been reduced to below £93,000.
The project costs were £25,000, giving an estimated return on investment of 471 per cent.
Seven of the individuals completed or have remained engaged with alcohol treatment services. One died, while another was imprisoned.
The project was not without its difficulties. One of the key challenges was having to work with no additional resources.
Ms Bailey said the local hospital was initially struggling to find the staff to fully engage with the project. The hospital and council worked together to secure charitable funding to get an alcohol care team established at the trust.
“You have to support each other and work through resourcing issues,” she said. Mr Ward said this sort of problem is common with partnership work. “You have to work hard to get good relationships going.
“I know one of the issues that gets brought up is that there is too much multi-agency work out there – and having another group is too much. I can understand that. What we are looking to do in some areas is incorporate into wider multi-agency work. But to do that you have to make sure the right people are there and they have the skills to review these cases.”
How the approach is being sustained
The Blue Light Project continues to be run in Sandwell – and work is now under way to look at how to build on the success of the scheme.
One idea that is being considered is the creation of assertive outreach workers to engage with these clients in the community, in their homes and on the streets. Ms Bailey said: “It is something that has been used in other Blue Light areas.
Having spoken to our frontline staff, they feel having an outreach worker who could go and see people, check they are okay and what help they may need could make a huge difference.”
Meanwhile, February saw the launch of Sandwell’s new integrated drug and alcohol treatment service delivered by Cranston. They had been run separately before that. The move should allow a more joined-up approach to substance misuse in the borough.
Substance Misuse Programme Manager Sandwell Metropolitan Borough Council firstname.lastname@example.org