Recommendations & Conclusions
25 items
2
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
Achieving the long-term aim of reducing drug-related harms will only be possible if departments work collaboratively and adapt their approach to the evolving threats. The government has created new national and local structures to enable a co-ordinated response to implementing the strategy and tackling the harms caused by illegal drugs. …
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Achieving the long-term aim of reducing drug-related harms will only be possible if departments work collaboratively and adapt their approach to the evolving threats. The government has created new national and local structures to enable a co-ordinated response to implementing the strategy and tackling the harms caused by illegal drugs. We welcome these positive steps, and the progress made in recruiting 1,200 new alcohol and drug workers and the 15% increase in the closure of county lines. The JCDU has a key role to play in providing strategic leadership, disseminating good practices and holding departments to account for progress against the strategy’s intended outcomes. But departments have mainly used funding to maintain or expand existing activities and, so far, this has not led to a fundamental shift in the approach to tackling illegal drugs. Dame Carol Black called for ‘whole-system change’ but expert witnesses consider that the strategy has not yet led to a joined-up cross-sector response to help people recover from addiction. The JCDU and departments have not yet established how the existing approach needs to change to achieve long-term aims. They also need to be aware of emerging trends in illegal drugs markets and adapt their approaches to new threats, such as synthetic opioids which are increasingly emerging as a problem in the UK. 1 Q93 6 Reducing the harm from illegal drugs Recommendation 2: The JCDU and departments should assess how the next phase of the strategy can build on progress in the first three years and embed a system- level focus on the difficult issues involved in tackling drug-related harms. In doing so, they will need to address structural barriers (e.g., to recovery and continuity of care), take account of changing threats and set clear accountabilities for delivery.
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Government response AI summary
The government states the JCDU and departments have well-established plans for longer-term delivery and evaluation. Specific actions include the cross-government Synthetic Opioids Taskforce leading the response to synthetic opioids, and DHSC developing an early warning system and a 10-year workforce plan.
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HM Treasury
3
Recommendation
Eleventh Report - Reducing the harm fro…
Accepted
Uncertainty over funding allocations has made it difficult for local authorities to commission and deliver the high-quality treatment and recovery services that are needed. In 2022–23 and 2023–24, DHSC encountered delays in allocating substance misuse treatment funding to local authorities. These delays hindered early progress by making it harder for …
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Uncertainty over funding allocations has made it difficult for local authorities to commission and deliver the high-quality treatment and recovery services that are needed. In 2022–23 and 2023–24, DHSC encountered delays in allocating substance misuse treatment funding to local authorities. These delays hindered early progress by making it harder for local authorities to commission services. We welcome that DHSC has confirmed substance misuse treatment funding for 2024–25 though note that at the time of our evidence session in December it had yet to award its public health grant. As we said in our report on Alcohol Treatment Services, DHSC should set out annual funding allocations to local authorities in good time. Further, as strategy funding is only committed to 2024–25, it is difficult for local authorities to recruit staff and contract with service providers to rebuild the treatment workforce. We are disappointed that departments seem unwilling to explore how to provide local authorities with more confidence over long-term funding. Recommendation 3: To improve certainty around funding for drug treatment services, the DHSC and Home Office should: • ensure allocations of drug-related funding and public health grant are confirmed well before the start of the relevant financial year; and, • consider what comfort they can provide to local authorities to allow them to plan for the longer term and deliver the right investments to make a difference in their areas.
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Government response AI summary
The government states it published supplementary Drug Strategy grants for 2024-25 in November 2023 and Public Health Grant allocations for 2024-25 in February 2024, providing clarity for local planning. Work is also ongoing to develop a strong case for investment beyond March 2025.
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HM Treasury
4
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
There are variations in local outcomes which the JCDU and DHSC have not yet addressed. The capacity and capability of local authorities to deliver drug treatment and recovery services have been significantly eroded in recent years. Between 2014–15 and 2021–22, local authorities saw annual spending on drug and alcohol treatment …
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There are variations in local outcomes which the JCDU and DHSC have not yet addressed. The capacity and capability of local authorities to deliver drug treatment and recovery services have been significantly eroded in recent years. Between 2014–15 and 2021–22, local authorities saw annual spending on drug and alcohol treatment services fall by 40% in real terms, leading to reductions in the availability of treatment services and variations in the quality of local services. As the £0.5 billion of strategy funding to local authorities for treatment and recovery was not sufficient to rebuild services across the whole of England, DHSC adopted a phased approach and prioritised initial funding to local areas experiencing the greatest harms. There are examples of innovative new approaches, but variations in outcomes between local areas remain and some areas are lagging behind. The JCDU and DHSC do not yet fully understand the extent of these differences, inhibiting learning about ‘what works’ and the dissemination of good practice. DHSC says it is considering withholding a proportion of funding if local areas do not meet certain targets, such as treatment and continuity of care. However, it is not clear that the strategy’s performance measures incentivise the right behaviours. We are also concerned about the extent to which treatment and recovery measures focus on quantity over quality and may risk incentivising the wrong things. Reducing the harm from illegal drugs 7 Recommendation 4: The JCDU and DHSC should build a comprehensive understanding of variations in local approaches, disseminating examples of good practice and innovation; providing support to local authorities that need it; and engage with local authorities to understand and address the incentives created by the strategy’s performance metrics.
