It has not proved possible to respond to the hon. Member in the time available before Dissolution.

Needle exchange and syringe services have played a vital role in harm reduction since the 1980s, reducing the number of drug-related deaths and blood-borne virus infections, particularly hepatitis C and HIV. They are commissioned by local authorities and are supported in this by Public Health England. The United Kingdom’s drug treatment clinical guidelines published in 2017 includes guidance on needle and syringe programmes and is available at the following link:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/673978/clinical_guidelines_2017.pdf

The information requested falls under the remit of the UK Statistics Authority. I have therefore asked the Authority to respond.

As part of the NHS Long Term Plan, we are establishing specialist Alcohol Care Teams (ACTs) in hospitals with the highest rates of alcohol harm. It is estimated that this will prevent 50,000 admissions over five years.

All clinical commissioning groups (CCGs) have been allocated a Health Inequalities Funding Supplement contribution to their indicative baselines. NHS England and NHS Improvement, through the Long Term Plan, have highlighted the evidence base for ACTs and indicated that where required, commissioners should utilise monies from this funding supplement to close health inequality gaps associated with alcohol dependence.

Additionally, for those areas with the highest levels of demand, additional targeted monies will be invested directly to ensure the provision of optimal ACTs starting from 2020/21.

Local authorities will also receive over £3 billion in 2019/20 to be used exclusively on public health including alcohol treatment services.

As part of the NHS Long Term Plan, we are establishing specialist Alcohol Care Teams (ACTs) in hospitals with the highest rates of alcohol harm. It is estimated that this will prevent 50,000 admissions over five years.

All clinical commissioning groups (CCGs) have been allocated a Health Inequalities Funding Supplement contribution to their indicative baselines. NHS England and NHS Improvement, through the Long Term Plan, have highlighted the evidence base for ACTs and indicated that where required, commissioners should utilise monies from this funding supplement to close health inequality gaps associated with alcohol dependence.

Additionally, for those areas with the highest levels of demand, additional targeted monies will be invested directly to ensure the provision of optimal ACTs starting from 2020/21.

Local authorities will also receive over £3 billion in 2019/20 to be used exclusively on public health including alcohol treatment services.

United Kingdom medical schools determine the content of their own curricula. The delivery of these undergraduate curricula have to meet the standards set by the General Medical Council (GMC), who then monitor and check to make sure that these standards are maintained. The standards require the curriculum to be formed in a way that allows all medical students to meet the GMC’s ‘Outcomes for Graduates’ by the time they complete their medical degree, which describe knowledge, skills and behaviour they have to show as newly registered doctors.

The GMC’s ‘Outcomes for Graduates’ state that doctors must be able to recognise and identify factors that suggest patient vulnerability and take action in response. In particular, they must be able to recognise where addiction (including to alcohol) is contributing to ill health and take action by seeking advice from colleagues and making appropriate referrals. Furthermore, the GMC’s Generic Professional Capabilities Framework states that doctors in training must be able to do the same and act on this information.

The Government is taking a range of action to reduce the demand for illegal drugs, including Class A drugs.

As set out in the 2017 Drug Strategy, our prevention approach combines uni-versal action for all young people with targeted action for groups at particular risk, including young people with a range of vulnerabilities, offenders and homeless people.

Our universal approach focuses on supporting evidence-based programmes which have a positive impact on young people, giving them the confidence and resilience to resist drug misuse. This includes investing in the Alcohol and Drugs Education and Prevention Information Service which provides practical advice and tools to schools and educators, and developing the 'Rise Above' digital hub. The Government is also introducing compulsory health education in all schools from September 2020, which will include a focus on the risks associated with drug misuse.

Alongside this, on 8 February the Home Secretary announced the appoint-ment of Professor Dame Carol Black to lead a major independent review of drugs, which will look at a wide range of issues including the drivers behind recent trends in Class A drug misuse.

No discussions have taken place between the Secretary of State for Health and Social Care and the Chancellor of the Exchequer on this issue.

Commissioners and providers of services have a joint responsibility to work collaboratively to meet the needs of people with co-occurring conditions. Public Health England (PHE) has therefore developed guidance to support commissioning and provision of joined up services for people with a dual diagnosis of mental health and substance misuse problems. The guidance sets out principles for how services should work, including that each person should have access to a care co-ordinator to help ensure all their needs are addressed. The guidance is available at the following link:

https://www.gov.uk/government/publications/people-with-co-occurring-conditions-commission-and-provide-services

PHE continues to support the ‘no wrong door’ approach when people present to services with co-occurring conditions. Commissioning guidance encourages services to respond collaboratively, effectively and flexibly offering compassionate and non-judgemental care centred around the persons needs which is accessible from every access point.

