Recommendation 5

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 local authority spending on drugs and alcohol because of a lack of robustness in the reported expenditure data, so these numbers, while the only figures available, will mask actual spending on alcohol treatment services. However, spending will vary according to local priorities in public health and is a decision for the local authority, so some variation is to be expected. More alarming are the local variations in both the proportion of dependent drinkers in treatment and the success rates from those treatments as these variations focus on local responses to alcohol dependency. While nationally, 82% of alcohol dependent people are not in treatment, locally authorities report treatment gaps of between 58% and 93%. It is still early days but we hope that the Department’s arrangements for focusing national efforts for health improvement through the Office for Health Improvement and Disparities (OHID), can give impetus to the uptake of alcohol treatment. Nationally, the proportion of patients successfully completing treatment is around 60%; locally, this ranges from 29% to 90%. We look to OHID to identify the exemplars and to share best practice. Recommendation 5: Working with local and national partners, the Department should: a) identify ways to increase uptake of treatment services in areas where the proportion or alcohol dependent people in treatment is lower; and b) seek to understand why success rates are particularly low or high in some areas and to identify opportunities to share best practice.