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Government response AI summary
The government states a Shared Outcomes Fund evaluation is underway, and the JCDU regularly disseminates good practice via guidance and events. DHSC is undertaking targeted work with 19 high-need local areas, including support for London and rolling out an Unmet Need Toolkit.
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HM Treasury
5
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
The JCDU and departments have not put sufficient emphasis on the importance of addressing the specific needs of different cohorts of people who use drugs. It is unacceptable that drug-related deaths in England increased by 80% between 2011 and 2021, to nearly 3,000 people each year. Drug use is highest …
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The JCDU and departments have not put sufficient emphasis on the importance of addressing the specific needs of different cohorts of people who use drugs. It is unacceptable that drug-related deaths in England increased by 80% between 2011 and 2021, to nearly 3,000 people each year. Drug use is highest amongst younger people. In June 2022, 19% of 16–24-year-olds reported having taken drugs, with 5% reporting having taken Class A drugs. Despite this, the 2021 strategy makes little reference to age, gender or ethnicity, nor how people with different characteristics may experience drug misuse and treatment. We were also concerned to hear that reductions in treatment services over the past decade have meant there is insufficient focus on targeting different cohorts of people affected by drugs. For example, the number of young people in treatment for substance misuse fell by 50% between 2010–11 and 2021–22. Further, the JCDU says that it recognises the barriers and challenges faced by women needing drug treatment, but could not provide any specific examples of local treatment services for women. Recommendation 5: The JCDU and departments should ensure that the barriers faced by differing cohorts of people who use drugs (such as women, young people, people from minority ethnic backgrounds) are properly understood and assure themselves that local authorities are sufficiently targeting these groups.
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Government response AI summary
The government states it has commissioned work to understand barriers faced by protected groups and has issued Drug Strategy guidance for local partners on equality of access. Current DHSC work includes enhancing data tools, providing targeted support, workforce development, and implementing a new commissioning quality …
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HM Treasury
6
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
Despite previous attempts to reduce the demand for illegal drugs, the JCDU and departments still do not understand how to change behaviours and prevent people from taking drugs. Reducing the demand for illegal drugs is crucial to mitigating the harms caused by their supply. Effective prevention can also represent better …
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Despite previous attempts to reduce the demand for illegal drugs, the JCDU and departments still do not understand how to change behaviours and prevent people from taking drugs. Reducing the demand for illegal drugs is crucial to mitigating the harms caused by their supply. Effective prevention can also represent better value for money than an enforcement-led approach, as it avoids future economic and social costs. However, drug use has shown no reduction in the last 10 years, with some 3 million people taking drugs each year. The government has attempted to reduce the demand for drugs in previous strategies but, despite this, the JCDU and Home Office still do not have an evidence base from which to develop effective interventions. It is striking that just £300,000—0.03% of strategy funding—has been committed to research drivers of increasing drug use among children and younger people. Preventing vulnerable people from taking drugs requires a holistic, cross- cutting response and long-term interventions must consider wider socio-economic factors. Vulnerability to illegal drug is often linked to trauma and wider social issues such as deprivation and, as we have reported previously, there is a well-established relationship between substance misuse and mental health. Recommendation 6: As a matter of urgency, the JCDU should co-ordinate work to develop an evidence-based plan for achieving the strategy’s aim of reducing demand for illegal drugs to a 30-year low. It should draw research together to provide a compelling evidence base, understand the impact of local initiatives and work with other departments to build on related government strategies (e.g. deprivation, vulnerable families, mental health, homelessness etc). 8 Reducing the harm from illegal drugs 1 Implementing the government drug strategy Introduction
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Government response AI summary
The government agrees and will develop an evidence-based plan by investing in compulsory drug education (RSHE), commissioning primary and secondary research on drug use drivers, supporting vulnerable families through family hubs, and developing a guide for local Combating Drugs Partnerships.
