National Audit Office report highlights need to build upon the Drug Strategy and develop a long term, funded plan for full delivery.

National Audit Office report highlights need to build upon the Drug Strategy and develop a long term, funded plan for full delivery.

The National Audit Office (NAO) has published its report Reducing the harm from illegal drugs, looking into the early implementation of the government’s ten year drug strategy From Harm to Hope.

We warmly welcome the report’s conclusion that “the government will only achieve value for money if it builds on the initial momentum of the new strategy and develops a longer-term, funded plan that delivers a joined-up, holistic response”.

NAO reports explore how government has spent money to deliver its policies, and whether that money has been used in the best way to achieve the intended outcome. This report is therefore an important milestone in the run up to a forthcoming Spending Review, during which departments work with the Treasury to agree departmental budgets including for implementation of the strategy beyond 2025.

Key findings and recommendations

The National Audit Office report highlights that there has been a 40% real-terms reduction in spending on adult drug and alcohol treatment between 2014-15 and 2021-22. Alongside this, since 2011, drug related deaths have increased by 80%. It finds that important work has begun to address the challenges set out in the Independent Review of Drugs by Dame Carol Black, but that they have not yet led to the fundamental shift in approach needed to address the complex and structural issues involved.

Collective Voice facilitated a roundtable meeting between the National Audit Office and the Collective Voice Drug and alcohol treatment and recovery providers leadership group to feed into their report. You can read the written submission we submitted based on those discussions here.

As an evaluation of the value-for-money of the 10-year drugs strategy, the NAO state that it is too early to conclude whether the strategy will reduce the harm from illegal drugs, with new funding and interventions taking time to address a complex set of issues. The ‘complex issues’ that the NAO highlight echo the challenges we focused on in our submission, and the report makes a number of welcome recommendations. These include:

Funding

Our submission pointed to the ongoing challenges organisations have faced around funding allocation announcements and the cliff edge facing the sector beyond 2025 which, in some instances, have left providers being asked to prepare for cuts within the next two years.

We therefore welcome the NAO’s recognition of the impact of the delays to the public health grant funding allocations have had on the ability of the treatment and recovery system to plan strategically. The NAO reports that these delays in 2022-2023 allocations caused a 14% underspend, hindering the commissioning of services and the recruitment and retention of staff within services,  and we support its recommendation that the Joint Combatting Drugs Unit (JCDU) and departments work with the treasury to provide greater certainty on future funding including commitments for the life of the strategy.

Workforce

We highlighted the persistent structural challenges facing our sector, arising from historical disinvestment, which limit abilities to recruit and retain staff, invest and innovate for the future, and build sector capacity.

The National Audit Office report recognises the staff shortages in the treatment and recovery sector, in particular reflecting  concerns around medical and psychological workforce gaps, and that it will take time to rebuild the capacity and expertise needed to achieve benefits, such as reducing caseloads, and provide tailored, expert support.

Cross government coordination

We welcomed the creation of the JCDU and local Combatting Drugs Partnerships (CDPs) as giving reason to believe that cross-government co-ordination and accountability will improve, but stated that there remains work to be done.

The National Audit Office findings echo this, stating that the JCDU needs to evolve its role to more efficiently work with central and local government, to better understand impact, evaluate progress, and assess changes needed to achieve the strategy, while also finding that local CDPs are at different levels of maturity.

Multiple and complex need

We highlighted that the sector is facing a significant increase in levels and complexity of need which challenge capacities and ways-of-working and our ongoing work as part of the Making Every Adult Matter Coalition calls for a more joined up approach across services and government departments to multiple and complex needs.

This is recognised by the National Audit Office, stating that people with complex needs come into contact with a range of services, which cut across departmental responsibilities including those connected with mental health, homelessness, employment, accommodation and justice. These services need to provide integrated support to minimise the risks of gaps and overlaps and provide the necessary support to vulnerable people and their families.

Meeting the needs of underserved groups

We highlighted that more needs to be done to understand and respond to the treatment and recovery needs of women and racially minoritised communities.

It is heartening to see the National Audit Office report acknowledging this and highlighting that reductions in funding for treatment services over the past decade have meant there is insufficient focus on targeting different cohorts of people affected by drugs, such as children and young adults, women and people from different ethnic backgrounds. These groups may have differing needs and require tailored support to encourage engagement with treatment services

What next?

The Public Accounts Committee (PAC) takes evidence from senior government officials relating to many of the National Audit Office reports. Following this,  the PAC usually publishes its own report and recommendations, which the government must respond to publicly. The PAC has already announced its inquiry into the Drugs Strategy which is currently receiving written evidence and will hear oral evidence on the 4^th December.

Collective Voice will be submitting evidence to the PAC, supporting the NAO’s analysis that achieving impact will take time and that JCDU, departments and the Treasury should work together to provide greater certainty on future funding commitments over the life of the strategy.