Every death in custody is a tragedy and we work hard to learn any lessons from each one. The Government publishes statistics on deaths in custody quarterly, and updated detailed tables annually. They can be viewed at https://www.gov.uk/government/statistics/safety-in-custody-quarterly-update-to-september-2017.

The ‘Guide to Safety in Custody Statistics’, published alongside the data, explains that although we monitor drug-related deaths, we do not use this category in published statistics because they are difficult to measure accurately. Deaths known to be drug-related but not believed to be self-inflicted overdoses are included within the “other / non-natural” category. However, this category also includes accidental deaths and the small proportion of deaths in which, even after all investigations have been concluded, the cause remains unknown.

Data about methods used in self-inflicted deaths in prisons is collected, and the number of self-inflicted deaths from overdoses remains low. The number of deaths in the “other / non-natural” category is also low, but we continue to monitor closely the increasing number of deaths in the “awaiting further information” category, because there is at least a suggestion that drugs may have been involved in the vast majority of these cases.

We know that the availability of psychoactive substances is a driver of instability in prisons, so we have implemented a number of measures to address it. They include a new drug testing programme, detection technology and sniffer dogs; and a drugs task force focused on the prisons with the worst drug problems, to tackle demand and supply.

The number of drug-related deaths in prisons remains low. However, every death in custody is a tragedy and we work hard to learn the lessons from each one.

The Government believes that prisons should be places of safety and reform. The number of self-inflicted deaths is extremely concerning and we are committed to reducing it. Our recent White Paper set out specific steps that we are taking to improve safety. They include investing over £100m to recruit an additional 2,500 staff across the estate by the end of 2018. We have taken immediate action to stabilise the estate by tackling the drugs, drones and phones that undermine security.

We have also provided an additional £10m of new annual funding for prison safety, supplemented by £2.9m from existing budgets. This has given a significant number of governors the opportunity to improve safety levels in their establishments. The government publishes statistics on deaths in custody quarterly on gov.uk.

Table 1 shows the cost of with cause breathalyser testing of National Offender Management Service staff in (a) 2010-11, (b) 2011-12 and (c) 2012-13.

Table 2 shows the number of individual with cause breathalyser tests of National Offender Management Service staff that took place in (a) 2010-11, (b) 2011-12 and (c) 2012-13.

The National Offender Management Service does not record information centrally to indicate whether any member of staff has refused a breathalyser test and therefore the supplier was not called upon. There is no evidence that any members of staff' refused to undergo breathalyser testing after the collection officer had been called out.

The National Offender Management Service does not record information centrally of staff that have been required to leave their place of work because (a) the breath alcohol level of the member of staff has breached the alcohol standard or (b) a member of staff has refused to participate in a breath test and concern remains about whether or not they are fit for duty as set out in the NOMS staff alcohol policy. However, Table 3 shows the number of positive breathalyser test in each of the last three financial years. Staff who provide a positive breathalyser test will be subject locally to the NOMS staff alcohol policy and the NOMS conduct and discipline policy.

Although the National Offender Management Service holds high level information centrally on staff who have been subject to disciplinary procedures, it is not possible

to extract detailed information for disciplinary action taken as a result of a positive breathalyser test or where a member of staff has refused a test.

Table 1 shows the cost of with cause breathalyser testing of National Offender Management Service staff in (a) 2010-11, (b) 2011-12 and (c) 2012-13.

Table 2 shows the number of individual with cause breathalyser tests of National Offender Management Service staff that took place in (a) 2010-11, (b) 2011-12 and (c) 2012-13.

The National Offender Management Service does not record information centrally to indicate whether any member of staff has refused a breathalyser test and therefore the supplier was not called upon. There is no evidence that any members of staff' refused to undergo breathalyser testing after the collection officer had been called out.

The National Offender Management Service does not record information centrally of staff that have been required to leave their place of work because (a) the breath alcohol level of the member of staff has breached the alcohol standard or (b) a member of staff has refused to participate in a breath test and concern remains about whether or not they are fit for duty as set out in the NOMS staff alcohol policy. However, Table 3 shows the number of positive breathalyser test in each of the last three financial years. Staff who provide a positive breathalyser test will be subject locally to the NOMS staff alcohol policy and the NOMS conduct and discipline policy.

