Recommendations & Conclusions
24 items
2
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
The Department for Health and Social Care, as the lead department, does not have sufficient understanding of total cost of alcohol harm. The harms to individuals and society that alcohol misuse can cause are well-known. Alcohol is linked to over 100 illnesses, can drive mental disorder, self-harm and suicide, and …
Government response. The government agreed and stated the recommendation is implemented, having updated the 2012 alcohol harm cost estimate for inflation to £25 billion in 2021 prices. It has also initiated an additional, longer-term project to fully update the estimate, beginning with …
HM Treasury
3
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
Delays by the Department in finalising the allocation of the Public Health Grant, coupled with short-term funding and reductions to the public health grant, make it difficult for local authorities to plan and commission alcohol treatment services effectively. Since 2015–16, local authorities have seen the grant 6 Alcohol treatment services …
Government response. The government agreed and stated the recommendation is implemented, committing to provide as much notice as feasible for Public Health Grant allocations. It confirmed that indicative allocations for 2024-25 have already been published, and aims to publish the final 2024-25 …
HM Treasury
4
Recommendation
Fifty-Fourth Report - Alcohol treatment…
Accepted
We are concerned that a high proportion of people with alcohol dependency are not in treatment and that there are unnecessary barriers to people in need of treatment. Treatment services for alcohol dependency are commissioned by local authorities. They show success rates of around 60% and they deliver an estimated …
Government response. The government agreed, detailing existing support for local authorities in addressing treatment barriers and announcing plans to develop the first UK-wide clinical guidelines for alcohol treatment, with consultation in Summer 2023 and publication later in the year. It is also …
HM Treasury
5
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
There is concerning local variation in reported spending on, and outcomes from, alcohol treatment. In 2021–22, the amount local authorities reported spending on alcohol treatment varied from £4,000 per 100,000 people to over £1 million, with median spending of £313,000. In her independent review, Dame Carol Black did not disaggregate …
Government response. The government agreed and stated the recommendation is implemented, having released a Local Outcomes Framework dashboard on April 20, 2023, for local authorities to benchmark and analyze treatment outcomes. The department committed to using this data and an unmet need …
HM Treasury
6
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
There has been a marked reduction in the size of treatment workforce, in particular, of addiction psychiatrists. Dame Carol Black’s independent review on drugs highlights that a prolonged shortage of funding has depleted the treatment and recovery workforce and resulted in a loss of skills, expertise, and capacity in the …
Government response. The government agreed, stating it is developing a substance misuse workforce strategic plan with a target publication date of Autumn 2023. It is also developing the first phase of a national drug and alcohol treatment and recovery capability framework and …
HM Treasury
1
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
On the basis of a Report by the Comptroller and Auditor General, we took evidence from the Department of Health & Social Care (the Department) on alcohol treatment services.1 We also took evidence from Alice Wiseman, Director of Public Health, Gateshead Council, and Board Member and Alcohol Policy Lead, Association …
Government response. The government agreed and stated the recommendation is implemented, explaining that it has already published a comprehensive assessment of strategies to tackle alcohol harm through former Public Health England. It continues to monitor the evidence base, including outputs from Public …
HM Treasury
7
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
When we asked if government’s drug strategy adequately dealt with alcohol, Dame Carol told us that she thought it began to deal with it. She hoped that of the circa 50,000 new treatment places that came with her independent review, 20,000 would be for alcohol- dependent people.13 She went on …
Government response. The government highlights its provision of additional funding through the drug strategy, which has enabled local authorities to increase alcohol treatment targets to 92,000 people in 2023-24 and over 100,000 in 2024-25.
HM Treasury
8
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
On discussing the merits of preventative measures, the Department told us that what works and does not work on alcohol was very well researched but that the right approach for some areas was highly contested. By way of example, it referenced alcohol pricing and the introduction of minimum unit pricing …
Government response. The government states it has already published a comprehensive assessment of effective strategies to tackle alcohol harm in England via the former Public Health England and continues to monitor the evidence base, including outputs from Scotland's alcohol strategy.
