Commissioners call for joined-up approach to opioid use disorder decision-making

Expert Faculty on Commissioning confirms speakers for ‘EXCO’, the first joint congress on excellence in commissioning for opioid use disorder.

Excellence in Commissioning for Opioid Use Disorders

The Expert Faculty on Commissioning will hold the first integrated meeting for commissioners and other experts focused on opioid use disorder (OUD) care. The event on 22 June 2018 is entitled ‘Excellence in Commissioning for Opioid Use Disorder’ and includes 75 experts from across England who will debate the future of addiction care for people with serious drug problems.

Senior experts including Rosanna O’Connor (director of alcohol, drugs and tobacco, Public Health England), Prof Rod Thomson (director of public health, Shropshire) and Mark Moody (chief executive, Change, Grow, Live) will lead the discussions in the meeting with commissioners responsible for designing and overseeing drug treatment services.

Terry Pearson, responsible for commissioning drug and alcohol services for Northamptonshire Country Council and joint lead for the Expert Faculty, commented: ‘There is significant innovation in the treatment of opioid use disorder – commissioners must act to ensure that we make the most appropriate use of new treatments and technologies avoiding unnecessary delays.’


Expert Faculty on Commissioning (EXCO)

2018 Congress, 22 June, Manchester


Plenary sessions

Rosanna O’Connor, director of alcohol, drugs and tobacco, Public Health England; Rod Thomson, director of public health, Shropshire Council; Mark Moody, chief executive, Change, Grow, Live; Stewart Atkinson, Office of Police and Crime Commissioner for Humberside; Terry Pearson, commissioning manager, Northamptonshire County Council; Jayne Randall, drug and alcohol strategic commissioner, Shropshire Council; Mark Gilman, Discovering Health, former PHE recovery lead; Anthony Bullock, senior commissioning manager, Staffordshire County Council; Paul Musgrave, senior manager, public health, Cumbria County Council; Annemarie Ward, CEO of FAVOR; Kerrie Hudson, operational lead, The Well Communities  

Workshop sessions

Collaboration and innovation: building a modern approach to commissioning OUD Service. Tony Mercer, health improvement manager (alcohol and other drugs), Public Health England; Will Haydock, senior health programme advisor, Public Health Dorset; Chris Lee, public health specialist: behaviour change, Lancashire County Council; Mark Webster, head of development in ACT Peer Recovery; Dave Vaughan, service manager, Recovery Works Ltd; Paula Harriott, Prison Reform Trust

Decision-making, evidence and outcomes: planning for key choices in commissioned services using data. Rosie Winyard, public health commissioning lead, Worcestershire County Council; Karen Cassidy, public health specialist, Blackburn; Clive Hallam, substance misuse commissioning manager at Wandsworth and Richmond Borough Councils; Annette Dale-Perera, chair of the recovery committee, Advisory Council on the Misuse of Drugs (ACMD); John Bucknall, commissioner, Halton Borough Council, Helen Phillips-Jackson, strategic commissioning manager – substance misuse, Sheffield City Council, Mark Knight, substance misuse lead, Greater Manchester Combined Authority.

All interested in the future of innovation in OUD care and the evolving role of commissioning are strongly recommended to join this event. Registration is free for those working in the field.

Please find more information and register at:



Jayne Randall (drugs and alcohol strategic commissioner, Shropshire)

The ‘new’ Drug Strategy 2017 defines the goals and scope of OUD care in England and identifies the future challenge: ‘Progress has been made in supporting people to recover from their dependence on drugs, but we need to go further.’ The 2017 ‘Orange Book’ or Drug misuse and dependence UK guidelines, Public Health England (PHE) and the Advisory Council on the Misuse of Drugs (ACMD) inform the debate on best practice in OUD care.

It is noted that ‘despite successes with falling numbers of young people currently developing heroin dependence, the morbidity, mortality and long-term needs of an ageing cohort of patients with long-term heroin dependence problems means that treatment is increasingly complex…’

The environment is not static – there is important change in progress and commission­ers of drug treatment services must ensure the decisions they make reflect the new options innova­tion can deliver. For example, depot forms of medication, which do not have the inherent risks of oral treatments, may be approved in England. Commissioners in each of the local authority public health departments can now work together in the expert faculty for the first time. This collabor­ation will be key in the future; I encourage all commissioners and others involved in decision-making for drug treat­ment services to participate in the expert faculty.


Development in the last 20 years led to a treatment system for OUD that achieved important successes, saving many lives and avoiding public health crises.

Mark Gilman (expert faculty participant, former PHE recovery lead)

Some now observe the approach to treatment today has remained unchanged for many years and there is a need for innovation to address some of the problems experienced by those using the treatment system

Problems with treatment reported include that many people are not in care, and some in treatment face worsening health and find it hard to get optimal care. Others may still be using on top or be involved in diversion of medications. Treatment is still associated with problems including the risk of domestic exposure and harm to others.

Important questions are in focus:

Why do so many people not use treatment services at all? Do the individuals in care get a service that is flexible and targeted to their needs? Do we do everything to minimise risks?

Considering the approach we have today, is the burden of treatment too great? Does the regimen of daily treatment and obligations around collection of medications make treatment too much of a burden for some?

At the highest level, what is the treatment system for? Does the legacy system we work within deliver the results for the people we aim to service today?  With innovation on the way – including new digital tools for online help, new medications with weekly or monthly dosing and better use of integrated data systems to join up care – does the structure of the treatment system make it possible to achieve the best possible results for the 300,000 people with very important needs?

There is now an opportunity to review all the assumptions we make about OUD care and ask, with open eyes, ‘What does good care really look like?’, address the gaps in the current treatment system and decide how to improve outcomes for people with OUD.

The expert faculty works to challenge assumptions and, with the responsibilities of its members, ensure that commissioning is a key lever in the ongoing evolution of treatment services. It is time to act.


About EXCo

The Expert Faculty on Commissioning is an independent group of experts, formed in 2016, that aims to support commissioners by sharing experience and insights on best practice, with the overall goal of improving outcomes for people with OUD.

The Expert Faculty is independent and participants do not receive payment. Specific programmes are funded individually.

The faculty works on a project basis with resources from all types of organisations and businesses. Organisations providing resources do not influence the thinking nor work of the faculty. Camurus AB, a company developing new medications for OUD, has provided funds for the logistics of the faculty annual congress.

More information at: