Drug and alcohol treatment funding for 2024/25

Collective Voice are pleased that the funding for drug and alcohol treatment for 2024/25 has been announced and is not subject to the delays we have seen in previous years. The announcement at this time should mean that local authorities and service providers have sufficient time for planning and commissioning services. 

The Black Review called for investment to improve outcomes in the drug and alcohol treatment and recovery system and the government’s funding between 2022-25 has rightly met that call. However we are concerned that a number of areas that have struggled to show improved outcomes over the last two years  have been informed  that an element of conditionality has been placed on a proportion of the funding.

Voluntary sector drug and alcohol services are fully committed to working with commissioners and the wider system to improve quality, capacity and outcomes but as highlighted by the National Audit Office it will take time for the renewed investment to mature and begin paying these dividends. 

The introduction of these measures penalises some areas for their performance based on this limited data and without sufficient acknowledgement of the extremely challenging and complex context in which services are operating. 

The Drug Strategy is being implemented and providers are working to improve services against the backdrop of the legacy of Covid-19 and subsequent increases in the cost of living which have had a significant impact on drug and alcohol treatment and recovery services and the people they serve. Alongside this, the drug related deaths crisis continues, exacerbated by the emergence of more dangerous synthetic drugs which have contaminated the drug supply.

Rather than act as an incentive for improved outcomes this move risks generating perverse and poorer outcomes and further entrenching health inequalities:

• Removing investment from the system at a time when we are facing a further increase in drug related deaths has significant risk attached to it – especially as the areas affected include a number with high levels of deprivation that are at greater risk of greater drug related deaths.

• Areas will be reticent to spend money in light of the risk of some of the funding being clawed back.

• Attaching payment to numbers in treatment may lead to service users being moved into treatment too soon or not moved on from treatment when appropriate, undermining the evidence based delivery of treatment.

• It risks further eroding the range and diversity of providers in the system, which has already been significantly damaged by previous disinvestment. The voluntary sector makes up a significant proportion of drug and alcohol charities but due to competitive tendering and a historic reduction of resources smaller, local and specialist organisations who have a vital role to play have struggled. These measures will exacerbate this as conditionality when passed on through contracts is in effect the introduction of payment by results (PbR) which presents particular problems for the voluntary sector and can exclude charities from the market, especially smaller organisations, due to the level of financial risk involved.

We do not believe these measures are in keeping with a public health approach to tackling the use of drugs. To achieve the ambition of the ten year drug strategy and to ensure that people who want to change the way that they use drugs can get the treatment and support that they need, the system requires sustained long term funding and commitment that is not conditional on limited short term performance metrics.

Collective Voice is writing to ministers to express our concerns and to offer to facilitate further discussion between government and voluntary sector providers on how the findings of the National Audit Office report can be addressed to ensure that current and future investment in the system has the maximum possible impact.