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HM Treasury
1
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Home Office and the Department for Health and Social Care.2 We also took evidence from Dame Carol Black, author of the government’s independent review of drugs; Mike Trace, Chief Executive Officer, Forward Trust; …
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On the basis of a report by the Comptroller and Auditor General, we took evidence from the Home Office and the Department for Health and Social Care.2 We also took evidence from Dame Carol Black, author of the government’s independent review of drugs; Mike Trace, Chief Executive Officer, Forward Trust; Alice Wiseman, Vice President and Addictions Lead, Association of Directors of Public Health and Director of Public Health, Gateshead Council; and Mark Lay, National Drugs Coordinator, National Police Chiefs’ Council.
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Government response AI summary
The government states its key achievements in combating drugs, including increased treatment places, county lines closures, improved prison leaver treatment, expanded drug testing, and increased substance-free units in prisons. It also notes ongoing evaluation and future planning for the next phase of the strategy.
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HM Treasury
7
Recommendation
Eleventh Report - Reducing the harm fro…
Accepted
We raised concerns that government would not be able to make a compelling case for continued funding at the next Spending Review. The JCDU and departments need to demonstrate to HM Treasury the impact of the £900 million of funding during the first three years of the strategy. However, Dame …
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We raised concerns that government would not be able to make a compelling case for continued funding at the next Spending Review. The JCDU and departments need to demonstrate to HM Treasury the impact of the £900 million of funding during the first three years of the strategy. However, Dame Carol highlighted the need to strengthen the approach to evaluation, highlighting the lack of resources in the JCDU.16 The NAO’s report also found that the JCDU lacked adequate evaluation capacity.17 The JCDU told us that the NAO’s recommendations on evaluation were being used to shape the thinking on its approach to evaluation, and that an additional £1 million in funding had been allocated by HM Treasury to assess the impact of local drug partnerships.18
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Government response AI summary
The government accepts the recommendation, stating that ongoing evaluations and commissioned studies are in place to build an evidence base on progress and economic impact, which will inform future investment proposals and strategy adjustments by the end of 2024.
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HM Treasury
8
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
We were also concerned that the JCDU and departments would not be able to develop a sufficient evidence base in the time available. They have begun to collect evidence on ‘what works’ but told us that timing was an issue and there would be limited evidence on the programme. However, …
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We were also concerned that the JCDU and departments would not be able to develop a sufficient evidence base in the time available. They have begun to collect evidence on ‘what works’ but told us that timing was an issue and there would be limited evidence on the programme. However, health interventions are based on clinical best practices and evaluation would provide some early evidence of impacts. The JCDU also said that Project ADDER, which pre-dated the strategy, would be evaluated and there were examples of progress in several local authority areas.19 In written evidence after the session DHSC also highlighted that clinical research for drug treatment and recovery interventions was being 9 Qq 3, 4 10 C&AG’s Report para 1.2 11 Qq 3, 57, 58 12 Q 4 13 Qq 3, 5, 23, 55, 115, 130 14 Q 100 15 Q 63 16 Q 38 17 C&AG’s Report para 16 18 Q 98 19 Qq 99, 100, 115 10 Reducing the harm from illegal drugs carried out at several UK institutions, including the universities of Bristol, St Andrews and Imperial College London. It will also commission further research as part of the new Addiction Mission.20 The need for a collaborative and flexible approach
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Government response AI summary
The government agrees with the implied need for an evidence base, stating that ongoing evaluation of projects and programmes is already in place and the JCDU has commissioned further evaluations to increase understanding and inform future strategy.
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HM Treasury
9
Recommendation
Eleventh Report - Reducing the harm fro…
Not Addressed
The introduction of the From harm to hope strategy has led to positive change. The appointment of a Combating Drugs minister and the nomination of the Home Office permanent secretary as senior responsible owner, alongside the creation of the Joint Combating Drugs Unit (JCDU), has improved coordination across six departments.21 …
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The introduction of the From harm to hope strategy has led to positive change. The appointment of a Combating Drugs minister and the nomination of the Home Office permanent secretary as senior responsible owner, alongside the creation of the Joint Combating Drugs Unit (JCDU), has improved coordination across six departments.21 Further, the creation of 106 new combating drugs partnerships has increased collaboration and accountability at a local level.22 We heard from Dame Carol and Mr Trace that these new structures were welcome and created the right “architecture” to implement the strategy, with stronger linkages between local and national government. The JCDU has done a good job so far, including articulating the strategy’s long-term outcomes, but Dame Carol considered that the JCDU needed strengthening as it was under resourced.23
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Government response AI summary
The government response describes the 'From harm to hope' drug strategy, its allocated funding, and the roles of various departments and the JCDU in its implementation. It does not address the committee's point that the JCDU needed strengthening due to under-resourcing.
