Conclusion 4

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.