Funding cuts for drug and alcohol treatment

In its response to the review, DrugScope, representing service providers, expressed a concern about the current volatility of funding. Drugscope highlighted PHE ADPH drugs alcohol commissioning 2014 the continuous drive to reassess and retender services, and the need for commissioners to understand the impact frequent tendering processes have on providers (see this post for an alternative model).

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Review of Drug and Alcohol Commissioning

Earlier this month (October 2014) Public Health England and the Association of Directors of Public Health published a joint review of drug and alcohol commissioning in England and Wales. This Department of Health funded review was based on a series of interviews with Directors of Public Health (94% of the 152 Upper Tier authorities participated) and Drugscope and looked at current and future commissioning plans for drug and alcohol treatment.

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Investment in services down

A very varied picture of commissioning and funding intentions emerged from the review, although it is clear that the substance misuse treatment sector is no longer immune from the public expenditure cuts. Here’s the key table from the report: commissioning changes As you can see, when we ignore the areas where data were not available or a decision had not been made, 31% areas were expecting a decrease in services for the current financial year – against 11% intending to increase their investment. The picture is bleaker still for 2015/16 with 34% expecting to make cuts and 7% expecting to fund more services (although it should be noted that only half areas were able to comment at the time of the review).

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Other findings

Other key findings from the review included several planned realignments of resources between alcohol and drug services – with an acknowledgement that alcohol treatment remains disproportionately under-funded. In addition to integrating drug and alcohol services, many areas were exploring a broader integration with services such as housing, younger people services, criminal justice, and local health delivery. There was also a general focus on improving outcomes, continuing the move to a recovery model. Interestingly, the review contained not a single mention of payment by results despite the Department of Health recent substance misuse PbR pilots.

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Tinkering

In its response to the review, DrugScope, representing service providers,  expressed a concern about the current volatility of funding. Drugscope highlighted PHE ADPH drugs alcohol commissioning 2014 the continuous drive to reassess and retender services, and the need for commissioners to understand the impact frequent tendering processes have on providers (see this post for an alternative model). A similar set of concerns was also raised by Public Health teams who admitted that one of the biggest challenges they face is ensuring the sustainability of drug and alcohol services. This manifested in a number of issues:

  • Uncertainties over future funding;
  • The potential impact of removing the public health ring-fenced grant;
  • Commissioning efficient and effective services to give better value to taxpayers; and
  • The impact of short commissioning cycles on creating a sustainable service.

I’d be very interested to hear readers’ experiences of local changes to drug and alcohol funding.

  • Is your area cutting or raising investment?
  • How frequent is your local (re-)commissioning cycle?

Please use the comments section below.

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3 Responses

  1. In Oxfordshire there’s a 4-year commissioning cycle. This isn’t too bad. Community services outside of Oxford have become very limited.

    In Gloucestershire there’s a real pressure on clients to say abstinence is their goal when it’s not really practical to even consider that at the start of a treatment journey. There’s also huge pressure to attend recovery-focused groups. The message given out is you won’t get your script if you don’t attend but their service agreement that each client signs doesn’t state that. However I’ve heard this is what Turning Point ( service provider ) do in a number of their locations.

    I believe the emphasis on “recovery” is not helpful to clients. OSP is about keeping clients safe first & foremost. This seems to get forgotten all too readily.

  2. Hi Liz
    Thanks for your comment, 4 years is better than some areas and gives some chance for new services to bed in.
    For me, the work is about keeping clients safe and promoting recovery – not many people do well if they’re on methadone for years. But it’s easier said than done…
    Russell

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