Public Health England (PHE) have announced 23 local authorities will be sharing a £6 million capital fund to invest in improving services and facilities for people with alcohol problems. Whilst some welcomed the news, others also pointed out ongoing cuts to national public health budgets and declines in overall alcohol treatment figures.
PHE say the current capital funding bids seek to improve access to alcohol treatment and to help meet the needs of parents or people experiencing rough sleeping with alcohol problems. For example, Oxfordshire will develop a dedicated alcohol centre within the ‘Oxford Homeless Hub’ as well as a clinical space in the Salvation Army Homelessness Hub.
Bids from Portsmouth, Derby, Nottingham and South Gloucestershire will provide additional beds for those sleeping rough in need of alcohol treatment to help improve successful recovery outcomes. Last year over 2,000 adults in treatment for alcohol had urgent housing problems, and 43% of those sleeping rough in London during 2017 to 2018 were found to have alcohol misuse problems according to PHE.
Other successful bids will result in new equipment and facilities, including seven projects which will purchase FibroScan machines to allow for rapid identification of those with existing liver disease. Elsewhere bids are reported to have a wider focus on improving the availability and removing the stigma around alcohol treatment services to increase the number of people engaging in alcohol treatment.
Birmingham will establish new accessible alcohol support services and Stoke-on-Trent will introduce new points of access, such as breakfast clubs, community venues and hospitals with the aim of 1000 people getting into treatment by 2021. In Croydon, the funding will be used to build an alcohol assessment facility at a new Family Centre to target vulnerable families. In Wolverhampton the existing alcohol services building will be redeveloped into a multiple-agency families hub that can act as a ‘home from home’ for vulnerable families. In Newcastle, a family centre will be re-developed and co-located with a Barnardo’s family support team to improve integrated care.
Further details of the local projects and spending overviews are detailed within the PHE release and in local reports such as from Portsmouth, Nottingham and Stoke.
Local pots versus national cuts?
Whilst awards of circa £250k will be welcomed in successful areas, many will be mindful of the many other areas going without and up against ongoing public health cuts. Some estimates suggest treatment budgets cuts total 26% for adult and 41% for youth services, whilst the Health Foundation has estimated an additional £3.2 billion per year would be needed to reverse the overall impact of public health cuts. Last year Alcohol Change UK called for a 1% increase in alcohol duties to raise £100 million each year for alcohol treatment which could save the NHS and other public services around £300 million annually.
Last year PHE also announced nine projects that were awarded a share of £4.5 million as part of the innovation fund to support local authorities seeking to address the needs of children of dependent drinkers. The nine areas were chosen for 'demonstrating a new and creative approach to reach and support families whose lives have been affected by alcohol', suggesting a broadening of the focus beyond just children of dependent parents. The £4.5 million of funding was made available following campaigning by a number of high profile MPs who had spoken openly about their experiences as 'children of alcoholics', launching a manifesto for action in 2017. It also included £500,000 to expand helplines for children as previously pledged.
As for the overall decline in the numbers of people accessing alcohol treatment, the last PHE release included an analysis seeking to explain the downward trend, including a 6% fall on the previous year and down 17% from the peak of 91,651 in 2013/14. PHE's inquiry identified 'financial pressures and service reconfiguration' as its main finding, suggesting substance services in the majority of areas had been reconfigured from having separate drug and alcohol services into single integrated systems. A range of further challenges were identified, including in some areas a loss of focus on alcohol clients, deteroriation in pathways and referral options and a loss of alcohol treatment expertise among staff.
Most areas therefore are likely to have been seeking to mitigate ongoing financial pressures via any such opportunities for some time, whether service redesign or funding for pots of money. Commitments such as the NHS Long Term Plan's pledge for Alcohol Care Teams, or the national CQUIN for brief intervention, may offer some further assurance, though national calls for further prioritisation of alcohol treatment and an end to public health cuts will no doubt continue. A new national alcohol strategy was expected this year.
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