Transcript
Dame Carol Black
It seems to me it’s extremely important – I know there are lots of other very, very important things going on – but if you want better health and you want a safer society, you need to pay attention to drugs.
Jennifer Newbould
In 2021, drug-related deaths in the UK were the highest ever recorded. Dame Carol Black’s independent review of drugs found that drugs cost an estimated £19bn to society annually and that long-term cuts in funding have led to a decline in skills, expertise and capacity in the treatment and recovery system.
Dame Carol Black
My review of drugs was commissioned by the then Home Secretary who was Sajid Javid and he asked me to do it in two parts. The first part was to really look at the evidence of where we were with the drug scene and with addiction. Wherever you looked, it didn’t matter which part of the drug agenda you looked at, we were in a bad place.
Jennifer Newbould
In response to the issue, the UK government published their 10-year drug strategy From Harm to Hope. This strategy included an additional £780m in funding over three years for the treatment and recovery system.
Lucy Strang
So over the past two-and-a-half years, RAND Europe and our partners have evaluated the first three years of the drug strategy’s Treatment and Recovery Portfolio implementation in England. We evaluated the Portfolio as a whole, as well as focusing in on five priority areas which are the housing support grant, efforts to improve the treatment and recovery workforce, lived-experience recovery organisations, the integration of mental and physical health services and the provision of depot buprenorphine, which is a long-lasting medication used for opioid substitution therapy in the recovery process. So the workforce within the treatment and recovery sector was obviously a key priority of this additional investment. There was a widespread recognition that, after years of disinvestment, the state of the workforce had been depleted and it was a real challenge to build that up over time, specifically within the planned timelines of the Portfolio.
Jennifer Newbould
Our findings suggest that it’s not necessarily the nature of the work that leads people to leave the sector, but other factors such as salary levels, job security, workload and the availability of resources. All these things are amenable to change and are what ultimately affect people’s desire to continue in the treatment and recovery sector.
Lucy Strang
Another key priority of the Treatment and Recovery Portfolio was to improve mental and physical health service integration. So it’s really critical for people who use treatment and recovery services to also have really well-integrated support from both mental and physical health services. This is because a lot of their needs are also extending to other mental health challenges or physical health needs and we do find that these individuals can often fall through the cracks between these services.
Dame Carol Black
So we’ve now got three more years of money. And if I had to concentrate now it would be on absolutely addressing the quality issue: the quality of the workforce, the quality of what is done in the treatment areas really being more sophisticated and person-centred about delivery.
Lucy Strang
What we found through our evaluations was a few really important steps that the government should take in ensuring that the Treatment and Recovery Portfolio meets its intended aims and continues to provide really good outcomes for people who are using these services and for people who are working in the sector. First of all, we recommended that the government continue to provide more funding security to really ensure that the full 10 years of the Portfolio will be recognised and realised.
Jennifer Newbould
So the funding was well received, but in many areas people felt that it just replaced years of disinvestment. If we don’t invest in people who use drugs and alcohol now, the problem will only get larger in the future.
Lucy Strang
We also really emphasised the importance of continuing to make progress with mental and physical health service integration to ensure that people who are using these services have all their needs addressed in a really collaborative and cohesive way.
Dame Carol Black
We have failed so far to get drug addiction considered a chronic health condition and given the parity of a health condition. We haven’t succeeded to improve the physical complications that drug-dependent people suffer from.
Lucy Strang
We also found that there is more work to be done in ensuring a whole-system approach to dealing with drug issues. So that involves work and collaboration across multiple sectors including health, education, employment, criminal justice and so on.
Dame Carol Black
I would say please empower your local delivery services to be brave, to be less bureaucratic and to deliver a person-centred service. These are individuals with complex problems and they needed not to be treated as a number, a form-filling exercise. They need to be treated as a person with a chronic health condition, given some choice and able to go along a journey which will lead to recovery.