Although the National Offender Management Service holds high level information centrally on staff who have been subject to disciplinary procedures, it is not possible

to extract detailed information for disciplinary action taken as a result of a positive breathalyser test or where a member of staff has refused a test.

Table 1 shows the cost of with cause breathalyser testing of National Offender Management Service staff in (a) 2010-11, (b) 2011-12 and (c) 2012-13.

Table 2 shows the number of individual with cause breathalyser tests of National Offender Management Service staff that took place in (a) 2010-11, (b) 2011-12 and (c) 2012-13.

The National Offender Management Service does not record information centrally to indicate whether any member of staff has refused a breathalyser test and therefore the supplier was not called upon. There is no evidence that any members of staff' refused to undergo breathalyser testing after the collection officer had been called out.

The National Offender Management Service does not record information centrally of staff that have been required to leave their place of work because (a) the breath alcohol level of the member of staff has breached the alcohol standard or (b) a member of staff has refused to participate in a breath test and concern remains about whether or not they are fit for duty as set out in the NOMS staff alcohol policy. However, Table 3 shows the number of positive breathalyser test in each of the last three financial years. Staff who provide a positive breathalyser test will be subject locally to the NOMS staff alcohol policy and the NOMS conduct and discipline policy.

Although the National Offender Management Service holds high level information centrally on staff who have been subject to disciplinary procedures, it is not possible

to extract detailed information for disciplinary action taken as a result of a positive breathalyser test or where a member of staff has refused a test.

Table 1 shows the cost of with cause breathalyser testing of National Offender Management Service staff in (a) 2010-11, (b) 2011-12 and (c) 2012-13.

Table 2 shows the number of individual with cause breathalyser tests of National Offender Management Service staff that took place in (a) 2010-11, (b) 2011-12 and (c) 2012-13.

The National Offender Management Service does not record information centrally to indicate whether any member of staff has refused a breathalyser test and therefore the supplier was not called upon. There is no evidence that any members of staff' refused to undergo breathalyser testing after the collection officer had been called out.

The National Offender Management Service does not record information centrally of staff that have been required to leave their place of work because (a) the breath alcohol level of the member of staff has breached the alcohol standard or (b) a member of staff has refused to participate in a breath test and concern remains about whether or not they are fit for duty as set out in the NOMS staff alcohol policy. However, Table 3 shows the number of positive breathalyser test in each of the last three financial years. Staff who provide a positive breathalyser test will be subject locally to the NOMS staff alcohol policy and the NOMS conduct and discipline policy.

Although the National Offender Management Service holds high level information centrally on staff who have been subject to disciplinary procedures, it is not possible

to extract detailed information for disciplinary action taken as a result of a positive breathalyser test or where a member of staff has refused a test.

Table 1 shows the cost of with cause breathalyser testing of National Offender Management Service staff in (a) 2010-11, (b) 2011-12 and (c) 2012-13.

Table 2 shows the number of individual with cause breathalyser tests of National Offender Management Service staff that took place in (a) 2010-11, (b) 2011-12 and (c) 2012-13.

The National Offender Management Service does not record information centrally to indicate whether any member of staff has refused a breathalyser test and therefore the supplier was not called upon. There is no evidence that any members of staff' refused to undergo breathalyser testing after the collection officer had been called out.

The National Offender Management Service does not record information centrally of staff that have been required to leave their place of work because (a) the breath alcohol level of the member of staff has breached the alcohol standard or (b) a member of staff has refused to participate in a breath test and concern remains about whether or not they are fit for duty as set out in the NOMS staff alcohol policy. However, Table 3 shows the number of positive breathalyser test in each of the last three financial years. Staff who provide a positive breathalyser test will be subject locally to the NOMS staff alcohol policy and the NOMS conduct and discipline policy.

Although the National Offender Management Service holds high level information centrally on staff who have been subject to disciplinary procedures, it is not possible

to extract detailed information for disciplinary action taken as a result of a positive breathalyser test or where a member of staff has refused a test.

[holding answer 3 July 2012]: Addaction's report and project will help improve the knowledge about interventions that work for families affected by substance misuse. The DCLG who lead on the Government's Troubled Families Programme will consider the report's recommendations and findings, particularly around the benefits of their family based interventions. Officials from the DCLG Troubled Families Unit recently visited the Brent project to meet staff and service users in the Breaking the Cycle project.