BCU-CP-59436 - Detoxification Services

Description

The MHLD Directorate are seeking approval to recommission the inpatient substance misuse detoxification service for North Wales.
The inpatient substance misuse detoxification service is for patients who have physical and/or psychological dependency to one or more substances with physical or psychiatric complications (co-morbidity) if they require a higher level of care than can be provided safely in the community.
North Wales is an outlier in several areas for substance misuse as outlined.
In 2022/2023, 19 of the 22 Local Authority areas in Wales saw a decrease in rates of individuals admitted to hospital with an alcohol-specific condition. The only 3 Local Authority areas that saw an increase were Gwynedd (4 per cent) Anglesey (7 per cent) and Wrexham (10 per cent).
Betsi Cadwaladr University Health Board (BCUHB) area has the highest rate of admissions related to illicit drugs (152.1 per 100,000 population) across Wales.
When looking at deaths from drug misuse for 2020-22 by local authority, Wrexham is in the top 5 local authorities with a population prevalence of 8.6 per 100,000 population compared with the Welsh average being 6.6 per 100,000 of the population.
The number of patients referred for inpatient substance misuse detoxification service has steadily increased over the last three years. This is from 194 admissions in 2022, 227 admissions in 2023 and 183 in 2024
To ensure that the existing service delivery model is still fit for purpose a full options appraisal process has been undertaken following the Better Business case methodology and explored a range of potential options including BCUHB delivery and external procurement.