HM Treasury
9
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
Alcohol harm impacts not only drinkers themselves but also their families and wider communities. It is linked to over 100 illnesses, can drive mental disorder, self-harm, and suicide, and is a major cause of preventable death. The Office for National Statistics reported that alcohol was linked to 42% of all …
Government response. The government agrees and has updated the 2012 estimated cost of alcohol to society to £25 billion in 2021 prices. It has also initiated a longer-term project to fully update this estimate, beginning with a review of evidence on costs …
HM Treasury
10
Recommendation
Fifty-Fourth Report - Alcohol treatment…
Accepted
The NAO’s report shows that drinking patterns have changed considerably since 2012 when the cost of alcohol related harms were last calculated, with young people generally drinking less.21 The Department told us that we had also seen more liver disease over that period.22 We suggested that, 11 years on and …
Government response. The government agrees and has updated the 2012 estimated cost of alcohol to society to £25 billion in 2021 prices. It has also initiated a longer-term project to fully update this estimate, beginning with a review of evidence on costs …
HM Treasury
11
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
The Department is responsible for allocating the annual ring-fenced Public Health Grant (PHG) to local authorities each year. The PHG fell by £630 million (in 2021–22 prices), from £3.96 billion to £3.32 billion, over the period from 2015–16 to 2021–22.23 This has had inevitable consequences on funding for drug and …
Government response. The government agrees with the committee's implied recommendation regarding funding certainty. It committed to giving as much notice as feasible for Public Health Grant allocations, having already published indicative allocations for 2024-25 and aiming to publish final 2024-25 allocations before …
HM Treasury
12
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
We heard from Ms Wiseman that local government welcomes the additional £533 million boost to funding for substance misuse treatment services provided through the 10-year drug strategy, and that it was good to have it ringfenced. However, Ms Wiseman cautioned that it did not take them back up to previous …
Government response. The government agrees to improve certainty and timeliness of funding allocations, committing to giving as much notice as feasible. It has already published indicative Public Health Grant allocations for 2024-25 and aims to publish final 2024-25 allocations before the end …
HM Treasury
13
Recommendation
Fifty-Fourth Report - Alcohol treatment…
Accepted
When we asked the Department why, at 2 March 2023, it had not yet awarded its PHG for 2023–24, the Department acknowledged that it was very late but not unusually so. The Department explained that over the last three years they have allocated it on 7 February, 16 March and …
Government response. The government agrees to improve certainty and timeliness of funding allocations, committing to giving as much notice as feasible. It has already published indicative Public Health Grant allocations for 2024-25 and aims to publish final 2024-25 allocations before the end …
HM Treasury
15
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
When we asked Ms Wiseman what was preventing people from accessing treatment, she explained that there was a big issue with people being able to accept that they have a problem in the first place. We heard that drinking alcohol in our communities is widespread and public awareness of the …
Government response. The government agrees, aiming for Spring 2025, and is developing UK-wide clinical guidelines on alcohol treatment to address barriers, a joint action plan with NHS England for co-occurring mental health and substance misuse conditions, and supports local authorities in identifying …
HM Treasury
16
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
Even once people accept they may have a problem, issues with stigma can prevent them from accessing help. For example, we heard that people often feel a sense of shame at being unable to “drink responsibly”.36 Dame Carol described the particular challenge for people early in their alcohol-dependency journeys in …
Government response. The government agrees, aiming for Spring 2025, and is developing UK-wide clinical guidelines on alcohol treatment to address barriers, a joint action plan with NHS England for co-occurring mental health and substance misuse conditions, and supports local authorities in identifying …
HM Treasury
17
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
Most people entering treatment for alcohol dependency in England self-refer. In 2021– 22, only 23% of referrals were from health services.40 Our expert witnesses thought much more could be done to identify people early and direct them towards treatment. Ms Taylor 30 Qq 11, 65 31 Qq 64, 86 32 …
Government response. The government agrees with the committee's implicit recommendation on early identification and treatment pathways. It is developing UK-wide clinical guidelines on alcohol treatment for consultation in Summer 2023 and final publication later in the year, and a joint action plan …
HM Treasury
18
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
Dame Carol, Sir Ian, Ms Taylor and Ms Wiseman all raised concerns about the relationship between mental ill health and alcohol. Sir Ian told us that an estimated 70% of people entering treatment for alcohol dependency have co-occurring mental health problems.42 The relationship between substance misuse and mental ill health …
Government response. The government agrees to address the relationship between mental ill-health and alcohol dependency. It is developing UK-wide clinical guidelines on alcohol treatment, with public consultation in Summer 2023 and final publication later in the year, and a joint action plan …
HM Treasury
19
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
Sir Ian and Ms Wiseman spoke of the cost effectiveness of in-patient and residential treatment services. We heard examples of how the lack of in-patient and residential services in some areas of the country meant patients were left either bouncing between community treatment services or having to travel long distances. …
Government response. NHS England is funding the development of specialist alcohol care teams in 25% of non-specialist acute hospitals by the end of 2023-24 to reduce alcohol-related ill health in the secondary care inpatient population.
