FDAP CONFERENCE
homelessness, but we were ending up with services
that dealt with one problem at a time.
‘We have a system that deals with numbers, but
behind every number is a human being,’ he said. The
MEAM project,
Voices from the frontline,
was trying to
build a better dialogue between people making
decisions and those affected.
‘This often requires people to work in a way they
may not have thought about or feel comfortable with,’
he said.
The family workforce could be an important part of
this, said Oliver Standing from Adfam, who challenged
the perception of families being ‘a bit of an add-on’.
‘The family workforce can be hard to pin down –
they could be a service, a standalone community
group, a carers’ centre, volunteers, drug and alcohol
workers or a generic service – there’s no standard
qualification but lots of dedicated people in it,’ he said.
Whatever their background, they needed to be
competent, trained, supported and connected to local
services, including police, bereavement and mental
health services.
‘Like others, we’re being asked to do more for less,’
he said, and ‘very high regional variation’ meant there
was even greater need for drug and alcohol services to
be trained to work with families.
Adfam worked with decision-makers, practitioners
and families and helped the three strands of activity to
feed into each other.
‘There’s no gigantic evidence base on family
support,’ he said. ‘But there’s something so affirming
when families can meet someone in a similar situation
who may be able to help.’
At the heart of effective outcomes were
commissioners, and Fiona Hackland, strategic
commissioner from the London Borough of Newham,
shared her thoughts.
‘Commissioning is not just buying services, it’s a
much more complex task,’ she said. ‘It’s about
identifying what’s needed locally across services and
making sure provision is in place to meet those needs.’
There was no qualification for commissioners,
other than relevant components of DANOS. Local
authority people were not used to commissioning
health-based responsibilities and didn’t necessarily
understand the process.
‘We can get bogged down in numbers and targets,
but we need to focus on the differences we want to
see,’ she said.
Funding was ‘clearly an issue’, with having to find
savings from the public health grant, and the changing
profile of substance misuse was an ongoing challenge.
Reprocurement cycles were going to get worse, with
short contracts causing ‘huge problems among service
users’. Not viewing the commissioner-provider
relationship as a partnership was also ‘not helpful’.
So how could commissioners ensure effectiveness?
‘Be clear about needs, prioritise needs and find the
best way to meet those needs,’ she said. Specifying the
service and outcomes we wanted was important –
‘without over-specifying, as that kills innovation’ – as
well as taking service users’ views into account.
For those worried about the added pressures of
CQC inspection since April, Patti Boden, CQC
inspection manager, had words of encouragement.
‘I don’t go out looking for inadequate services – we
go out looking for good,’ she said. ‘How open are they
with commissioners? We’re trying to make sure
services are well led, with clear vision and values and
performance targets, KPIs and visible leadership.
‘We’re also looking to see that the recovery agenda
is at the top of their list,’ she said, adding ‘this is not a
tick list, but around evidence from service users.’
Among the elements for improvement were risk,
care/recovery plans that were too generic, and the
quality of commissioning and clinical interventions.
‘We tell you where you’re going wrong, but we
don’t tell you how to fix it – that’s up to you,’ she said.
Taking stock of the day’s contributions, Carole
Sharma asked ‘do we need to rethink the skills and
knowledge of the effective practitioner?’
‘We’re facing an aging client population, multiple
and complex needs, reduced generic services and a
simplified view of what alcohol and drug problems are
and how to fix them,’ she said.
It was more complicated than ‘just say no’ and a
spell in rehab, with ‘entrenched problems’. Reduced
budgets for training and development, reduced
learning environments for some licensed practitioners
such as doctors, large caseloads and the demands of
the regulator were constant challenges – although the
demands of the regulator were a step in the right
direction ‘as they stop a lot of arguments about what
is good’. But there were a lack of national drivers for
workforce development and still no national
qualification framework.
‘What are the questions we need to consider?’ she
asked. ‘What’s the best use of trained specialists’ time
and competence? Do we broaden our skills and
knowledge to meet the emerging needs of clients and
patients? Do we use our specialists to support the
generic health and care workforce in relation to
alcohol and other drugs? Has DANOS had its day?’
Appealing to the audience – and the profession as
a whole – she added, ‘Is there a need for FDAP to
change? If you do feel you need a professional
organisation, a safe space to develop the workforce,
you need to get people to join.’
DDN
18 |
drinkanddrugsnews
| July/August 2016
What’s your view? Do you need the support of a professional organisation? Email responses to
to contribute to our letters page, or send your questions for Carole Sharma on any aspect of workforce development.
‘We have to get
much smarter at
tapping into a
new narrative’
Paul Hayes
‘We’re doing more
for less, but we
have a good pool
of workers’
Guy Pink
‘We can get bogged
down in numbers
and targets...
we need to focus’
Fiona Hackland
