Collective Voice responds to Spending Review consultation

As part of its preparations for the Spending Review and the Budget (to be announced on 11 June), the Government has been holding a consultation for organisations and individuals to express views on how it should prioritise and distribute funding.

Collective Voice – like other interested organisations, including CGL – has submitted to this consultation.

You can download our full response here, but I thought it would be helpful to summarise a few key points here.

I want to emphasise that this is a specific response to the Treasury, so we focus on issues relating to spending and savings to the public finances. This isn’t necessarily a comprehensive picture of all our policy ‘asks’, and it’s not written in the way we’d explain things for other audiences or in other contexts.

Our basic starting point is that problematic use of alcohol and other drugs places considerable pressure on public services and society, notably in relation to health, crime, employment and social care.

But the good news is that substance use treatment works to reduce harm and help people turn their lives around, delivering a good return on investment for public services and communities.

What we need to do this – and what we’ve had for the past few years – is investment of time and money from central government, meaning that there are the resources to do good work, and there’s leadership from the centre to make sure that action is taken.

We highlight how these benefits relate to a number of the Government’s Missions, and the costs and benefits cut across departmental and organisational boundaries. This is why the arrangements set up under the previous Government to have local and national structures bringing together departments and organisations are essential.

Harm related to alcohol or other drugs might not be ‘top of the list’ for many departments – there are many other significant challenges in health and social care, for example – but when we look at the difference effective action can make to a whole range of areas, it’s clearly worth focusing in.

Ringfenced funding and shared accountability (both nationally and locally) have been essential to deliver an effective and efficient response to problems related to alcohol and other drugs.

This approach is clearly working, because we’ve delivered positive results on key metrics set out by Government. More people are in treatment than at any point since 2009-10, and we’ve got vastly improved rates of ‘continuity of care’ between prison and community.

However, this can only be seen as the first step in rebuilding and improving support for people who use substances.

On the broader strategic points, we still think there is more to do in the following areas:

• Leadership: ensure there is genuine buy-in from all relevant departments and delivery partners
• Stability: effectively convey a long-term commitment and stability to this work
• Oversight: appropriate and proportionate processes for accountability and outcomes measurement
• Innovation: support innovation and research, notably through commissioning standards and the Addiction Healthcare Goals
• Workforce: provide focus and ambition that goes beyond the current workforce plan

We then go on to outline specific recommendations in relation to certain issues. In no particular order:

• Introduce a specific alcohol strategy, with dedicated funding, clear priorities, outcome metrics and cross-departmental governance
• Simplify the licensing process for local provision of drug checking and provide national leadership to drive the establishment and maintenance of a network of accessible labs for analysis
• Ensure the legal framework and funding structures permit a range of models of enhanced harm reduction centres to be piloted across the UK
• Commission substance use treatment in prison directly as a dedicated service, with new investment and a clear strategic focus on this issue from all relevant departments and agencies
• Establish a specific programme to improve the treatment offer for currently under-served groups
• Develop and implement a commissioning model that ensures the availability of – and equitable access to – evidence-based residential treatment
• Create a direct, funded pathway from prison to residential substance use treatment
• Set clear expectations for family support services, provide investment to deliver this support, and actively review compliance
• Support a programme to enable electronic prescribing for controlled drugs through community-based prescribing
• Conduct a full review of the data collected and processes required by the National Drug Treatment Monitoring System to ensure they reflect current challenges, practice and priorities
• Improve integration of datasets relevant to substance use at both the individual and aggregate level, accompanied by clear and public communication
• Produce clear guidance, agreed across all relevant departments, to help local delivery partners in supporting young people who use substances

All of these should, of course, entail genuine co-production with the people who our services aim to support, whether or not they’re currently engaged in treatment.

I’d encourage you to read the full submission – or at least the sections on the topics that interest you most – so you can understand why we’re recommending these particular areas for action.

A key plank of the Collective Voice strategy, as well as ensuring that the ‘sector’ has a ‘voice’ to speak to Government, is to bring organisations and individuals together across the field. For several of these recommendations, while our work will probably be easier with direct Government leadership, there is a lot we can do collectively without that ‘rubber stamp’ from a Government department.

I look forward to continuing to work with people right across the field to drive real change and improvement in services. If you’re interested in any of these themes – or you think we’re missing a key part of the picture – then please get in touch, and maybe get involved in our forums, which bring together people working on key issues right across the field.