HM Treasury
20
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
In 2021–22, the amount individual local authorities reported spending on alcohol treatment varied from £4,000 per 100,000 people to over £1 million, with median spending of £313,000. Three local authorities reported spending £0 on alcohol treatment services.45 In her independent review Dame Carol did not disaggregate local authority spending on …
Government response. The government agrees and will release a toolkit in Summer 2023 to help local authorities compare treatment numbers, identify pathway needs, and reduce unmet need. It has also released a Local Outcomes Framework dashboard (April 2023) to benchmark and analyse …
HM Treasury
21
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
The NAO’s report showed considerable local variation in both the proportion of dependent drinkers in treatment and the success rates from those treatments. Nationally, an estimated 82% of alcohol dependent adults in England were not in treatment in 2018– 41 Qq 2–3, 7, 26 42 Qq 2, 13, 76; ATS0003 …
Government response. The government agrees and will release a toolkit in Summer 2023 to help local authorities compare treatment numbers, identify pathway needs, and reduce unmet need. It has also released a Local Outcomes Framework dashboard (April 2023) to benchmark and analyse …
HM Treasury
22
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
While noting the variation in performance outlined in the NAO’s report, the Department told us that local authorities broadly did “a great job of commissioning public health services.” The Department told us that it had published a set of guidelines through OHID to give more help to local authorities commissioning …
Government response. The government agrees to provide targeted support to local authorities. It committed to releasing a toolkit in Summer 2023 to help compare treatment numbers and identify referral pathway needs, and released a Local Outcomes Framework dashboard on 20 April 2023 …
HM Treasury
23
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
Dame Carol’s independent review on drugs highlighted that a prolonged shortage of funding and frequent retendering of treatment services had led to a high turnover of staff and depletion of skills. During the session, Dame Carol explained that the number of addiction psychiatrists, psychologists, nurses and social workers in the …
Government response. The government agrees to address workforce issues, committing to develop and publish a substance misuse workforce strategic plan, a national drug and alcohol treatment and recovery capability framework, and a workforce calculator by Autumn 2023. It also continues to support …
HM Treasury
24
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
The Department acknowledged the fall in clinical psychiatrists and mental health practitioners and agreed that services needed access to the full set of professionals.54 The Department noted that it had already committed to securing an additional 800 mental health and clinical professionals in the drug strategy.55 It assured us it …
Government response. The government agrees to address workforce issues, committing to develop and publish a substance misuse workforce strategic plan, a national drug and alcohol treatment and recovery capability framework, and a workforce calculator by Autumn 2023. It also continues to support …
HM Treasury
25
Conclusion
Fifty-Fourth Report - Alcohol treatment…
Accepted
The Department assured us that, as part of its monitoring activity, it would be looking closely at the numbers of people employed. We heard it was keen that the additional funding (£533 million) serve to reintroduce health professionals into treatment services, including clinical psychiatrists and mental health practitioners. The Department …
Government response. The government agrees and is developing a substance misuse workforce strategic plan, a national drug and alcohol treatment and recovery capability framework, and a workforce calculator, all to be published by Autumn 2023, in addition to supporting local authorities with …
HM Treasury