All Party Parliamentary Group for Complex Needs

Inaugural meeting for the 2017 Parliament

4pm, 13th September 2017

Room 12 (TV interview room), House of Lords

Minutes of the meeting

1. Attendance

In attendance at the meeting were:

 Lord Victor Adebowale (chair)  Thangam Debbonaire MP  Baroness Armstrong of Hill Top  Lord Stone of Blackheath  Lord Harris of Haringey

2. Report of activity from the previous parliament and briefing on current project – social action and complex needs

Attendees were provided with a report on the APPG’s work during the previous parliament, the current project on complex needs and a proposed programme of events for the coming year (attached to the minutes).

3. Election of officers

The following officers were elected 2017 parliament

 Luciana Berger MP (co-chair)  Lord Victor Adebowale (co-chair)  Johnny Mercer MP (vice chair)  Steve Reed MP (officer)  Baroness Gardner (officer)  Baroness Jolly (officer)  Baroness Armstrong of Hill Top (officer)

All-Party Parliamentary Group on Complex Needs & Dual Diagnosis

Activity during 2016-2017

About the APPG

The All-Party Parliamentary Group (APPG) on complex needs and dual diagnosis was established in 2007 in recognition of the fact that people seeking help often have a number of over-lapping needs including problems around access to housing, social care, unemployment services, mental health provision or substance misuse support. In most cases each service is administered by separate service providers. The result is that people with multiple or complex needs fall through the gaps in service provision. Providers recognise that the best model for helping those individuals with a dual diagnosis or complex needs is through an integrated service that aims to address all of the issues they face.

Secretariat is provided by Turning Point, a large social enterprise which specialises in working with people with complex needs. The APPG has a network of nearly 300 members including the VCSE, academia, local government, the NHS, regulatory bodies and individual service users/family members. The work of the APPG is diverse and has covered issues such as mental health and the criminal justice system; looked after children and care leavers; sex workers; legal highs; veterans and joining up policy on multiple needs from the perspective of those on the frontline. The group undertakes inquiries into key topics, gathering written and oral evidence from the network and undertaking surveys of service users and professionals.

Complex needs & dual diagnosis key facts

 Research suggests that up to 70% of people in drug services and 86% of alcohol services users experienced mental health problems (Public Health England, 2014).  Over half (55%) of an estimated 58,000 people nationally experiencing severe and multiple disadvantages including substance misuse, also have a diagnosed mental health condition (Lankelly Chase Foundation, 2015).  Four out of five prisoners who are drug dependent have two additional mental health problems (NHS Confederation, 2009).  The cost to society of those with severe and multiple disadvantages in life, such as drug misuse combined with homelessness, could be in the region of more than £10bn a year (Lankelly Chase Foundation, 2015).  Mental health and substance misuse issues are high among the homeless population. 12% have both a mental health and substance misuse problem, while 41% of homeless people surveyed by Homeless Link said that they used alcohol or drugs to cope with their mental health issues (Homeless Link, 2014).  More than half (54%) of suicides occur among patients with a history of alcohol or drug misuse (or both). Alcohol abuse is also a key predictor of suicide/premature death (National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, 2015).

 Between 22 and 44% of adult psychiatric inpatients in England also have a substance misuse problem (NHS Confederation, 2011).  People with serious mental health problems live 15 to 20 years less than the rest of the population (Wahlbeck et al, 2011). The figure is nine to 17 years less in those who misuse alcohol and drugs.

Reports during the last parliament (May 2015 – June 2017)

Report Dual Dilemma http://www.turning-point.co.uk/media/1138757/dual_dilemma.pdf

Briefing on older people with complex needs http://www.turning- point.co.uk/media/1138454/appg_older_people_update_july_2016_v2.pdf

Meeting held during the last parliament (May 2015 - June 2017)

3rd November 2015 – Looked After Children and Care Leavers

Presentations from:

 Sharon Hodgson MP - Shadow Children’s Minister  Sarah Brennan - CEO of YoungMinds  Lois Dugmore - Dual Diagnosis Consultant Nurse at the Leicestershire Partnership NHS Trust

2nd February 2016 – Making Every Adult Matter (MEAM) Coalition

Presentations from:

 Sam Thomas – Manager of Voices from the Frontline, MEAM  Nicola Drinkwater – Policy Officer for Voices from the Frontline, Clinks and MEAM  Sandra Morgan – Beneficiary Ambassador, Opportunity Nottingham  Steve Reed MP – Member of Parliament for Croydon North and Shadow Minister for Communities and Local Government

14th January 2016 – Veterans

Presentations from:

 Prof Neil Greenberg - Professor of Defence Mental Health, speaking on behalf of Help for Heroes  Wing Commander (Retired) Dr Walter Busuttil – Medical Director and Consultant Psychiatrist, Combat Stress  Maj Gen (Rtd) Nick Caplin – CEO, Blind Veterans  Kevin Lowe – 1 st Batallion, Royal Regiment of Wales, British Army (served between 1998- 2002)  Bill Nevill – Royal Engineers, British Army (served 1969 and 1981)

12th July 2016 – Older people with complex needs

Presentations from:

 Dr Tony Rao - Visiting Researcher at the Institute of Psychiatry (Mental health of older adults) at KCL, Substance misuse in Older People Working Group at RCPsych, Dementia Clinical Academic Group Lead for Dual Diagnosis and Consultant Old Age Psychiatrist at South and Maudsley NHS Foundation Trust  Dr Karla Greenberg - Consultant Psychiatrist in Older Person’s mental health and Clinical Director of March on Stress

19th October 2016 – Women with Complex Needs

Presentations from

 Katherine Sacks-Jones - Director of Agenda, the alliance for women and girls at risk.  Jennifer Holly - Project Coordinator, AVA (Against Violence and Abuse)  Prof. Sarah Johnsen - Professorial Fellow in the Institute for Social Policy, Environment and Real Estate at Heriot-Watt University  Ian Hamilton- Lecturer in Mental Health in the Department of Health Sciences at the University of York  Lisa Dando - Director of Brighton Women’s Centre and a professionally qualified psychotherapist and clinical supervisor  Polly Neate - Chief Executive Officer of Women’s Aid, attending on behalf of the APPG on Domestic Violence

15th June 2017 - Complex Needs and Social Action

Presentations from

 Sarah Robinson - Research Manager, CFE Research  Lee Orrell - Opportunity Nottingham  Andy Wilding - Inspiring Change Manchester  Paula Harriott - Head of Involvement, Revolving Doors  Tim Sampey - CEO Build on Belief  Dr Michael Taylor  MEAM and partners

The APPG Network

The APPG has a highly engaged network of nearly 300 expert members including frontline workers, VCSE organisations, academia, police, local government, the NHS, regulatory bodies and individual service users/family members. Organisations represented include:

Council for Disabled Children Mental Health Act Commission Coventry City Council Mental Health Foundation Abingdon Hospital Middlesex University Action on Addiction Addaction Mind Brighton and Hove Addicts 4 Addicts NACRO Adfam National Appropriate Adult Network Advance UK National Federation of Women's Institutes Agenda National Probation Service Angelus Foundation National Voices Single Homelessness Project NCVO Association of Mental Health Providers Nelson Trust Association for Young Peoples Health NHS Central Manchester CCG AVA Project NHS Confederation BAC O’Connor Centre NHS South West/DH South West Barnet, Enfield and Haringey Mental Health NICE Trust Beresford Project Norfolk Fire & Rescue Service Big Lottery Fund North Staffordshire Combined Healthcare Blenheim Opportunity Nottingham Blind Veterans Oxford Brookes University BMA Oxleas NHS Foundation Trust Bradford District CCG Passage Brent Council Pathway Broadway Lodge PHE London Build on Belief PHE West Midlands CAIS Wales Phoenix Futures Camden & Islington Mental Health Foundation Policy Exchange Trust Camden and Islington Foundation Trust PORSCH Carers in Hertfordshire Public Health England Castle Craig Hospital RCPsych Centre for Better Health Real Insight Recovery Focus Centrepoint Rehabilitation for Addicted Prisoners Trust Clinks Research Assistant to Professor Charlie Brooker/PhD student CNWL Foundation Trust Responsible Gambling Strategy Board Coaching Inside and Out COBSEO Revolving Doors

Collaborate RMBI Care Collective Voice Royal British Legion Combat Stress Royal College of Speech and Language Therapists Community Links Shared Lives Plus Contact a Family South London and Maudsley NHS Foundation Trust CQC Southampton University Crisis St Giles Trust DASCT/NHS Bolton St Mungo’s DCLG St Mungos Broadway Demos Standing Together Department of Health Step Together Volunteering Devon and Cornwall Police Stockton Borough Council Disability Rights UK Stonewall Drug & Alcohol Findings Substance Misuse Solutions Drugscope Surrey County Council Dual Diagnosis Anonymous UK Sussex Oakleaf Dual Diagnosis Journal Sutton Council Electoral Reform Society Thames Valley Probation Service Federation of Drug and Alcohol Professionals The Association of Police and Crime Commissioners Fulfilling Lives, Islington & Camden The Edge Recovery Café cambridge Groundswell The Hidden Homeless Health in Justice The Royal College of Psychiatrists Homeless Link Tom Harrison House Hopkinson House Complex Needs Hostel TONIC Consultants Housing care and support Journal Tower Hamlets Link Worker Service Imagine Mental Health Tri-borough Public Health Team IPPR Turning Point IPRI BP University of Huddersfield Kent County Council University of Southampton KeyRing University of Southampton Lankelly Chase University of York LBBD User Voice Leicestershire Partnership NHS Trust VODG London Borough of Barking and Dagenham Voices of Stoke London Borough of Sutton Voluntary Action Islington London Clinical Senate Wakefield and 5 Towns Recovery College Loughborough Univerity Wave Trust LSE Westminster Dual Diagnosis Service MacMillan Women's Aid Manchester MH and Social Care Trust WY-FI Project MCCH YJB MEAM York House GP Surgery Mencap YoungMinds

