What’s going on?
What is happening to the commissioning landscape and how will it affect us, asks Marcus Roberts
With the new commissioning structures now starting to kick in at local level, what, if anything, do we know about the impact on drug and alcohol services?
Recent figures from the Department of Communities and Local Government (DCLG) suggest that investment in our sector may have risen slightly this year compared to 2012-13. The unappetisingly titled Local authority revenue expenditure and financing: 2013-14 suggests that 37 per cent of the local public health budget is going into drug and alcohol services.
The figures are described, however, as ‘the latest national statistics on budget estimates’ rather than a record of the actual spend. At least one unitary authority is recorded as budgeting nothing on substance misuse, while others record surprisingly large rises. It is also unclear what significance the government attaches to this analysis. It appeared like a bolt from the blue without herald or fanfare (although DCLG is required to ‘share’ the findings with PHE which will ‘review’ them on behalf of the secretary of state for health).
DrugScope has also been dipping into joint health and wellbeing strategies emerging from health and wellbeing boards. We can report that some of them have more to say about drugs and/or alcohol than others. It’s more difficult to know how to interprete this. It is a worry if key strategic documents are muted or silent on substance misuse. But some local areas could be developing their strategies to hone in on areas where they want to innovate or improve (or they could be developing separate strategies for particular types of service). From this perspective, a lack of reference to drug and alcohol services could be more a signal of broad satisfaction with local provision, than a mark of indifference. Again, it’s hard to say.
We can also report that it is messier out there in local authorities than an organogram derived from national policy might lead one to expect – although I guess that is what one should expect from ‘localism’. DrugScope has, for example, been in contact with the London boroughs to find out how their commissioning structures may be morphing post April 2013. Only three said drug and alcohol commissioning was now located in public health.
DrugScope is currently developing an ‘observatory’ as part of work with the Recovery Partnership to monitor what is happening in local areas. Perhaps the main message from our initial forays is that marshalling and analysing current resources can feel a bit like a combination of wrestling jelly and sitting a particularly vexing exam. Still, landmarks and signposts are beginning to emerge from the fog, and, hopefully, a clearer sense of what is happening will take shape in the months ahead. The truth is it may be 2014-15 (or the year after) before all the pieces fall into place and a full picture of the overall impact takes shape.
The DCLG statistics referred to in this column are at http://bit.ly/15uXGDH
Marcus Roberts is director of policy and membership at DrugScope, the national membership organisation for the drugs field, www.drugscope.org.uk