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March 2013 |
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Opening session
available – and rapid response.
There were threats, however, he pointed out. The move from the NTA to PHE, the
disappearance of PCTs and commissioning’s shift to local authorities meant there
was a potential for fragmentation and the creation of postcode lotteries. There was
also a reluctance to change on the part of some practitioners and organisations, and
a lack of universally applied standards.
GPs in some areas had also been told that they could not do shared care, he said
– ‘a real issue for us moving forward’ – and there were also concerns around tenders.
‘If you have a contract you are less likely to get it when it comes up for tender than
if you are applying from elsewhere.’ Other growing challenges included the plethora
of newer drugs, the increasing population of elderly users and the misuse of
prescription and over-the-counter drugs.
Stigma would also need to be properly addressed, he stated. ‘It’s just normal
people living their lives, and they need to be supported.’ Peer support was vital in this
– ‘we need groups making those links’ – as was social capital. ‘I can’t write a
prescription for a job or a house or meaningful training.’ Links with the right agencies
were crucial here, he told the conference, and needed to be ‘really embedded’ in
primary care.
‘There’s a lot of change happening, and you need to talk to GPs, commissioners
and everyone involved in commissioning these services,’ he urged delegates. ‘And
you need to do it now.’
*****
Service users had played a ‘very significant’ part in improving treatment, shaping
services and ‘challenging us at the centre to do more and do better,’ the NTA’s
director of delivery Rosanna O’Connor told the conference. ‘And long may that last.’
The last decade had seen drug use declining, fewer people injecting and more
drug users recovering, she said. ‘Treatment systems and services are much better, in
that people are not dropping out as they used to, and the prospects for people
coming into treatment today are much better than they were a decade ago.’
Treatment also stopped around 5m crimes a year and saved £2.50 for every pound
spent. ‘Those are powerful messages to people in local authorities,’ she stated.
‘Drug treatment is in reasonably good shape, alcohol treatment is catching up,
and drug and alcohol treatment and recovery are priorities for Public Health
England. The political interest is still there, and that holds the money in.’
However the systemwas about to shift from a central funding body to 151 local
authorities, all of which would have differing priorities, she said, although local
commissioning would also bring new opportunities. ‘Hopefully there’ll be
opportunities to join things up better – around families, housing, training – but
disinvestment is still a risk.’
Nonetheless those local authorities would still be required to report on how
much they spent on alcohol treatment, drug treatment for adults and drug
treatment for younger people, she explained. Recovery ambition would need to be
maintained and championed, and it was crucial to make the best of what the new
arrangements offered.
‘Your voice, and the voices of carers and families, the people who care about
you, have been, and will continue to be, vital in shaping and improving local
services,’ she said. ‘There’s been no substitute for the power that comes with
people like me being able to say, “Well, service users would challenge you on that”.
People in commissioning and in provider land will claim things that won’t stand up
to scrutiny, and you have a vital role in challenging that. Maintain your voice locally
– it’s really important.’
*****
Alliance CEO Ken Stringer stated that his organisation was ‘snowed under to the
point of dysfunction’, however, as a result of people being ‘forced off scripts’ and
out of treatment. ‘That’s not to say there’s not a lot of good practice out there –
there is. But there’s some very bad practice as well.’
‘Tell us where it’s happening and we’ll do something about it,’ O’Connor replied.
‘It shouldn’t be happening – it’s not policy.’
It was vital to forge new alliances to make the case for continuing investment,
she said. ‘The bit of the NTA that I’m responsible for – the parts that do the
guidance and documents, and the local teams – will still be there in Public Health
England, so keep in touch. We need you. There’s no success without you.’
DDN
‘Many times in the workplace I’ve
been overlooked for promotion
because I’m open about my history,
and you can see the attitudes of
A&E staff change instantly...’
LEE COLLINGHAM
‘Drug treatment is in reasonably
good shape, alcohol treatment is
catching up, and drug and alcohol
treatment and recovery are priorities
for Public Health England.’
ROSANNA O’CONNOR