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HM Treasury
10
Conclusion
Eleventh Report - Reducing the harm fro…
Acknowledged
There have been signs of progress in some areas.24 For example, local areas have recruited an extra 1,220 drug workers, exceeding the 3-year target already.25 In terms of disrupting the supply of drugs, over 2,000 county lines have been closed (exceeding the initial three-year target) and there have been 4,800 …
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There have been signs of progress in some areas.24 For example, local areas have recruited an extra 1,220 drug workers, exceeding the 3-year target already.25 In terms of disrupting the supply of drugs, over 2,000 county lines have been closed (exceeding the initial three-year target) and there have been 4,800 disruptions of criminal gangs (against a target of 8,800 by 2025).26 We also heard from Mr Lay and Ms Millar that the police are increasingly seeking to divert people to treatment or a drug awareness course, instead of a prosecution for drugs possession.27 The Home Office told us that the police had conducted 50,000 drug tests at the point of arrest.28
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Government response AI summary
The government acknowledged the committee's observation on progress and provided further specific achievements, including increasing treatment places, closing county lines, improving prison leaver treatment, and expanding drug testing on arrest.
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HM Treasury
11
Recommendation
Eleventh Report - Reducing the harm fro…
Accepted
Dame Carol told us that she had challenged government to work together in a more collaborative and integrated way to deliver system-wide change. The whole system needs to join up to support longer-term recovery and enhanced rehabilitation, including mental health support, housing and getting people into work.29 We were concerned …
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Dame Carol told us that she had challenged government to work together in a more collaborative and integrated way to deliver system-wide change. The whole system needs to join up to support longer-term recovery and enhanced rehabilitation, including mental health support, housing and getting people into work.29 We were concerned that there had not been a fundamental shift in approach, with the NAO’s report showing that much of the strategy funding had been used to expand or extend existing projects.30 The JCDU told us that it was starting to see change – such as the creation of 10,000 of the intended 12,000 new drug treatment places in the last six months (an increase on the March 2023 figure of 2,600 in the NAO’s report).31 The Home Office also provided written evidence after the session on what it and other departments are doing to improve the provision of housing and support for prison leavers with drug addiction issues.32 However, the JCDU acknowledged that reforms, including cultural change, are long-term aims and it will take 20 Correspondence from Department for Health and Social Care, 4 January 2024 21 Q 3 22 Q 58 23 Q 6 24 Q 55 25 Q 79 26 Q 102 27 Qq 16, 106 28 Q 113 29 Q 3 30 Q 55; C&AG’s Report para 9 31 Q 55; C&AG’s Report para 2.16 32 Correspondence from Home Office, 15 December 2023 Reducing the harm from illegal drugs 11 time to see the changes envisaged by Dame Carol.33 In addition, local areas have found it harder to recruit more professional workers, such as psychologists and mental health nurses, and retention in the sector is a problem, with turnover of 27% across third sector treatment providers.34
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Government response AI summary
The government accepts the recommendation with an April 2025 target, committing to a whole-system approach to reducing drug-related harm. Specific actions include coordinating the Synthetic Opioids Taskforce, developing an early warning system, improving the treatment workforce, and enhancing links between prison and community treatment services.
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HM Treasury
12
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
Mr Trace told us that changes in drug markets can happen rapidly, and that if synthetic opioids became more prevalent in the UK, the strategy would need to adapt rapidly.35 Mr Lay told us that there had been a synthetic opioid (isonitazenes) outbreak in London in 2021 and that policing …
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Mr Trace told us that changes in drug markets can happen rapidly, and that if synthetic opioids became more prevalent in the UK, the strategy would need to adapt rapidly.35 Mr Lay told us that there had been a synthetic opioid (isonitazenes) outbreak in London in 2021 and that policing was undertaking significant work on this threat.36 The Home Office told us it was alive to the changing risks posed by illegal drugs and work was underway to prepare for this emergent threat. It has increased efforts at the border to prevent the importation of fentanyl or its ingredients and has set up a cross-government task force.37 Impacts of funding uncertainty
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Government response AI summary
The government reiterated its robust action against synthetic opioids, including the existing cross-government Synthetic Opioids Taskforce and the ongoing development of an early warning and drugs harm surveillance system.
