The morning’s second session, chaired by Peter Hunter, allowed audience members to put their concerns to some of the sector’s key players
The new drug strategy is one of my key priorities,’ minister for preventing abuse, exploitation and crime, Karen Bradley, told delegates via video, and the government was looking for meaningful input to make sure it was implemented effectively.
‘The government recognises that drug use is a complex, evolving issue,’ she said. While it was ‘dedicated to ensuring that fewer people use drugs in the first place,’ the support was also in place for those who did, she said, with action needed at local, international and individual level. ‘We need more targeted action for the most vulnerable’, as there were strong links between substance misuse and other vulnerabilities.
This meant that effective partnership working was essential, and recovery-orientated systems of care needed to be far broader than ‘just treatment’ alone. ‘I do not underestimate your vital role in peer support and motivating others in their recovery,’ she told the audience.
Delegates then heard from Karen Biggs, chair of the Collective Voice umbrella group of some of the sector’s largest providers. Its aim was to ensure that the sector had a voice, she said, with the group already having input into Professor Dame Carol Black’s benefits review and the new drug strategy.
The sector as a whole had made very good progress in understanding how the service user voice could have an impact, she stated. ‘How do we develop a service user voice that can impact national decision-making? We want to create a model that gives the service user voice an input into policy influencing what goes into the drug strategy, not just how it’s implemented in local services.’
However, there were no illusions about the current situation, she stated. There had been significant funding cuts across the country, and there would be more, ‘And we aren’t naïve enough to think that cuts in the general public sector aren’t going to affect drug services – of course they are. But we’re keen to see that they’re proportionate, and that the harms are minimised and contained.’
It was also essential to make sure that services were responsive, she said, with evidence-based commissioning and delivery to address evolving challenges such as new psychoactive substances. ‘And as the pressure on other services hits, we’re going to see much higher presentation rates of people with complex needs. It’s not hard to see that the risk of stigma will increase as local authorities have to make tough decisions about the services they fund.’
The money for drug services was now the responsibility of local authorities, Rosanna O’Connor of Public Health England (PHE) reminded delegates. ‘They’re responsible for what happens in their own patch. The money transferred to them was a huge pot, but there are also huge pressures on local authorities, so it’s not surprising if that funding begins to shrink. That’s why making your voice heard is vital.’
The recent increase in drug-related deaths was also a ‘massive concern’, she said, and a major PHE work stream had been implemented around it. ‘There’s been something like a 64 per cent increase in heroin-related deaths over the last couple of years, but most of those people had not been in treatment for four or five years. I know some people think that people are being pushed out of treatment to meet recovery targets, but if you look at the figures the increases in deaths aren’t among the people in services – the people who have that safety net.’
One real concern was cuts to other associated services, however, such as wider social support. ‘As that network that’s wider than services themselves begins to fall away – and these are often services that are easy to cut – it’s possible that that is having an impact.’
FDAP chief executive Carole Sharma then explained how her organisation – the professional body for the paid and unpaid drug sector workforce – was trying to improve quality and make sure everyone was working to an ethical framework and code of conduct. ‘As service users, your voice is essential to that,’ she said.
Many delegates expressed concern about custody of children and other parental issues, and O’Connor reassured them that there was an increased focus on substance-using parents across government departments. ‘What this government is particularly interested in is improving the life chances of drug-using parents. I recognise that there is a huge amount of extra pressure on service users who have parental responsibility, and I think the way local services link with safeguarding and children’s services is hugely important. When it comes to that, the voice of service users is much more important than mine.’
There was, however, a difference between being listened to and being heard, some delegates argued. ‘It’s about how meaningful it is,’ said one, while another stated that ‘it’s all about recovery now – if you’re not jumping through those hoops then you’re really in trouble’.
‘In the South West we’ve not had any consultation about cuts or the impact of cuts,’ said a representative from Badsuf (Bournemouth Alcohol and Drug Service User Forum). ‘If ever there was a time for service user consultation, it’s now. Consultation and representation is meaningful only if it’s genuinely listened to and acted upon.’
‘That it’s getting harder to have meaningful consultation and input because of the cuts is absolutely right,’ agreed Karen Biggs. However, Chris Ford argued that the ‘main concern’ of Collective Voice – as a ‘collection of eight of the biggest providers’ – was ‘keeping hold of the part of the sector they’ve got, because the NHS has been pushed out’.
‘I think we collectively have to work at making sure that service users have a voice,’ stressed O’Connor. ‘It isn’t Karen and her colleagues that have pushed the NHS out – that has been a decision of commissioners and policy makers, and it’s at local level that service users need to have a voice. It’s absolutely vital.’
One Coventry-based delegate stated that his organisation had ‘moved past service user involvement now – we’re about recovery visibility. We’re part of the community, and we sit down with commissioners to shape services. The point is that we don’t need anyone’s permission. We just get up and make it happen.’
Just a ‘tiny amount of the money that’s being wasted on everything else’ could have a huge impact if it ‘went to the right place’, he told the panel. ‘It would change all your statistics.’
On the question of the growing problem of gambling addiction, O’Connor told the conference that it was ‘absolutely shocking how it’s mushroomed in front of us, with advertising on every TV and billboard. But although it’s a massive problem, the last thing we want to do at the moment is take any more money out of drug and alcohol treatment. So it’s been pushed back to the industry to fund that treatment.’
‘I came to a DDN conference and thought, “I could do that”,’ Red Rose Recovery CEO Peter Yarwood told the conference’s closing session. ‘So I took that inspiration back to Lancashire and found people who believed in me.’
Trying to get his life back together after 20 years dominated by drugs and prison, he became ‘massively demotivated’ after attempts to find work were thwarted by his criminal record. ‘Society will stigmatise you, but I took that stumbling block and made it into a building block,’ he told delegates.
Lancashire User Forum was now a limited company, he said, and in the last year alone its volunteers had contributed more than 15,000 hours of valuable work in the county. ‘That’s social, economic value that we’re returning to the community. We focus our energies on what’s positive, not what’s wrong – I’m bigger than my treatment.’ The organisation now had almost 30 employees, he said, ‘and we’ve got a philanthropist who’s investing not just money but providing technology as well.’
‘You’re more than people tell you,’ said his colleague Steve Watson. ‘It’s about hope, not thinking, “I can’t do it”.’
‘Red Rose Recovery saw something in me,’ added another colleague, Mark. ‘I was fresh out of treatment but they but they believed in me. If I’d stayed in the box I was told I had to, I would have gone crazy. Treatment is essential, but it won’t keep you clean. It’s about purpose, worth, belonging. Believe in each other.’