A review of alcohol treatment in England has been released, highlighting key issues and themes facing the sector. The report, based on extensive stakeholder consultation, was undertaken by Alcohol Concern on behalf of the Recovery Partnership.
Key themes identified within the report are:
- The enthusiasm of the alcohol field for being involved in a debate about its future;
- The gap in meeting the needs of people with 'dual diagnosis';
- Managing change resistant drinkers with chaotic patterns of behaviour;
- The problems being experienced in the residential rehabilitation sector.
The report's aim is 'to identify key issues in current service provision which should be considered by commissioners, providers and others'. It identified significant change to the alcohol treatment system has been evident in the last three years, with 70% of respondents saying local services had been recommissioned in the period.
Despite this, most felt services were improving and there had been benefits from joining with drug services and pooled treatment budgets. Alcohol was also considered a priority in many areas, with increasing investment in hospital liaison services.
Significant issues were evident though, particularly in response to pressures from changing services and frequent commissioning cycles. The tensions between tendering competition and service user needs should be addressed, as well the various knock-on issues on the ground caused by re-tendering.
Nonetheless a 'relatively positive view' prevailed around service provision, such as around operational aspects of waiting times and interventions offered. Access to residential services though was identified as an issue, particularly owing to limited community care funding.
The challenge of complex needs came out as the 'clearest message', particularly continued failure to properly meet the needs of the 'dually diagnosed' - those with alcohol and mental health issues. A widely held concern was evident that cuts and separation of mental health and substance misuse budgets may have led to a worsening gap between services.
Training and workforce development were also significant issues, including the need for further improvement amongst non-specialists partners, such as Primary Care in particular. This included more IBA and better understanding of problem drinking and pathways. Within the treatment sector, further work to develop and capture professional accreditation was sought after.
Finally, a key theme underpinning this was an expressed need for further national guidance and leadership. Without this, local areas will struggle to to resolve big issues such as dual diagnosis and complex needs.
Where next for the sector?
Historically a far lower priority for investment compared to drugs, alcohol's growing recognition and the pooling of treatment budgets and services may have gone some way to alleviating this. This may have contributed to a slow climb in numbers entering alcohol treatment over recent years, but those seeking to reduce alcohol dependency - and the key related issues - still face many challenges.
Shock news recently came when Drugscope announced its closure earlier this year. Many in the alcohol treatment field may feel that they could not afford the loss of Alcohol Concern's advocacy, who have managed to survive despite withdrawal of Government funding in 2011. The report's findings were also gathered before in-year cuts to public health budgets were announced in June - how the £200 million of savings will impact services is yet to be determined.