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HM Treasury
13
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
DHSC is responsible for allocating the annual Public Health Grant and Supplementary Substance Misuse Treatment and Recovery Grant to local authorities each year. The NAO’s report highlighted that there had been significant delays in confirming allocations of these grants for the first two years of the strategy’s implementation.38 DHSC told …
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DHSC is responsible for allocating the annual Public Health Grant and Supplementary Substance Misuse Treatment and Recovery Grant to local authorities each year. The NAO’s report highlighted that there had been significant delays in confirming allocations of these grants for the first two years of the strategy’s implementation.38 DHSC told us that it had confirmed substance misuse funding for 2024–25, but had yet to announce allocations of the public heath grant.39 Delays in allocating funding create difficulties for local authorities, restricting their ability to work with local service providers and, unless they are prepared to take risks, in commissioning services without financial certainty. Ms Wiseman suggested there was a need for more flexibility, for example allowing local authorities a full 12 months to use funding allocations.40 In our recent report on alcohol treatment services, we also pointed out the impact of funding delays on local authorities’ ability to plan and commission services and on recruitment and retention.41
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Government response AI summary
The government agrees to provide as much notice as feasible for future financial allocations, noting that 2024-25 drug strategy grants were published in November 2023 and Public Health Grant allocations in February 2024 to provide clarity for local authorities.
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HM Treasury
14
Conclusion
Eleventh Report - Reducing the harm fro…
Acknowledged
While the strategy has a 10-year timescale to achieve its intended outcomes, its funding allocations are restricted to government Spending Review periods, typically for two to four years.42 When asked about how they could provide greater assurance to local bodies on longer-term funding, departments told us they were unable to …
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While the strategy has a 10-year timescale to achieve its intended outcomes, its funding allocations are restricted to government Spending Review periods, typically for two to four years.42 When asked about how they could provide greater assurance to local bodies on longer-term funding, departments told us they were unable to do this because “that is not how spending reviews work” and that the existence of a 10-year strategy “was the best reassurance that we can give”.43 Ms Wiseman told us that the lack of longer-term certainty posed risks for local authorities and implementing bodies, especially in their ability to plan for the long-term and recruit the best people. When they are only able to 33 Qq 55, 58 34 Q 4; C&AG’s Report para 2.12 35 Q 23 36 Qq 15,31 37 Q 124 38 C&AG’s Report paras 13, 2.10 39 Qq 33, 88 40 Qq 32–35 41 Committee of Public Accounts, Alcohol treatment services, Fifty-Fourth Report of Session 2022–23, 24 May 2023, para 13 42 Background to the 2020 Spending Review – House of Commons Library (parliament.uk) 43 Qq 87, 93 12 Reducing the harm from illegal drugs offer 12-month contracts, it is difficult to recruit and train staff to work with the most vulnerable people in society, and there is a need to offer contracts beyond 2025 to enable people to develop careers in the sector.44
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Government response AI summary
The government acknowledges the committee's concerns about long-term funding, explaining that spending reviews dictate allocations and that work is ongoing to develop a strong case for investment beyond March 2025.
