The treatment sector’s ability to absorb funding cuts through efficiency savings and service redesign has been ‘exhausted’, according to the latest State of the sector report.
There has already been ‘substantial service redesign and some hard decisions made’ and the system is starting to buckle under the pressure, says the document, which is based on stakeholder interviews and published by Adfam on behalf of the Recovery Partnership. While there had so far been no serious compromise in service quality or safety standards, the capacity of the sector to respond to further cuts ‘has been seriously eroded’ on the provider side and increasingly in terms of commissioning capacity as well, it warns.
‘The sector has passed the point at which efficiencies and service remodelling can continually compensate for the loss of funding, and moved into a period where choices about service configuration have become much harder,’ it states.
A high turnover of commissioners is causing concerns about loss of expertise, and there are ongoing worries about rising caseloads and erosion of service capacity, it warns, with some areas ‘losing valuable one-to-one support’ and many services using volunteers out of necessity. The previous State of the sector document – the third – had already found that almost 60 per cent of residential services and 40 per cent of community services were reporting deceases in funding (DDN, April 2016, page 5). Only central government intervention can now protect the sector from further cuts, the latest report states, as there ‘appears to be high variation locally in priorities and ways of working’.
The report had uncovered ‘worrying signs that potentially serious damage’ has been done to the treatment system, said Adfam chief executive Vivienne Evans. ‘These findings echo those of the Advisory Council on the Misuse of Drugs in their powerful commissioning report released in the autumn’ (DDN, October, page 4). While there were ‘many wonderfully talented and dedicated people’ working in the sector, funding pressures meant they were ‘unable to deliver to the gold-standard we’d all like to see’, she stated, leaving ‘some vulnerable people with substance misuse problems not able to get the help they need’.
State of the sector 2017 – beyond the tipping point at www.adfam.org.uk