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‘NOW, MORE THAN EVER BEFORE
,
drug and alcohol services need to
make friends and influence people,’
says DrugScope chief executive
Marcus Roberts in his introduction to
the charity’s new
Making the case
resource, a guide to flying the flag for
local treatment services in a radically
altered landscape.
From before
DDN
’s existence until
last year, treatment providers knew
there was a central ring-fenced budget
set aside and overseen by the NTA (see
Paul Hayes profile, page 20), while they
now have to compete for the attentions
of local directors of public health, some
of whom may be sympathetic, onside
and committed, and some of whom
may have other priorities entirely.
‘Localism creates opportunities, but
also, in a period of austerity, a real and
present risk of disinvestment,’ writes
Roberts, while Hayes argues that
localism might be ‘a great theoretical
prospect’ in opposition but is ‘no way
to run a government.’
Treatment providers need to be
seen to be ‘responding flexibly and
creatively’ in this challenging
environment, stresses the DrugScope
document, and it details how to
persuasively argue the case for
services, including using ‘big picture’
data and demonstrating the wider
impact the sector can have. And it’s a
sector that remains in a ‘state of flux’,
as DrugScope’s senior policy officer
Paul Anders wrote recently, when
urging people to contribute to the
charity’s latest
State of the sector
research (
DDN
, September, page 8).
‘While there was little in the 2013
survey to cause particular alarm,’ he
said, there was a strong sense that the
process of change – relating to both
funding and commissioning – ‘had
only just started’.
Alcohol Concern’s updated ‘alcohol
harm map’ (see news story, page 5),
meanwhile, shows that the total
number of alcohol-related NHS
admissions in England – when
inpatient, outpatient and A&E visits are
all included – almost hit the 10m mark
in 2012-13, and while more than half of
alcohol-related hospital admissions
were to A&E, it was inpatient
admissions that were responsible for
nearly two thirds of the total cost
burden. And it’s quite a burden, with
the cost of inpatient admissions ‘partly
attributable’ to alcohol standing at
£1.3bn on top of the £518m chalked
up to those ‘wholly attributable’. Then,
less than a week later, Public Health
England (PHE) launched its liver
disease profiles, setting out how the
male mortality rate for the disease is
now four times higher in some local
authority areas than others.
The strain on the NHS from
alcohol-related ill health is now
‘intolerable’, says Alcohol Concern. So
how come, despite the stark statistics
released in the last couple of weeks,
the overall narrative is supposed to be
that drinking levels are going down? ‘I
think because the number of people
abstaining from drinking has increased
over the last 20 years, so that makes it
look like the overall drinking levels are
falling,’ Alcohol Concern chief
executive Jackie Ballard tells
DDN
.
‘The reasons for people abstaining can
be anything from a choice to do so to
religious reasons – and if you look at
the alcohol harm maps, the London
boroughs with the highest ethnic
minority communities are where you’ll
expect to see a higher percentage of
non-drinkers – but there’s also, in
terms of increasing hospital
admissions, a kind of health catch-up.
The impact on your health of drinking
over guideline limits is not necessarily
immediate for most people. It may be
immediate if you’re binge drinking and
collapse on a Saturday night, but for
most people it’s a cumulative effect.
‘We know the figures are going in
the wrong direction,’ she continues.
‘Liver disease deaths are going up,
and we’re the only European country
where that’s increasing. So we do have
a problem. Whatever the
drinks industry figures
say about the total
amount of alcohol they’re
selling, firstly they’re
selling higher strength
alcohol and so on, and
secondly there’s 9m
people drinking at levels
that pose a risk to their
health.’
So now that treatment
providers have to
compete with the other
priorities of directors of
public health, are people
who need help for an
alcohol problem likely to
be able to get it? ‘We
know that we haven’t
reached even 15 per cent
of people who need
treatment getting it,’ she
states. ‘There’s reasons
for that in terms of
whether the pathways are
clear locally, whether GPs
ask people questions
about their drinking and
refer them to the right
place, whether people
themselves are resistant
to getting treatment – a
number of issues. But at
the back of all that, yes,
there’s been a massive
squeeze on public
spending and treatment is having to
fight its corner with all the other
demands on local budgets.’
One of the arguments for the advent
of Public Health England was that it
would help to level the playing field
between drug and alcohol treatment. Is
that happening so far? ‘Alcohol is one
of the priorities for PHE, and we,
through our consultancy and training
arm, have been doing a lot of work with
local authorities across the country,
working with treatment-resistant
drinkers, on treatment strategies,
interventions and brief advice.
‘We are seeing a lot of interest from
local authorities and I think that the
profile of alcohol is rising – it’s not yet
on a par with drugs, but it is rising up.’
Making the case: a practical guide
to promoting drug and alcohol
treatment and recovery services locally
available at www.drugscope.org.uk
Alcohol harm map at
www.alcoholconcern.org.uk
Liver disease profiles at
fingertips.phe.org.uk/profile/liver-disease
Alcohol Concern’s conference is on
19 November in London. Details at
www.alcoholconcern.org.uk
As
DDN
marks its tenth anniversary we take a look at
some indicators of what the future might hold
News focus |
Analysis
ONE DIRECTION?
6 |
drinkanddrugsnews
| November 2014
www.drinkanddrugsnews.com
‘We know that we
haven’t reached even
15 per cent of people
who need treatment
getting it...’
Jackie Ballard, chief executive,
Alcohol Concern
Emli Bendixen/Third Sector