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HM Treasury
15
Conclusion
Eleventh Report - Reducing the harm fro…
Successful recovery from addiction to illegal drugs, such as opiates, is difficult, with high levels of recidivism.45 In its recent report, the Home Affairs Committee highlighted the efficacy of specialist programmes—such as diamorphine assisted treatment—in helping those with a long history of addiction and poor treatment outcomes.46 We heard from …
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Successful recovery from addiction to illegal drugs, such as opiates, is difficult, with high levels of recidivism.45 In its recent report, the Home Affairs Committee highlighted the efficacy of specialist programmes—such as diamorphine assisted treatment—in helping those with a long history of addiction and poor treatment outcomes.46 We heard from Dame Carol and Ms Wiseman that there was a case for the provision of this specialist treatment service, which would likely reduce opiate-related deaths. However, they told us that as the treatment was some 15 times more expensive than standard treatments, it was not something that could be funded locally and this would need to be provided at a national level.47 44 Q 8 45 An evidence review of the outcomes that can be expected of drug misuse treatment in England (publishing. service.gov.uk) Figure 48 46 Home Affairs Committee, Drugs, Third Report of Session 2022–23, 12 July 2023, para 172 47 Q 11 Reducing the harm from illegal drugs 13 2 Developing a long-term approach Local variations in funding, approaches and outcomes
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HM Treasury
16
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
Drug treatment services declined over the last decade, with a real-terms funding cut of 40% across England between 2014–15 and 2021–22. The position varies widely across local areas, with 42 of 150 unitary authorities seeing falls of 50% or more.48 Dame Carol, Ms Wiseman and Mr Trace summarised the consequences …
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Drug treatment services declined over the last decade, with a real-terms funding cut of 40% across England between 2014–15 and 2021–22. The position varies widely across local areas, with 42 of 150 unitary authorities seeing falls of 50% or more.48 Dame Carol, Ms Wiseman and Mr Trace summarised the consequences of this, describing a broken system staffed by demoralised workers, with most of the protective structures (such as youth groups) that prevented young people from taking up drugs being destroyed or reduced.49 DHSC has allocated £488 million of new funding to local authorities over 2022–23 to 2024–25 but this has not replaced all of the funding that was lost.50 The JCDU told us the strategy was addressing some of the funding cuts and DHSC highlighted that, so far, local authorities were using strategy funding to “fix the foundations” and rebuild the drug treatment workforce.51
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Government response AI summary
The government acknowledged the committee's observations about past funding cuts and outlined ongoing achievements, including increasing treatment places, developing a 10-year workforce strategic plan, and improving links between prison and community treatment services.
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HM Treasury
17
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
DHSC has allocated strategy funding for drug treatment and recovery to local authorities on a phased basis over three years, with the areas suffering greatest harm receiving priority.52 Mr Trace told us there is no national system, with variations in the availability and quality of services, particularly in areas such …
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DHSC has allocated strategy funding for drug treatment and recovery to local authorities on a phased basis over three years, with the areas suffering greatest harm receiving priority.52 Mr Trace told us there is no national system, with variations in the availability and quality of services, particularly in areas such as criminal justice diversion schemes.53 The NAO report showed wide variations across local areas on the number of people in treatment, with 98 out of 150 unitary authorities in England having 48% or more of the people who used opiates and/or crack cocaine not in treatment.54 Evidence from Changing Lives also highlighted concerns that every area was expected to be performing to the same level, despite some having less time to use additional new funding.55
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Government response AI summary
The government agreed with the committee's observation on variations, detailing actions to support local areas including an evaluation of the whole-system approach, dissemination of good practice, targeted work with 19 local authorities to develop improvement plans, and the rollout of an "Unmet Need Toolkit."
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HM Treasury
18
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
DHSC highlighted that local areas will base treatment and recovery services on local needs and demographics. We heard that the strategy was leading to innovation and good practice but the JCDU and departments could not point to specific examples.56 Dame Carol told us progress was patchy, with some local authorities …
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DHSC highlighted that local areas will base treatment and recovery services on local needs and demographics. We heard that the strategy was leading to innovation and good practice but the JCDU and departments could not point to specific examples.56 Dame Carol told us progress was patchy, with some local authorities finding it more difficult to make systemic change.57 DHSC recognised that there is variability across combating drugs partnerships, with 19 of 30 areas it reviewed requiring extra assistance.58 It is considering withholding a proportion of funding allocations for 2024–25 unless these areas develop improvement plans.59
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Government response AI summary
The government agreed with the committee, stating DHSC is undertaking targeted work with the 19 local authorities needing improvement, including agreeing tailored performance improvement plans, disseminating good practice, and conducting an evaluation of the whole-system approach.
