One year on , an alliance of 13 NHS trusts is gaining momentum in addressing the failings of the sector and developing more effective pathways to care , as Danny Hames explains
‘ The impact of the abstinence vs harm reduction debates of the last few years , leading directly and indirectly to some some individuals being pushed through treatment systems too quickly , has been oversimplified and dangerous .‘
partnerships
One year on , an alliance of 13 NHS trusts is gaining momentum in addressing the failings of the sector and developing more effective pathways to care , as Danny Hames explains
A morAl imperAtive
The NHS Substance Misuse Providers Alliance ( NHSSMPA ) has been in existence for just over a year . NHSSMPA is a collaboration of 13 NHS trusts , all of which provide substance misuse services in the community and prisons . While NHS provision has changed in the last few years and just over a quarter all community substance misuse treatment systems are NHS , we continue to provide inpatient detoxification facilities nationwide and work in numerous prisons . Celebrating 70 years of the NHS , and in this time working with those affected by drugs and alcohol , means it is in our DNA .
Our aims are to work more closely as NHS providers , and with our colleagues in the third sector , to improve
Age-specific mortality rates for deaths relating to drug misuse , deaths registered 1993 to 2016 . England and Wales
outcomes for service users through sharing and de vel - op ing practice and to offer policy makers engage ment with the NHS substance misuse community .
What unites NHSSMPA is a belief that people deserve high quality services which can improve their lives . For us , this means a competent and qualified workforce where volunteers complement but are not relied upon ; interventions that are evidence based and individualised ; that we are effective partners and contributors to a local health and social care economy ; and that we protect the safety of our service users while walking alongside them to provide the best chance of recovery .
The impact of the abstinence vs harm reduction debates of the last few years , leading directly and indirectly to some some individuals being pushed through treatment systems too quickly , has been oversimplified and dangerous . Thankfully , NHSSMPA believes the new drug strategy and the presentations accompanying this have underlined a change in tone . For us as NHS providers , harm reduction has always and continues to be a priority .
There is ( quite rightly ) a very prominent debate regarding the reduction in funding for substance misuse services , and of course NHSSMPA strongly believes that services should be adequately
funded . However , we should not let this mask the fact that recently doubt has been cast upon the governance and quality of the sector .
The emphasis on ensuring we are competent and thoughtful guardians of funding , and that this properly benefits service users , has never been more important . Local authorities are experiencing significant challenges to their budgets and there are numerous patient groups deserving of funding . So there is a strong moral imperative to use the monies we receive effectively , most importantly because :
1 . We are seeing the highest levels of drug-related deaths since records began . In 2016 this numbered 2,593 deaths associated with drug misuse .
2 . Recovery rates are dropping for opiate users . In 2011 -12 treatment completion was 8.59 per cent ; year to end November 2017 it was 6.7 per cent ( NDTMS ). This is all despite a narrative underpinning many procurement exercises that service redesign will mean improved performance .
3 . The CQC ’ s recent review of non NHS residential was shocking – 63 per cent of services were assessed as not meeting the regulation on ‘ safe care and treatment ’ ( CQC ).
4 . The unfortunate demise of Lifeline , a charity with an income of £ 53m , demonstrated poor organisational governance and left more than 5,300 potential creditors , including other charities .
‘ The impact of the abstinence vs harm reduction debates of the last few years , leading directly and indirectly to some some individuals being pushed through treatment systems too quickly , has been oversimplified and dangerous .‘
NHSSMPA is highly committed to advocating for appropriate funding , but we must not ignore that there have been very significant indications that the sector needs to improve its governance and outcomes for patients . NHSSMPA organisations have a public service and moral duty to achieve this . Over the coming years NHS providers will make our contribution and commit our expertise , because justifying the effectiveness and quality of what we offer has never been more necessary .
Danny Hames is chair of the NHS Substance Misuse Providers Alliance
If you are a NHS trust and would like to find out more about NHSSMPA please contact candie . lincoln @ sssft . nhs . uk
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