Source · Select Committees · Public Accounts Committee
Recommendation 4
4
Accepted
Address barriers to alcohol treatment access and improve integrated care for co-occurring conditions
Recommendation
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 £3 benefit immediately for every £1 invested, and potentially far more in the longer- term. Treatment is also accessible as 98% of peopled referred to alcohol treatment services start treatment within 3 weeks. Yet 82% of dependent drinkers in England are not in treatment. The earlier people get into treatment the better, but too many people are falling through the gaps. Only 23% of people who are referred to treatment for alcohol come from health services. We heard that one of the biggest challenges is that people may not accept they have a problem in the first place as heavy drinking is normalised and public awareness of the associated harms is low. It is not only the drinkers themselves — we also heard that the healthcare workers assessing them often fail to spot early signs of problem drinking. Where people do recognise it, stigma around dependency and a reluctance to receive treatment alongside drug users can prevent them from accessing services. Given the well- established relationship between substance misuse and mental ill health, we were concerned to hear that some people are denied access to mental health services because of their alcohol dependency (and vice versa). Approximately 70% of people entering treatment for alcohol dependency also experience problems with their mental health. Alcohol treatment services 7 Recommendation 4: The Department should set out: • how it is working with local authorities to address the barriers to people with alcohol dependency from getting the treatment they need; and • what it is doing to help improve integrated care for people with co-occurring alcohol and mental health problems and to ensure that they receive
Government Response Summary
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 developing a joint action plan with NHS England to improve integrated care for co-occurring alcohol and mental health problems.
Government Response
Accepted
HM Government
Accepted
The government agrees with the Committee’s recommendation. of the additional drug strategy investment. The department is providing a range of support to all local authorities for identifying and addressing barriers to engagement with treatment, including interpretation of local data, advice on specific treatment pathways, troubleshooting and sharing of best practice. Further targeted support is also provided to high priority areas for service improvement. The department, in partnership with the devolved administrations, is developing the first UK-wide clinical guidelines on alcohol treatment, which include guidance for commissioners and services on addressing barriers to treatment. The guidelines will go out for public consultation in Summer 2023 and final guidelines will be published later in the year. The department and NHS England are developing a joint action plan to address co- occurring mental health and drug/alcohol-related conditions. This programme of work will improve access to mental health services for people with drug and alcohol misuse conditions, as well as improve the links between mental health and substance misuse services. The department already published the Commissioning Quality Standard for drug and alcohol treatment services in August 2022. This includes requirements for local authorities to engage with other local services, such as mental health providers, to provide coordinated packages of care that support recovery, including for people with co-occurring mental health conditions.