State of the Sector Report 2013

10 February 2014
Blenheim welcomes the State of the Sector Report 2013 prepared by Drugscope on behalf of the recovery partnership and believes that such a report is needed on an annual basis in the current climate of public sector upheaval and funding cuts.

England has the best drug treatment system in the world. It exists because of the investment of far sighted statesmen from all political parties, and the dedication of amazing people, organisations and public officials over the last 50 years.

The drugs war may (and should) be over, but we need to continue to help people fight dependency. The resources for this are under serious threat, as are the services that support some of the most vulnerable in society. Blenheim believes that the State of the Sector Report needs to become annual, and that it is important to keep this under close scrutiny.

Blenheim notes that the report indicates that in relation to disinvestment;

“35% of respondents reported decreased funding, compared to 20% reporting an increase. Around a third to a quarter of services reporting increased or decreased funding had experienced this change as a result of gaining or losing services through retendering and re-commissioning. This is not evidence of widespread disinvestment, but key stakeholders including Public Health England should remain alert to this risk.”

Blenheim notes that there is no evidence in the report of widespread disinvestment 2013/14 as in the early stages of 2013/14 Local Authorities got to grips with their new responsibilities. However, Blenheim is aware of active discussions happening in a large number of Local Authorities about significant cuts in public health budgets for 2014/15 and specifically cuts to drugs and alcohol service budgets. We believe there remains a significant and current threat of significant disinvestment in services for vulnerable people in poor health and facing multiple and complex problems. Such disinvestment will effect the poorest and most vulnerable in society.

Blenheim notes the report states that;

“Almost half of participating services reported a decrease in front line staff and six out of ten reported an increase in the use of volunteers. Increased opportunities for volunteering, including as a means to support volunteers closer to paid work is a positive, but the sector must retain the expertise and professionalism it has worked hard to acquire.”

As organisations struggle to manage increased caseloads, declining budgets and decreases in front line staffing, the increased use of volunteers becomes inevitable. Like many organisations, Blenheim is seeking to engage members of the community to volunteer to improve the lives of our beneficiaries. They make an amazing contribution to what Blenheim and other organisations can provide. However, we are seriously concerned about the failure in some parts of the sector to ensure adequate training, competency assessment, and supervision for managers, staff and volunteers. We echo the call for the sector to “retain the expertise and professionalism it has worked so hard to acquire.”

Blenheim notes from the report that;

“There is limited confidence in the way and extent to which drugs and alcohol are included in Joint Strategic Needs Assessments, and less still about their inclusion in Police and Crime Plans. Overall awareness of the latter is particularly low.”

This is a serious issue in a time of competing priorities and reductions in funding, within both public health and crime agendas drugs and alcohol struggle to make the top four key issues; this may act as a driver for disinvestment. Drugs and Alcohol dependency are what the Cabinet Office once described as “wicked problems” that have a major impact on a wide range of Government agencies and agenda’s but are the priority in none. It was because of this that overarching drug strategies have been in place for the last 20 years, the NTA was established and monies were ring fenced for spending on drugs services. Blenheim believe that a ring fence on money for drugs and alcohol services should be implemented in a way that will impact on local areas spending priorities and act as an incentive to continue to invest and improve drugs and alcohol services as was the case until April 2013.

Blenheim notes that;

“In addition to questions about the extent of inclusion of drugs and alcohol, there are some concerns that Joint Strategic Needs Assessments tend to focus on population-level harms rather than services for relatively small but entrenched groups. There are parallel concerns that Police and Crime Plans are more concerned with the night-time economy and antisocial behaviour.”

The moving of drugs and alcohol service provision into Public Health changes the focus away from the needs of vulnerable heavily addicted people with often multiple economic, social and health problems onto the needs of the wider population. The not insignificant needs of this far larger population will mean fewer resources overtime to support those heavily dependant on drugs and alcohol with multiple and complex needs.

Whilst the focus on the needs of the wider population is important Blenheim believe that this should not be at the expense of health services for those with the recognised medical conditions of Alcohol Use Disorder or Drug Use Disorder and the provision of support to tackle the often complex needs that surround these conditions.

Blenheim notes that;

“While many respondents indicated that they were forming new partnerships within and beyond the sector, longstanding areas of concern continue to be problematic, particularly:
– Housing and housing support,
– Support for clients with complex needs or multiple exclusions
– employment and employment support”

Blenheim welcomes the ongoing concern expressed in the report in relation to housing, complex needs and employment. At Blenheim we are concerned about the lack of access to the employment market for people with a history of drug and alcohol misuse, particularly where this is associated with criminal convictions. Changes to welfare benefits will impact detrimentally on housing stability and the level of homelessness experienced by our beneficiaries. The decommissioning of many NHS providers of drug and alcohol misuse services is resulting in a decline in many areas in access to specialist mental health service provision.

Blenheim notes the comment below and shares the serious concerns;

“The negative impact of re-commissioning and retendering was raised by many participants and all
interviewees. Above all, the disruption caused, cost associated with and potential impact on staff morale were seen as harming services with little evidence that frequent re-commissioning serves any positive purpose where services are performing well.”

At Blenheim we are aware that these concerns are shared by many politicians, and senior officials in the Department of Health, Cabinet Office and Public Health England. A significant number of commissioners have also raised their serious concerns over the commissioning environment and the increasing lack of resources within commissioning teams to tender services effectively.

Blenheim is seriously concerned that the provision of services to people with significant and multiple needs is being disrupted by frequent re-commissioning and system redesign. It has a detrimental impact on the ability of organisations to take care of people accessing services. It has had a significant negative effect on staff morale and the ability of charities to invest their own resources into the provision of services. Often promised efficiency savings don’t materialise and Payment by Results schemes are not implemented. Blenheim continues to work with Drugscope and organisations across the sector to draft a consensus statement from providers and charities working with those people experiencing drug and alcohol problems expressing our serious shared concerns.

Click here to read the full report

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