Current project - Social Action and Complex Needs

The Office for Civil Society have provided a small grant (£20K over 2 years) to support the APPG to undertake a call for evidence around social action. They are interested in the particular challenges and benefits of different types of social action in relation to people with complex health and social care needs. The key question is: How can social action improve outcomes, prevent crisis, support recovery and develop more responsive services for people with complex needs

Social action is about people coming together to help improve their lives and solve the problems that are important in their communities. This might include: supported volunteering opportunities for people in recovery, opportunities for members of the wider community to volunteer in a range of different roles supporting people in treatment, social enterprise initiatives which enable people to gain new skills and become part of their community again or community projects which seek to improve the experience of people with complex needs, build new networks and reduce stigma.

Activity to date

 Between April and May 2017, the APPG ran a joint call for evidence with the Office for Civil Society  The APPG invited its membership network to submit evidence - this is a network of engaged professionals from within the VCSE, academia, local government, NHS, regulatory bodies, as well as many service users  Other organisations engaged in work that was of interest to the APPG were also invited to contribute, along with Department for Culture, Media and Sport Arm’s Length Bodies, sector membership/umbrella organisations and APPGs working in similar areas  Both written and oral evidence was taken  The APPG has received submissions from a wide range of organisations and individuals, including charities, community groups, the NHS, peer-led organisations and networks, care providers, academics, public sector professionals and individuals with lived experience  Contributors to date include: Addaction, Build on Belief, Fulfilling Lives (the BIg Lottery complex needs programme), Nacro, NCVO, Nesta, North Staffordshire Combined Healthcare, Making Every Adult Matter (MEAM), Revolving Doors, St Giles Trust, Step Together Volunteering, Turning Point  The APPG will be producing a report that brings together case study examples, key learning, themes and ways forward based on the evidence received.

Next steps

Once the report has been completed a roundtable meeting, chaired by the Minister for Civil Society, Tracey Crouch, will bring together system leaders to consider the evidence and develop sustained action for change. The roundtable is an opportunity to: explore and develop practical solutions for system transformation; support much needed involvement of volunteer involving charities in transformation initiatives; develop mechanisms for enabling VCSE investment and expertise; consider how system partners could better collaborate with citizens to harness people power; and identify ways the participants can take action to increase the impact volunteer involving charities can have in reducing

pressure on statutory services. It is also an opportunity to develop cross-sector shared practice, bring user voices into the process and draw on best practice across the NHS, local government and VCSE organisations.

Confirmed participants include:

Simon Stevens Chief Executive, NHSE Mark Lloyd Chief Executive, LGA Lord Victor Adebowale Joint Chair of the APPG for Complex Needs, CE Turning Point Baroness Hollins Crossbench peer/APPG Member Dawn Austwick Chief Executive, Big Lottery Fund Paul Hayes Chief Executive, Collective Voices Duncan Tree Head of Policy, Volunteering Matters Sarah Brennan Chief Executive, Young Minds Neil Churchill Head of Patient and Public Insight, NHSE Dr Farrukh Alam Divisional Medical Director for addiction and offenders, CNWL Sam Allen Chief Executive, NHS Sussex Partnership Trust Helen Walker Chief Executive, TimeBank Daniel Ware Director, Dual Diagnosis Anonymous UK Alan Butler Director, Dual Diagnosis Anonymous UK Gaye Flounders Senior Operations Manager, Turning Point Tbc Turning Point peer mentor with lived experience David Ford Founder, Expert Link Tbc Expert Link member with lived experience Clark Carlisle Founder of the Clark Carlisle Foundation for Dual Diagnosis (former premiership footballer)

If you would like to attend the roundtable, which will likely take place in October/November 2017, please contact [email protected]

APPG for Complex Needs and Dual Diagnosis

Proposed programme for 2017 – 2018

November 2017 – Complex needs and social action roundtable

January 2018 – Joint meeting with the Nelson Trust

April 2018 – Women/Transitions/Veterans (topic tbc)

September 2018 - AGM