State of the Sector 2013
Key findings and recommendations
• 35% of respondents reported decreased funding, compared to 20% reporting an increase. Around a third to a quarter of services reporting increased or decreased funding had experienced this change as a result of gaining or losing services through retendering and recommissioning. This is not evidence of widespread disinvestment, but key stakeholders including Public Health England should remain alert to this risk.
• Almost half of participating services reported a decrease in front line staff and six out of ten reported an increase in the use of volunteers. Increased opportunities for volunteering, including as a means to support volunteers closer to paid work is a positive, but the sector must retain the expertise and professionalism it has worked hard to acquire.
• Engagement with two crucial new structures – Health and Wellbeing Boards and Police and Crime Commissioners is mixed. Where it is happening, it appears to be meaningful and constructive, but it is patchy. Nationally, under half of the respondents to the online questionnaire indicated any kind of
engagement with their Police and Crime Commissioner, whilst slightly more reported engagement with their local Health and Wellbeing Board.
• If the responses to the survey are representative, a particular effort may be needed in London to improve links between the Mayor’s Office for Policing and Crime, London Boroughs and drug and alcohol services.
• There are encouraging signs that Police and Crime Commissioners appreciate the role their position can potentially play in partnership with public health and the advantages of joint commissioning. However, it appears that this interest has not yet been universally reciprocated by Health and Wellbeing Boards. It seems likely that there will be mutual advantage to working closely.
• There is limited confidence in the way and extent to which drugs and alcohol are included in Joint Strategic Needs Assessments, and less still about their inclusion in Police and Crime Plans. Overall awareness of the latter is particularly low.
• In addition to questions about the extent of inclusion of drugs and alcohol, there are some concerns that Joint Strategic Needs Assessments tend to focus on population-level harms rather than services for relatively small but entrenched groups. There are parallel concerns that Police and Crime Plans are more concerned with the night-time economy and antisocial behaviour.
• While many respondents indicated that they were forming new partnerships within and beyond the sector, longstanding areas of concern continue to be problematic, particularly:
- housing and housing support,
- support for clients with complex needs or multiple exclusions
- employment and employment support
• Many respondents and interviewees acknowledged the need for more partnerships, more holistic services and the use of the ‘whole system’ approach advocated in the 2010 Drug Strategy. In the form of localism and mechanisms such as Community Budgets, there is some scope to achieve this ambition, but balancing reduced budgets and competing needs will ask much of local leaders, commissioners and services.
• The positive message of recovery and reintegration has been warmly welcomed by the majority of respondents. However, services, commissioners and policy makers may need to give consideration to how services are designed and commissioned, and the sorts of messages that are delivered when it is difficult to envisage all clients being able to immediately join in the ‘recovery agenda’
• The findings of the survey broadly reflect official statistics that indicate that crack and heroin use is at the lowest point since the current monitoring system was introduced and falling. However, a majority of respondents were concerned by other developments, including novel psychoactive substances and problem alcohol use. Designing and commissioning of transition-age services may be an important step to addressing these emerging themes.
• The negative impact of recommissioning and retendering was raised by many participants and all interviewees. Above all, the disruption caused, cost associated with and potential impact on staff morale were seen as harming services, with little evidence that frequent recommissioning serves any positive purpose where services are performing well.