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HM Treasury
19
Conclusion
Eleventh Report - Reducing the harm fro…
Acknowledged
We have previously highlighted the importance of effective performance metrics as a means of assessing progress in implementation.60 The JCDU has developed the National Outcomes Framework as a basis for assessing progress towards outcomes of reduced 48 C&AG’s Report, para 9 49 Q 3 50 Q 59; C&AG’s Report, Figure …
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We have previously highlighted the importance of effective performance metrics as a means of assessing progress in implementation.60 The JCDU has developed the National Outcomes Framework as a basis for assessing progress towards outcomes of reduced 48 C&AG’s Report, para 9 49 Q 3 50 Q 59; C&AG’s Report, Figure 8 51 Qq 57, 58 52 Q 57; C&AG’s Report, para 2.10 53 Q 18 54 C&AG’s Report para 1.6 55 Ev RHD0005 56 Qq 73, 101, 115, 136 57 Q 3 58 Q 80 59 Q 101 60 Committee of Public Accounts, Improving outcomes for women in the criminal justice system, Fifty-First Report of Session 2021–22, 28 April 2022, para 6 14 Reducing the harm from illegal drugs drug use, drug-related deaths and crime.61 However, Mr Trace expressed concerns that performance measures created an obsession with the numbers and did not focus on the outcomes being sought.62 After the session, Mr Trace provided supplementary evidence that local authorities are incentivised to offer a minimal level of service to a maximum number of people, rather than measuring the numbers of people they have helped to recover from their addiction.63 He argued that the current framework creates perverse incentives and risks micromanagement at the local level.64 When challenged, DHSC told us that process indicators are necessary for long-term conditions as they help focus on what is needed to improve services, such as the workforce and numbers of people in treatment.65 Mr Trace also stated that measures of enforcement activity were still too focused on process rather than outcomes, and that that law enforcement bodies should prioritise outcomes, such as reducing the availability of drugs and lowering drug-related violence.66 Targeting treatment and recovery services
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Government response AI summary
The government acknowledged concerns about performance metrics by stating ongoing evaluations and tracking of outcomes within the National Combating Drugs Outcomes Framework will increase understanding of progress and inform potential adjustments to their approach.
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HM Treasury
20
Recommendation
Eleventh Report - Reducing the harm fro…
Not Addressed
In the year ending June 2022, 9.2% of 16–59-year-olds in England and Wales reported having taken drugs at least once within the past year, with 2.7% having taken Class A drugs. These proportions are higher for younger adults, with 19% of 16–24-year-olds reporting having taken drugs within the past year, …
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In the year ending June 2022, 9.2% of 16–59-year-olds in England and Wales reported having taken drugs at least once within the past year, with 2.7% having taken Class A drugs. These proportions are higher for younger adults, with 19% of 16–24-year-olds reporting having taken drugs within the past year, and 5% reporting having taken Class A drugs.67 We asked if there were specific targets for reducing drug use for young people. The JCDU told us it had a target to reduce overall drug use to a 30 year low of 8.2% but did not have a specific target for young people, or other cohorts. We emphasised the importance of setting more specific targets, tracking behaviours over a longer timeframe and considering how to influence behaviours.68 The NAO’s report highlights the importance of this as the number of under 18s in treatment fell by 50% between 2010–11 and 2021–22.69
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Government response AI summary
The government's response outlines existing and ongoing work to monitor impacts, address diverse needs, and reduce drug demand through education and research, but does not commit to setting specific drug use reduction targets for young people or other cohorts as recommended.
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HM Treasury
21
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
We were concerned that the government’s drug strategy made little reference to women.70 Written evidence submitted by the Office of the West Midlands Police and Crime Commissioner underlined the limited consideration of women and girls in the strategy, and the lack of reference to wider work on women in the …
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We were concerned that the government’s drug strategy made little reference to women.70 Written evidence submitted by the Office of the West Midlands Police and Crime Commissioner underlined the limited consideration of women and girls in the strategy, and the lack of reference to wider work on women in the criminal justice system.71 This was reinforced by evidence submitted by Dr Fay Dennis of Goldsmiths, University of London, who highlighted that barriers to drug treatment were magnified for those marginalised by gender, sexuality, class and race.72 When asked what was being done to target different cohorts of people taking drugs, the JCDU told us it was aware there are specific barriers faced by women seeking treatment for drugs misuse but could not offer any examples of targeted treatment services. It is up to the combating drugs partnerships to draw up local needs assessments, taking account of the differing demographics in their area.73 61 Q 83 62 Qq 6, 38, 40 63 Supplementary evidence from Mr Mike Trace, Chief Executive Officer of Forward Trust, 13 December 2023 64 Q 40 65 Q 74 66 Supplementary evidence from Mr Mike Trace, Chief Executive Officer of Forward Trust 67 C&AG’s Report, para 1.3 68 Qq 118–121 69 C&AG’s Report, para 1.6 70 Q 136 71 (RHD0007) 72 (RHD0002) 73 Q 136 Reducing the harm from illegal drugs 15 Preventing drug use
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Government response AI summary
The government agreed with the committee's concern regarding women, committing to specific work addressing service access needs for protected groups, supporting local authorities to commission needs-based services, and developing national outcomes framework measures to understand differential impacts.
