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State of the Sector 2017: Beyond the Tipping Point

This report was commissioned as part of the work of the Recovery Partnership, by Department of Health as one of a series of “State of the Sector” reports on the drug and alcohol treatment sector in England. Using qualitative research, it provides a snapshot of the sector during the period of December 2016 to March 2017.
The report finds that reductions in public sector funding channelled to the drug and alcohol sector have been absorbed, principally through efficiency savings and service redesign. As such, there had so far been no serious compromise in service quality or safety standards at the time the research was conducted. However, the report also finds that, while further evolution of service models is needed to encompass multiple needs, the capacity of the sector to respond to further cuts has been seriously eroded. This is especially true on the provider side, but in terms of commissioning capacity also.

The sector has passed the point at which efficiencies and service remodelling can continually compensate for the loss of funding and moved into a period where choices about service configuration have become much harder. Decisions will be required as to what elements of service are retained or withdrawn.

We are presented with a scenario still unfolding at all levels: central government, local governance and the shape of provision, as well as the challenges of ever-changing patterns of drug use. Commissioners and service providers will continue to develop new delivery models to respond to the multiple pressures being faced. However, the on-going, annual reductions in Public Health Grant and the lack of protection by funding mechanisms afforded to local authority budgets for such services are, taken together, of serious concern. These are expected to result in a significant loss of benefits currently delivered for service users and their families and communities.

The report sets out in narrative form many aspects of commissioning and practice which can be used as a starting point for informing policy and for further research.