Agenda item

Report of the Director of Public Health & Wellbeing

The Board received a Briefing Note regarding an overview of the current Early Intervention and Children and Young People (CYP) Substance Misuse (Positive Choices).  The contract was ending in March 2027 and was being brought to the Board for discussion around the future model and delivery of the service.

The Scrutiny Board also considered a private Briefing Note relating to this matter.  The grounds for privacy were that it related to an individual and information regarding the Early Intervention & CYP Substance Misuse (Minute 20 refers).

The Public Health Team at Coventry City Council commissioned an Early Intervention and CYP Substance Misuse service in 2018 to support children and young people who were at risk of using substances, those at risk of exploitation and those in need of support with developing healthy relationships.  The contract was awarded to Change Grow Live (CGL) who launched the “Positive Choices” service.  This service contributed to Coventry’s preventative approach to improving outcomes for children and young people.  The service worked collaboratively with schools, health professionals and organisations such as Youth Justice to provide education, guidance and one-to-one support.

Positive Choices offered support for the following presenting needs:

• Substance Misuse
• Relationships, Online Safety and Sexual Health (ROSH)
• Hidden Harm
• Low level exploitation
• CYP coming through the Youth Justice Service (YJS)

Positive Choices understood the challenges families faced when affected by substance use and other issues affecting children, young people and families and the support was designed to help families feel empowered, connected and strengthened.

The team provided parenting support using the Solihull Approach and hosted regular groups for parents run by an experienced Children and Families team.  For those requiring more tailored support, there was an offer of one-to-one phone calls or face-to-face appointments.  Positive Choices also offered diversionary activities including fun sessions at the community allotment and climbing.  They worked alongside schools and had co-located to several schools across the city to support an early intervention offer around ROSH and substance misuse and were committed to support Coventry Alternative Provision (CAP) service, a group offer to schools who referred young people to the CAP programme.  These groups also focused on ROSH and substance misuse.  CAP would also be offered to primary schools and therefore, a Hidden Harm programme would be available for primary age children.

An engagement plan had been developed ensuring a comprehensive and inclusive approach to commissioning.  Engagement activities would target a range of audiences and a variety of engagement methods would be used.  Young people would also play an active role in the evaluation of the tender process to ensure their voices were reflected in service design and decision making.

A wider piece of work to review the current range of services for CYP in Coventry who were at risk of poor outcomes was in place.

The data on health risk behaviours in CYP had recently been reviewed.  The full report was in draft form and included a review of the literature and analysis of available data. Up-to-date local data on behaviours in CYP was lacking.  National data was based on surveys from a sample of schools so produced with general findings that could not be disaggregated at a local level. Those who were most vulnerable and at greatest risk were least likely to be surveyed and captured in routine data due to for eg. absence from school.

The most risky behaviours such as alcohol and substance use and misuse, smoking, anti-social behaviour, etc, were initiated in adolescence and tended to cluster, so any person engaging in one of these behaviours put individuals at risk of long-term health and wider outcomes including lower educational attainment, being bullied, mental health problems, obesity, teenage pregnancy, problem gambling and being in trouble with the police. There were also longer-term poor health outcomes such as cancer, cardiovascular disease, liver disease and mental health issues.

At a national level, there had been a small decline in the number of school age pupils who had ever drunk alcohol and the proportion of 11-15 year olds who had drunk alcohol in the preceding week however, a significant number of young people were consuming alcohol at a very young age.  There was a similar pattern for drug use at a national level.  Unhealthy relationships were difficult to measure however, a consequence of risky sexual behaviours could be sexually transmitted infections (STIs) and the rate of diagnosis in Coventry residents was 905 per 100,000 which was higher than the national average of 694 per 100,000.  Teenage pregnancy was another consequence.  The under 18s conception rate in Coventry was 21.2 per 1,000; significantly higher than the national level of 13.9 per 1,000.  Unhealthy relationships could put young people at risk of being victims or perpetrators of domestic abuse, sexual violence and exploitation.

The Early Intervention and Young Person’s Substance Misuse service delivered impact by providing early, targeted support that prevented young people from developing more serious substance misuse issues and the associated wider harms.  By working with young people at the earliest signs of risk meant fewer young people entering care, fewer hospital admissions, improved school attendance, improved mental health and emotional wellbeing and reduced anti-social behaviour.

RESOLVED that the Health and Social Care Scrutiny Board (5):

1.  Actively engage in the recommissioning process to provide insight and feedback on the proposed service to the Cabinet Member.

2.  Provide contributions in shaping the service specification and identifying priorities for the new contract.

3.  Consider issues raised as part of the planning stage for  recommissioning.