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HM Treasury
22
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
Around 3 million people in England and Wales take illegal drugs each year, around one in 11 adults. Despite attempts in the 2010 and 2017 drugs strategies to reduce long- term demand, this figure has remained largely unchanged since 2010–11.74 Our recent report on alcohol treatment services highlighted the importance …
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Around 3 million people in England and Wales take illegal drugs each year, around one in 11 adults. Despite attempts in the 2010 and 2017 drugs strategies to reduce long- term demand, this figure has remained largely unchanged since 2010–11.74 Our recent report on alcohol treatment services highlighted the importance of prevention strategies in reducing the impact of substance misuse.75 The JCDU agreed that prevention was crucial to the overall success of the strategy and reduction of drug-related harms. Government witnesses concurred on the significance of investment in prevention and other aspects of the strategy, highlighting the long-term benefits to the economy, health and wider society.76
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Government response AI summary
The government agreed with the committee's observation on the importance of prevention, committing to continued investment in drug education, primary and secondary research on drug use drivers, supporting vulnerable families, and developing a guide for local partnerships on prevention.
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HM Treasury
23
Recommendation
Eleventh Report - Reducing the harm fro…
Accepted
The JCDU and Home Office did not have an evidence base about what works in preventing individuals from taking up drug use.77 The drug strategy has a strong focus on the link between criminal activity and drug use, with initiatives such as drug testing on arrest and out of court …
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The JCDU and Home Office did not have an evidence base about what works in preventing individuals from taking up drug use.77 The drug strategy has a strong focus on the link between criminal activity and drug use, with initiatives such as drug testing on arrest and out of court disposals. Mr Lay also highlighted the work of the Home Office, NPCC and police to divert people into drug education systems.78 The JCDU also set out other work to reduce long-term demand, such as working with DfE on drug education in schools, commissioning the Advisory Council on the Misuse of Drugs to set out recommendations on prevention and setting up a sub-group to develop new proposals.79
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Government response AI summary
The government accepts the recommendation with an April 2025 target, committing to building the evidence base on drug prevention. Actions include ensuring compulsory drug education, conducting primary and secondary research, launching a new cross-government innovation fund, evaluating the RSHE curriculum, and commissioning advice from the …
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HM Treasury
24
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
Dame Carol and Ms Wiseman told us that there was little investment in research into the behaviours and factors that lead to substance misuse.80 The JCDU pointed to the £5 million investment in the ‘innovation fund’ which is looking at building evidence around the key area of reducing demand.81 However, …
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Dame Carol and Ms Wiseman told us that there was little investment in research into the behaviours and factors that lead to substance misuse.80 The JCDU pointed to the £5 million investment in the ‘innovation fund’ which is looking at building evidence around the key area of reducing demand.81 However, departments have committed just £350,000 to research drivers of recreational drug use, which is equivalent to less than 0.03% of the strategy funding over 2022–23 to 2024–25.82
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Government response AI summary
The government agreed with the committee's observation on research investment, stating it will continue to invest in primary and secondary research on drug use drivers, and is delivering a new cross-government innovation fund to build the evidence base and test interventions.
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HM Treasury
25
Conclusion
Eleventh Report - Reducing the harm fro…
Accepted
Ms Wiseman told us that preventing vulnerable people falling victim to substance misuse must include consideration of issues such as deprivation, trauma, poor mental ill health, and adverse childhood experiences. The support networks and services that were once available to help families have been eroded over the past decade. Ms …
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Ms Wiseman told us that preventing vulnerable people falling victim to substance misuse must include consideration of issues such as deprivation, trauma, poor mental ill health, and adverse childhood experiences. The support networks and services that were once available to help families have been eroded over the past decade. Ms Wiseman highlighted the need for primary prevention measures, providing services to vulnerable children and families and to break the intergenerational cycle of substance misuse.83 The JCDU and DHSC agreed that there needed to be a “whole of society” response as the issues went beyond what could be funded by the strategy. Such a response needs to consider wider factors, focusing on prevention and recognising the importance of education, housing and employment to help stop people from using drugs.84 74 Q 115; C&AG’s Report, para 1.3 75 Committee of Public Accounts, Alcohol treatment services, Fifty-Fourth Report of Session 2022–23, 24 May 2023, para 6 76 Qq 100, 115 77 C&AG’s Report, para 10 78 Q 15 79 Q 115 80 Qq 13, 19 81 Q 67 82 Q 69; C&AG’s Report, Figure 9 83 Q 12 84 Q 115 16 Reducing the harm from illegal drugs
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Government response AI summary
The government agreed, committing to continue investing in primary prevention activities such as compulsory drug education in schools, research into drug use drivers, supporting vulnerable families via family hubs, developing prevention guides for local partnerships, and delivering a cross-government innovation fund.
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HM Treasury