A recent report of the Government’s £80 million investment into the treatment of drug and alcohol users has highlighted that “non-existent staff and fragmented clinical services” were the dominant barrier to successful implementation of improved practices for some of the most marginalised service users. 

The rough societal costs of drug misuse are calculated to be in the region of £20 billion each year, and yet it is found only £650 million was spent on drug and alcohol treatment between 2020 and 2021  

Succeeding the publication of Dame Carol Black’s wholly Independent Review of Drugs in mainland England, the Government granted £80 million of one-year funding to improve treatments for drug and alcohol misusers, £55 million of which was specifically set aside for supporting local authorities in improving treatment for opiate users and within the criminal justice system in particular. 

Limiting factors  

Reports investigating the impact of this fresh funding, researchers from the University of York found that the one-year funding period sadly severely limited the ability for commissioners and managers to plan ahead and recruit and train new staff to revitalise this area of health and social care.  

The 2012 Health and Social Care Act saw significant and sustained budget cuts and substantially reduced the incentives for partnership work, resulting in considerable staff exits and the damaging loss of shared resources to help support service users with the most complex needs.    

Researchers discovered that the seismic loss of skilled professionals and the increasing fragmentation of services, meant the ability to join the dots between criminal justice, drugs treatment, housing, employment and social care, was wiped and health professionals were therefore unable to develop effective rehabilitation treatment programmes.   

The fixed contracts conundrum  

Persistent struggles to recruit staff with suitable relevant experience within a short time-frame resulted in local authorities counterproductively competing in the same limited recruitment pool, or seconding staff from other local services, leaving staffing huge gaps elsewhere.  

Dr Geoff Page, from the University of York’s Department of Social Policy and Social Work, concerning highlighted: “The last decade has really seen all of the features that make drug treatment an appealing workplace disappear. The latest investment to be spent in a one-year cycle, meant that jobs to tempt people back into this area had to be fixed at one-year contracts, which for many is not an attractive offer.  

“It is an area of work that over the years has been deskilled and deprofessionalised, adding to the problem of how you recruit people that have relevant experience and who can handle complex work and carry the responsibility of the health of some of the most vulnerable people in their community.”  

Some retaining of services 

The report however showed that there were some positive impacts from the Government investment, such as a renewed focus on harm and crime reduction, as well as new beds and facilities for drug detoxification. The most underlying worry, however, for health authorities nationwide was retaining services once the year-investment window had closed. Very few thought they would be able to maintain new services beyond the initial year, without assurances of additional funding.  

The researchers recommended that to counter these concerns more long-term guaranteed funding must be implemented to work towards clearly defined goals that can be measured in a more realistic timeframe.  This should thoroughly help commissioners and managers to plan a long-term upskilling of a workforce, to retain any services built over the initial year and help tempt many more staff into jobs.  

Organisations working in silos, managing their own budgets in isolation, was proven to be a major barrier to success in this area, and therefore researchers suggest that a thorough reconsideration of shared budgets and collaborative working across multi-service teams must be the way forward.  

Defining national skills 

Dr Page elaborated: “One of our core recommendations is establishing national skills standards to professionalise the job, and give the profession a status that will help recruitment and retention of staff, something that is currently completely absent from all calls to support this complex area.” 

The research is funded by the NIHR Policy Research Programme, through the Partnership for Responsive Policy Analysis and Research Programme (PREPARE), a collaboration between the University of York and the King’s Fund for fast-response analysis to inform Department of Health and Social Care’s policy development.   

The research is published on the PREPARE website; to view click here.